Vacancies

“We are a living wage paying organisation”

Job Vacancy: 2 x Hospital re-admissions Prevention Worker hosted at Hamara (ABA are also hosting 1 role)

Type of Contract: 12 months Fixed Term Contract

Hours: 37 hours per week (5 days a week)

Location: Citywide Outreach (Flexible working locations in Leeds)

Salary: £21,589

Reporting to: Co-ordinator

Duration: Fixed Term Contract until April 2023

Purpose of Post

  • To work in partnership with ABA project workers and enhance the services provided by the NHS local neighbourhood teams by supporting the BME community on discharge from hospital to prevent readmissions, keep patients safe and active, access other services and reduce isolation.

Main Duties

  • To conduct initial needs assessments with patients to establish support required around mental, physical and support requirements and co-produce care plans with patients using the ‘What matters to me’ approach.
  • To promote healthy choices to improve health and wellbeing, manage long-term conditions and reduce hospital readmissions.
  • To liaise with local agencies to ensure appropriate referral mechanisms are in place.
  • To work jointly with colleagues in health and social care to allow for seamless referrals, information sharing and person centred care planning to add value to the service and outcomes.
  • To provide signposting advice and guidance to patients supporting them to make informed choices about services.

Candidates must have:

  • Experience of engaging with communities and building good relationships whilst observing professional boundaries.
  • Ability to liaise and build partnerships with voluntary and statutory agencies.
  • Experience of supporting individuals to develop their health and well-being including support planning, signposting and advice and guidance;
  • Knowledge of third sector organisations, support groups and activities within the locality;
  • Excellent communication skills both written and verbal;
  • Ability to speak one or more South Asian or other community language;
  • Full driving license and access to own vehicle;

How to apply:

If you are interested in applying for this role, please click here – Apply Online

Closing Date: Monday 6th June. We strongly advise submitting an application early. We reserve the right to close posts early on sufficient number of applications.

Interviews to be held:  Wednesday 15th June

Main Purpose of the Job:

 

  • To enhance the services provided by the NHS local neighbourhood teams by supporting the BME community on discharge from hospital to prevent readmissions, keep patients safe and active, access other services and reduce isolation.

 

Working Relations:

 

Internal:         The appointed person will work closely with the Co-ordinator and the Community Connectors.  S/he will report directly to the Co-ordinator and will provide regular updates on delivery.

 

External:        The post holder will work collaboratively with staff from the NHS neighbourhood teams, LCC and the Third Sector whilst developing close working relationships with relevant statutory agencies such as the Local GP Practices, Libraries and Leisure Services.

 

Main Tasks:

 

  1. To conduct initial needs assessments with patients to establish support required around mental, physical and support requirements and co-produce care plans with patients using the ‘What matters to me’ approach.

 

  1. To promote healthy choices to improve health and wellbeing, manage long-term conditions and reduce hospital readmissions.

 

  1. To liaise with local agencies to ensure appropriate referral mechanisms are in place. Eg equipment, transport to appointments etc

 

  1. To work jointly with colleagues in health and social care to allow for seamless referrals, information sharing and person centred care planning to add value to the service and outcomes.

 

  1. Contribute to setting up and running effective administrative, monitoring and evaluation systems.

 

  1. Act in accordance with organisational policies and practices.

 

  1. To provide signposting advice and guidance to patients supporting them to make informed choices about services.

 

  1. Conduct regular wellbeing calls to patients on discharge from hospital.

 

  1. Support patients in their own home to rebuild independence and confidence after hospital admission including support to access shopping, completing light cleaning duties and meal prep.

 

  1. To encourage patients to take up and access workshops and health activities and signpost to any other physical and recreational activities, assist in the publicising of local groups including via social media where appropriate.

 

  1. To work closely with partners from the Health and Wellbeing Partnership to identify needs and priorities.

 

  1. Act as an advocate and coordinator of support for patients on discharge of hospital including support to access health, care and other services.

 

  1. To raise awareness of Mental Health, Diabetes, COPD and other long term conditions, the impacts of unhealthy lifestyle choices, the benefits of physical activity and support groups.

 

  1. To ensure that the ‘5 Ways to Well-being’ are promoted and considered in all plans and activities, taking into account demographics of the area whilst remaining culturally and religiously sensitive.

 

  1. Promote the Digital Health Hub and ensure patients are supported to become digitally included and confident at using digital to improve health and wellbeing.

 

  1. Monitor activity and evaluate with the support of the Co-ordinator

 

  1. Provide regular progress reports to the Co-ordinator.

 

  1. Any other duties commensurate to the post.

Criteria

Requirements

Essential/ Desirable

Assessment

R = Reference, I = Interview,

AF = Application Form and AS

= Assessment

Experience

Experience of building relationships with a wide range of communities and stakeholders.

Experience of building and maintaining relationships whilst maintaining professional boundaries.

Experience of outreach work in deprived communities.

Experience of working in a community setting to tackle health inequalities.

Supporting people within their own home to undertake basic tasks such as cleaning and meal prep.

E

 

E

 

 

E

 

D

 

D

AF, I

 

AF, I

 

 

AF, I

 

AF, I

 

AF, I, AS

Specialist

Knowledge/ Skills

Proven knowledge and understanding of health and well-being, health inequalities, economic development, financial inclusion and community cohesion.

Sound knowledge, understanding and appreciation of barriers and challenges faced by differing communities and marginalised groups.

Awareness and understanding of current political, social and economic challenges faced by community organisations currently.

Awareness of referral agencies, voluntary and third sector organisations and community centres providing activities for older people.

Due to the nature of the role it is desirable that the successful candidate can speak 1 or more South Asian or African language.

E

 

 

 

E

 

 

 

 

E

 

 

D

 

 

D

AF, I, AS

 

 

 

AF, I, AS

 

 

 

 

AF, I, AS

 

 

AF, I, AS

 

 

AF, I

Qualifications

Educated to degree level or equivalent.

D

AF, I

Interpersonal Skills

A personal commitment to and enthusiasm for Hamara HLC’s purpose and values

Excellent at building internal and external relationships

Organised approach, able to manage own time effectively and work under own initiative

Ability to work under pressure and meet tight deadlines

Excellent attention to detail

Excellent ICT skills and familiarity with MS Word, Excel, Outlook and PowerPoint

Excellent interpersonal and relationship building skills

Enthusiastic, flexible and friendly, with a ‘can do’ attitude

To be trustworthy and honest.

E

 

E

 

E

 

E

 

E

E

 

E

 

E

 

E

AF, I

 

AF, I, R

 

AF, I, R

 

AF, I, R

 

AF, I, R

AF, I

 

AF, I

 

AF, I, R

 

AF, I, R

Other job related

requirements

Willingness to undertake any training necessary

Willingness to work flexible hours where required.

Driver with access to own vehicle

E

 

D

 

E

AF, I

 

AF, I

 

AF, I

 

Job Vacancy: Personalised Care Coordinator

Type of Contract: Permanent, Full Time. Part Time and Job Shares will be considered

Hours: 37 hours per week

Service area: Health

Salary: £22,548 – £24,881

Website: https://www.hamara.org.uk 

Responsible for: No line management responsibility

Responsible to: Hub lead and Clinical Lead for the Care Coordinator Hub

Purpose of Post

Hamara HLC is a registered charity working to improve health, education and opportunities of our community.  Hamara works closely with several GP practices across East Leeds and support Burmantofts, Harehills & Richmond Hill PCN with the employment of their Personalised Care Coordinators.

Please see separate Person Specification for FULL details

Key objectives of the role:

  • Managing, identifying and providing coordination of care for the patients within our PCN.
  • Coordinate personalised care by prioritising patients in highest risk group, delivering strategies that engage wider workforce and digital/tech to optimise self-care and remote care.
  • Coordinate the work of healthcare professionals and non-clinical staff (including volunteers) who are involved in the care of the PCN’s patients. Contribute to tackling inequalities in health and social care, particularly regarding individuals with long-term conditions. An ethos of promotion of independence and partnership-working is integral to this post.

 

Knowledge, experience, personal qualities and qualifications required:

  • Excellent written and verbal communication skills and interpersonal skills
  • Clinical System experience (desirable)
  • Excellent organisational and administration skills
  • Experience providing advice/signposting to users (desirable)
  • Conscientious, hardworking and self- motivated to work with minimal supervision and have the ability to work as part of a team.
  • Ability to work with information, clinicians, social workers and managers
  • Ability to meet deadlines and work under pressure
  • Ability to engage and sustain relationships with all professionals, other organisations and patients
  • Experience of working with healthcare professionals and or previous experience in the NHS or social care or relevant field (desirable)
  • Experience in use of databases
  • Experience of administrative duties
  • Working in a multi-disciplinary setting where influence and negotiation is required
  • GCSE/Diploma/ HNC level (or relevant experience)
  • NVQ Level 3 Business Administration (or relevant experience)

 

Successful candidates must have the following:

  • A minimum of 2 years of experience, possibly in a related role providing the skills and attributes can be fully evidenced.
  • Be capable of handling sensitive information and ensuring confidentiality is maintained.
  • Have good communication skills both written and verbal.
  • Be able to work independently and be self-motivated.
  • The ability to organise, prioritise and work to deadlines.
  • Experience of the Community/Voluntary or Health & Social Care sector is essential.
  • Experience of working with BAME communities, is highly desirable but not essential.

How to apply:

If you wish to discuss the role further, please email sophie.peel@hamara.co.uk and we will arrange a call.

All applications must be received by 9am Monday 6th June 2022. Interviews will be held week beginning 13th June.  Applications received after the closing deadline will not be considered.

We will aim to respond to candidates selected for interview within 1 week. We will unfortunately not be able to respond to all unsuccessful applicants.

If you are interested in applying for this role, please click here – Apply Online

Closing Date: Monday 6th June 2022

Job Summary/Main purpose of the job:

The Care Coordinator will be part of the Primary Care Network (PCN) Multi-Disciplinary Team (MDT) who are responsible for managing the care of people registered with practices within BHR PCN.

A key part of the role of a care coordinator role is working in the Care Coordinator Hub (CCH) managed by the PCN manager and the nominated clinical lead.

The care coordinator hub is a team of the PCN staff that provide support to practices within the PCN to manage, identify and provide coordination of care for the PCN population. The hub approach ensures that a central team are focused on proactively seeking frameworks and models of care for priority patients within the PCN and its local context.

The Care Coordinator Hub will support the PCN approach to health population management by coordinating personalised care by prioritising patients in highest risk group, delivering strategies that engage wider workforce and digital/tech to optimise self-care and remote care.

The Care Coordinator Hub will also be central to developing solutions to unplanned care by understanding what factors are driving poor outcomes in different population groups. Ensuring the PCN are designing and planning models of care which will improve health and wellbeing today and also in the future.

This will involve coordinating the work of healthcare professionals and non-clinical staff including volunteers involved in the care of patients registered at GP practices within the wider PCN population.

The post holder will contribute to tackling inequalities in health and social care particularly regarding individuals with long-term conditions. An ethos of promotion of independence and partnership-working is integral to this post.

 

Primary Duties and Areas of Responsibility:

Care Coordinator Hub

•           Support patients and practices in appointment bookings for target groups of patients.

•           Supporting patients to complete questionnaires to identify and assess their levels of wellbeing and skills, knowledge to manage their own health.

•           Liaise with all clinical and non-clinical members in the multi-disciplinary team (MDT).

•           Support management and allocation of referrals into the personalised care team.

•           Support reporting requirements associated within the DES specifications for required services.

•           Support reporting to strategic team any systematic trends of potential threats and their implications or opportunities and likely future developments.

•           Manage and support PCN clinical system hub unit, rota’s and smart card access.

•           Answer and take calls from internal PCN staff and external MDT members about patients receiving care from the personalised care team and other PCN MDT staff as appropriate.

•           Performing administrative tasks (including appointments, diaries, patient searches).

Patient Identification

•           Receive and collate information from clinical systems to understand what factors are driving poor outcomes in different population groups.

•           Use search tools for risk stratification of  patients.

•           Review end of year PQI data for the PCN.

Maintenance of IT based information systems and responsibility for key performance data:

•           To ensure the IT requirements for recording activity are adhered to in collaboration with other team members

•           Accurate update and maintenance of GP systems within the MDT.

•           To provide agreed performance/activity data within the MDT and PCN and wider BHR PCN.

Communication and collaborative working relationships

•           Demonstrates ability to work as a member of a team.

•           Is able to recognise personal limitations and refer to more appropriate colleague(s) when necessary.

•           Actively work toward developing and maintaining effective working relationships both within and outside the PCN or group of PCNs.

•           Liaises with other stakeholders as needed for the collective benefit of patients including but not limited to Patients GP, Nurses, other practice staff and other healthcare professionals including pharmacists and pharmacy technicians from provider and commissioning organisations.

•           Work with patients, PCN practices and partners.

•           Develop excellent working relationships with the all partners, wider service networks including the voluntary sector, GP practices, adult social care, hospitals, community pharmacists and other members of the MDT.

•           Meet regularly with the clinical lead and review prioritisations.

•           Keep the MDT and BHR PCN abreast of ‘good news’ stories.

•           Manage and prioritise workload on a daily basis and deal with the competing demands.

Other responsibilities

•           To act at all times in an anti-discriminatory manner.

•           To be able to plan and respond to workload according to operational priorities.

•           To support the delivery of these functions across wider locality areas where necessary.

•           To undertake any training required in order to maintain competency including mandatory training.

•           To contribute to, and work within a safe working environment.

•           The Care Coordinator must at all times carry out duties and responsibilities with due regard to the GP Practice’s equal opportunity policies and procedures.

•           The Care Coordinator is expected to take responsibility for self-development on a continuous basis, undertaking on-the-job training as required.

•           The Care Coordinator must be aware of individual responsibilities under the Health and Safety at Work Act, and identify and report as necessary any untoward accident, incident or potentially hazardous environment.

Patient Care

•           Communicate effectively and sensitively and use language appropriate to a patient and carer/relative’s condition and level of understanding.

•           Effectively use all methods of communication and be aware of and manage barriers to communication.

•           Effectively recognise and manage challenging behaviours, carers and or relatives.

•           Provide information to patients, their carers and/or relatives on behalf of the team.

Supporting Care Delivery

•           Be the point of liaison for patients and interface with all health and social care professionals, including keeping everyone informed and updated.

•           Follow through actions identified by the MDT including arranging tests, referrals, signposting, etc.

•           Follow through with patients and others involved to ensure all services and care arrangements are in place.

Autonomy/Scope within Role

•           The post holder will be required to work within clearly defined organisational protocols, policies and procedures.

Key Relationships

Key Working Relationships Internal:

•           Clinical Lead for the CCH.

•           GPs and General practice teams within the PCN.

•           PCN Clinical Director/s.

•           PCN network manager.

•           MDT members including but not exhaustive: Clinical Pharmacists, technicians, Physician Associates, Physios, Paramedics, Social Prescribing Link Workers, Patient Ambassadors, health and wellbeing coach, practice managers.

Key Working Relationships External:

•           GPs from neighbouring PCNs

•           Service providers

•           Social care

•           Voluntary services

•           Patients

•           Carers/relatives

Health and Safety/Risk Management

•           The post-holder must comply at all times with the organisation and Practice’s Health and Safety policies, in particular by following agreed safe working procedures and reporting incidents using the organisation’s Incident Reporting System.

•           The post-holder will comply with the Data Protection Act (1984), The General Data Protection Regulations (2018) and the Access to Health Records Act (1990).

•           The post-holder will comply with all necessary training requirements relevant to the role as identified by the organisation.

Equality and Diversity

•           The post-holder must co-operate with all policies and procedures designed to ensure equality of employment. Co-workers, patients and visitors must be treated equally irrespective of gender, ethnic origin, age, disability, sexual orientation, religion etc.

Respect for Patient Confidentiality

•           The post-holder should always respect patient confidentiality and not divulge patient information unless sanctioned by the requirements of the role.

Special Working Conditions

•           The post-holder is required to travel independently between practice sites (where applicable), and to attend meetings etc. hosted by other agencies.

 

 

 

Organisational Requirements

General:

 

·         To support colleagues with any operational needs, as and when required.

·         To work outside of ordinary office hours, as required.

·         To complete any other reasonable duties, as required.

·         To respect and uphold Hamara’s written policies and procedures in place.

·         To attend any meetings, as required.

·         To commit to personal and professional development. This includes undertaking appropriate training where required, or requested to do so.

·         To commit to the ethos and values of Hamara. 

·         Satisfactory DBS Clearance

 

Equal Opportunities:

Hamara is an equal opportunities employer. Hamara is committed to promoting anti-discriminatory practices within the society, the organisation and in the promotion of its services to the community. Hamara expects all employees to understand, comply with and to promote its policies in their work and to challenge prejudice and discrimination issues, as appropriate, and undertake any appropriate training.

Safeguarding:

Hamara is committed to ensuring the safeguarding and wellbeing of children and vulnerable adults, and all applicants and staff will be required to demonstrate understanding of and commitment to best safeguarding practice.

Criteria

Requirements

Assessment

R: References

I: Interview

AF: Application Form

 

Experience/Knowledge/ Skills  

  • Experience of working with healthcare professionals and or previous experience in the NHS or social care or relevant field (desirable)
  • Experience in use of databases
  • Experience of administrative duties
  • Excellent written and verbal communication skills and interpersonal skills
  • Clinical System experience (desirable)
  • Evidence of excellent knowledge of Microsoft Office and Excel
  • Experience providing advice/signposting to users (desirable)
  • Able to use NHS Choices website effectively (desirable)
  • Able to deal with patients sensitively
  • Able to demonstrate a clear understanding of working with confidential information and an understanding of patients confidentiality
  • Working in a multi-disciplinary setting where influence and negotiation is required
  • Understand and use common health and social care terminology.
  • Working in a busy and demanding environment whilst delivering in a timely manner
  • Understanding of current issues facing the NHS (desirable)
  • Understanding of health and social care processes (desirable)

 

 

R + I + AF

 

 

 

 

Education, Qualifications and Training

·         GCSE/Diploma/ HNC level (or relevant experience)

·         NVQ Level 3 Business Administration (or relevant experience)

·         Long term conditions training (desirable)

·         Welfare Rights basic training (desirable)

                                         

I + AF

 

 

Skills and Attributes

·         Able to work as part of a team

·         Able to prioritise and manage own workload

·         Excellent motivational and influencing skills

·         Excellent negotiating skills

·         Excellent interpersonal skills

·         Strong analytical and judgement skills

·         Ability to analyse and interpret information and present results in a clear and concise manner

·         Excellent organisational and administration skills

·         Maintain a calm and sensitive approach when dealing with people in distress

·         Demonstrate the importance of cultural factors in communicating with people

 

R, I + AF

 

Other job related requirements

·         Willingness to undergo further training or development as the job develops

·         Requires a flexible approach, and a highly motivated post holder. The role may need to be reviewed and developed in the future in line with changing priorities

·         Access to and ability to use transport as travel between sites across Leeds may be required for meetings and training.

 

I + AF