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Care Co-ordinator

Care Co-ordinator

NHSLondon, England, United Kingdom
28 days ago
Job type
  • Full-time
  • Permanent
Job description

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Job Summary

Ensure accurate coding and records are kept, reviewed and monitored, coordinate care planning, and ensure effective communication among different care teams. Organise and managed huddles and MDT meetings, follow up on actions, and ensure continuity of care. Be part of the recall and referrlas team.

Job Summary

Ensure accurate coding and records are kept, reviewed and monitored, coordinate care planning, and ensure effective communication among different care teams. Organise and managed huddles and MDT meetings, follow up on actions, and ensure continuity of care. Be part of the recall and referrlas team.

Main duties of the job

  • Assessment and Planning
  • Conduct or contribute to assessments of patients' health and social care needs.
  • Develop personalised care plans with input from the patient, family, and other professionals.
  • Coordinating Services
  • Act as the main point of contact for the patient, helping them access various services (e.g., GPs, social services, mental health teams).
  • Ensure communication between different parts of the health and care system.
  • Monitoring and Reviewing Care
  • Regularly review care plans to ensure they remain relevant.
  • Adjust support as the patient's condition or circumstances change.
  • Advocacy and Support
  • Help patients understand their care options and make informed decisions.
  • Ensure the patient's voice is heard in planning and decision-making.
  • Multidisciplinary Collaboration
  • Work closely with doctors, nurses, social workers, therapists, and others.
  • Attend multidisciplinary team (MDT) meetings to discuss cases and ensure coordinated care.
  • Documentation and Reporting
  • Keep accurate records of assessments, care plans, and interactions.
  • Report concerns or changes in patient condition promptly.
  • Promoting Independence
  • Support patients in managing their own care where appropriate.
  • Encourage self-care and access to community support.

Who They Typically Support

  • People with long-term conditions
  • Those with mental health issues
  • Patients with multiple health needs
  • Older adults or individuals needing social care coordination

    • About Us

    We are a large very friendly team consisting of 8 partners, 4 salaried GP's, 3 nurse practitioners, 5 nurses, 1 HCA along and 10 admin / reception members. This is an extremely busy practice with approx. 16,000 patients. We are all mindful of each other and will always help out where and when needed. The successful person will receive 20 days leave pro rata in the first year and the salary is £14.65 per hour.

    Details

    Date posted

    09 June 2025

    Pay scheme

    Other

    Salary

    14.65 an hour

    Contract

    Permanent

    Working pattern

    Full-time

    Reference number

    A2284-25-0001

    Job locations

    Albion Street Group Practice

    87 Albion Street

    London

    SE16 7JX

    Job Description

    Job responsibilities2. Personalised Care Planning 3. Navigation & Signposting 4. Multidisciplinary Team (MDT) Working 5. Proactive Population Health Management 6. Administration & Record-Keeping 7. Health Promotion & Preventative Care Job description

  • Patient Support & Coordination
  • Identify patients who would benefit from care coordination (e.g. elderly, frail, frequent attenders, or with multiple conditions).
  • Serve as the main contact point for patients and their carers regarding their care journey.
  • Build trusted relationships with patients, encouraging self-management where possible.
  • Work with patients to co-create personalised care plans tailored to their health needs and life goals.
  • Ensure plans reflect patient preferences, involving family or carers when appropriate.
  • Schedule and coordinate regular reviews of care plans.
  • Help patients access appropriate servicesboth NHS (e.g., clinics, community nurses) and non-NHS (e.g., social prescribing, voluntary sector).
  • Signpost patients to relevant community resources or support groups.
  • Collaborate closely with GPs, nurses, pharmacists, social prescribers, health coaches, and other practice or Primary Care Network (PCN) staff.
  • Attend regular MDT meetings to discuss complex patients and ensure joined-up care.
  • Use data and digital tools (e.g., patient registries, risk stratification software) to identify groups who need targeted interventions.
  • Support proactive care, not just reactive appointments.
  • Keep detailed and accurate records of all patient interactions, updates to care plans, and referrals.
  • Update clinical systems (like EMIS or SystmOne) with care coordination notes and plans.
  • Encourage and support patients in attending health checks, screenings, and vaccinations.
  • Promote healthier lifestyles in line with NHS guidance.

    • Job responsibilities2. Personalised Care Planning 3. Navigation & Signposting 4. Multidisciplinary Team (MDT) Working 5. Proactive Population Health Management 6. Administration & Record-Keeping 7. Health Promotion & Preventative Care

  • Patient Support & Coordination
  • Identify patients who would benefit from care coordination (e.g. elderly, frail, frequent attenders, or with multiple conditions).
  • Serve as the main contact point for patients and their carers regarding their care journey.
  • Build trusted relationships with patients, encouraging self-management where possible.
  • Work with patients to co-create personalised care plans tailored to their health needs and life goals.
  • Ensure plans reflect patient preferences, involving family or carers when appropriate.
  • Schedule and coordinate regular reviews of care plans.
  • Help patients access appropriate servicesboth NHS (e.g., clinics, community nurses) and non-NHS (e.g., social prescribing, voluntary sector).
  • Signpost patients to relevant community resources or support groups.
  • Collaborate closely with GPs, nurses, pharmacists, social prescribers, health coaches, and other practice or Primary Care Network (PCN) staff.
  • Attend regular MDT meetings to discuss complex patients and ensure joined-up care.
  • Use data and digital tools (e.g., patient registries, risk stratification software) to identify groups who need targeted interventions.
  • Support proactive care, not just reactive appointments.
  • Keep detailed and accurate records of all patient interactions, updates to care plans, and referrals.
  • Update clinical systems (like EMIS or SystmOne) with care coordination notes and plans.
  • Encourage and support patients in attending health checks, screenings, and vaccinations.
  • Promote healthier lifestyles in line with NHS guidance.

    • Person Specification

    Qualifications

    Essential

  • Key Skills for a Care Coordinator in General Practice :
  • Strong communication and interpersonal skills
  • Empathy and patience
  • Good organisational and record-keeping abilities
  • Understanding of confidentiality and safeguarding
  • Knowledge of local services and health systems

    • Person Specification

    Essential

  • Key Skills for a Care Coordinator in General Practice :
  • Strong communication and interpersonal skills
  • Empathy and patience
  • Good organisational and record-keeping abilities
  • Understanding of confidentiality and safeguarding
  • Knowledge of local services and health systems

    • Disclosure and Barring Service Check

    This post is subject to the Rehabilitation of Offenders Act (Exceptions Order) 1975 and as such it will be necessary for a submission for Disclosure to be made to the Disclosure and Barring Service (formerly known as CRB) to check for any previous criminal convictions.

    Employer details

    Employer name

    Albion Street Group Practice

    Address

    Albion Street Group Practice

    87 Albion Street

    London

    SE16 7JX

    Employer's website

    https : / / www.albionstreetgrouppractice.co.uk / (Opens in a new tab)

    Employer details

    Employer name

    Albion Street Group Practice

    Address

    Albion Street Group Practice

    87 Albion Street

    London

    SE16 7JX

    Employer's website

    https : / / www.albionstreetgrouppractice.co.uk / (Opens in a new tab)

    Seniority level

    Seniority level

    Entry level

    Employment type

    Employment type

    Full-time

    Job function

    Job function

    Other

    Industries

    Hospitals

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    Care Coordinator • London, England, United Kingdom