Job description

Job responsibilities

Main Responsibilities

• Work with GP Surgeries to identify potential referrals to the Tier 2 Frailty Service
• Working with Frailty Team colleagues, use risk stratification tools to identify patients at risk and ensure they receive assessment and care in a timely fashion
• Support the Frailty Team in the delivery of Complex Care, coordinating care delivery between service providers as needed
• Make Social Prescribing referrals, as appropriate
• Contribute to planned team huddles and multi-disciplinary team meetings
• Hold regular welfare calls with the patient / carer
• Maintain excellent working relationships with all those involved in the provision and development of services for those with long-term conditions, sharing regular updates of planned care and any changes when they occur
• Work closely with the Frailty Team and others involved in care delivery to ensure patients have relevant referrals and access in place; attend and liaise with the Frailty Team MDT groups, regularly attending case conferences and providing relevant updates

Communication Skills

The post-holder will recognize the importance of effective communication within the team and will strive to:

• Communicate with patients in a welcoming way, which is non-judgmental and respects patients feelings, circumstances, and rights
• Utilise and demonstrate sensitive communication styles to ensure patients are fully informed of reasons for contact when contacting them for example, on welfare calls
• Communicate highly sensitive patient information and progress effectively with other team members and outside relevant health and social care providers, as appropriate
• Ensure all documented notes are contemporaneous

Supporting Responsibilities

Quality

• Contribute to the effectiveness of the team by reflecting on own and team activities and making suggestions on ways to improve and enhance the teams performance
• Participate in the management, review, and identification of learning from patient complaints and significant events
• Deliver evidence-based care according to the National Institute for Clinical Excellence (NICE) and Care Quality Commission (CQC) guidelines

Information Technology

• Possess basic computing and keyboard skills
• Have a good working knowledge of relevant areas of clinical systems and other programmes as appropriate to the role
• Demonstrate a good working knowledge of the policy on information and clinical governance

Research and Audit

• Contribute to the collection of data for research/audit purposes
• Identify audit topics relevant to the Frailty Team

Professional and Educational Responsibilities

• Ensure all Statutory and Mandatory training is complete
• Avail of all opportunities to develop both clinical knowledge and practical skills

Person Specification

Qualifications

Essential

• Maths and English at GCSE level or equivalent.
• Evidence of relevant experience in a health, social care, community, primary care or care-coordination environment.
• Willingness to undertake all required statutory and mandatory training.
• Good working knowledge of confidentiality, information governance and clinical governance.

Desirable

• Social Prescribing qualification or relevant experience of making/working with social prescribing referrals.
• Relevant qualification or training in health and social care, care coordination, frailty, long-term conditions or a related field.

Experience

Essential

• Customer focused service delivery
• Team working
• Ability to deal with situations sensitively and appropriately, remaining polite and calm at all times

Desirable

• Experience in change management
• Evidence of management experience / training

Personal Attributes

Essential

• Positive, professional and patient-centred approach.
• Compassionate, empathetic and respectful towards patients and carers.
• Able to remain calm and professional when dealing with challenging or sensitive situations.
• Flexible and willing to support colleagues and service requirements.
• Reliable, organised and able to work independently and as part of a team.

Desirable

• Experience working with vulnerable adults or people with complex needs.
• Experience working in a community healthcare or social care environment.

Knowledge & Skills

Essential

• Good verbal and written communication skills.
• Excellent organisational and time management skills.

Desirable

• Able to use electronic systems effectively.
• Ability to maintain accurate and timely records.
• Ability to communicate sensitively with patients, carers and professionals.
• Ability to prioritise and coordinate multiple tasks.

Employer details

Employer name

Harrow Health CIC

Address

Harrow Health CIC- 2nd Floor

7 St John's Road

Harrow

HA1 2EY

United Kingdom

Employer's website

https://www.harrowhealth.org.uk (Opens in a new tab)