Job description
1. Clinical Practice
• Deliver high-quality, compassionate care to patients in their homes, and across our 3 GP Practices.
• Support registered clinicians (GPs, Nurses, AHPs) in the delivery of clinical care.
• Undertake delegated clinical tasks within scope of practice, such as:
• Monitoring vital signs (e.g. blood pressure, pulse, temperature, oxygen saturation)
• Phlebotomy (if trained)
• ECG recording
• Urinalysis and simple diagnostic procedures
• Assist with personal care where required, promoting dignity and independence.
• Observe and report changes in patients conditions, escalating concerns appropriately.
• Support infection prevention and control measures in all care environments.
2. Care Planning and Coordination
• Support the delivery of individualised care plans developed by registered clinicians.
• Assist in carrying out basic patient assessments (within competency).
• Contribute to the monitoring of patients with long-term conditions.
• Support proactive care initiatives, including regular monitoring of care home residents.
• Work with the multidisciplinary team (MDT) to ensure coordinated and continuous care.
3. Communication and Collaborative Working
• Work independently and in partnership with GPs and the wider MDT.
• Communicate effectively with patients, families, and carers.
• Work as part of a wider multidisciplinary team including GPs, nurses, pharmacists, and allied health professionals.
• Build positive working relationships with colleagues across GP practices and care homes.
• Share relevant information with team members to support safe, coordinated care.
• Advocate for patients needs and preferences where appropriate.
• Contribute to MDT meetings where required.
4. Health Promotion and Patient Support
• Support patients to maintain independence, dignity, and wellbeing.
• Promote healthy lifestyles and provide basic health advice (e.g. hydration, nutrition, mobility).
• Assist in supporting vaccination and screening programmes where appropriate.
• Provide reassurance and emotional support to patients and carers.
5. Service Delivery and Development
• Work flexibly across GP practices and care homes within the PCN.
• Support proactive care teams in delivering high-quality patient services.
• Assist with quality improvement initiatives, audits, and data collection.
• Contribute to maintaining accurate patient records and service outcomes.
• Support the achievement of local and national healthcare targets.
6. Administration and Governance
• Maintain accurate and up-to-date patient records using clinical systems such as EMIS and SystmOne.
• Ensure compliance with relevant policies including:
• Infection prevention and control
• Safeguarding
• Health and safety
• Follow safe working practices and escalate risks appropriately.
• Support effective communication within the PCN and across partner organisations.
7. Professional Development
• Maintain high standards of personal and professional conduct.
• Participate in regular supervision and appraisal processes.
• Undertake mandatory training and continuing professional development (CPD).
• Work within defined competencies and seek support when required.
• Engage in reflective practice and ongoing learning.
General Responsibilities
Attend and contribute to team, practice, and PCN meetings.
Work within all organisational policies, procedures, and NHS standards.
Maintain confidentiality in line with data protection and information governance requirements.
• Carry out any other duties commensurate with the role.
Key Working Relationships
PCN Clinical Director
Proactive Care Team
PCN Clinical Leads
GPs, Practice Managers, nurses and other practice staff
PCN teams: Leadership, Clinical Pharmacists, Social Prescribers, Dietician, Health and Wellbeing Coaches,
Providers of care including acute trusts, independent sector and providers, neighbourhood teams, community services, geriatricians, community matrons, community mental health services
Local Care Partnerships linked to the PCN
Confidentiality
Ensure that confidentiality is adhered to in terms of patient information and the protection of personal and sensitive data.
Health and Safety
Identify risks involved in work activities and undertake activities in a way that manages risks.
Actively report health and safety hazards and infection hazards immediately when recognised.
Maintenance of general standards of cleanliness consistent with the scope of the role.
Equality and Diversity
Act in a way that recognises the importance of peoples rights, interpreting them in a way that is consistent with PCN practice procedures and policies, and current legislation.
Safeguarding
Be familiar with and adhere to PCN practice safeguarding policies, procedures and guidelines for both children and adults at risk of abuse or neglect in conjunction with Multi-agency Safeguarding Children and Safeguarding Adults at risk of abuse and/or neglect policy, protocols, and guidelines.
Job description
Job responsibilities
1. Clinical Practice
• Deliver high-quality, compassionate care to patients in their homes, and across our 3 GP Practices.
• Support registered clinicians (GPs, Nurses, AHPs) in the delivery of clinical care.
• Undertake delegated clinical tasks within scope of practice, such as:
• Monitoring vital signs (e.g. blood pressure, pulse, temperature, oxygen saturation)
• Phlebotomy (if trained)
• ECG recording
• Urinalysis and simple diagnostic procedures
• Assist with personal care where required, promoting dignity and independence.
• Observe and report changes in patients conditions, escalating concerns appropriately.
• Support infection prevention and control measures in all care environments.
2. Care Planning and Coordination
• Support the delivery of individualised care plans developed by registered clinicians.
• Assist in carrying out basic patient assessments (within competency).
• Contribute to the monitoring of patients with long-term conditions.
• Support proactive care initiatives, including regular monitoring of care home residents.
• Work with the multidisciplinary team (MDT) to ensure coordinated and continuous care.
3. Communication and Collaborative Working
• Work independently and in partnership with GPs and the wider MDT.
• Communicate effectively with patients, families, and carers.
• Work as part of a wider multidisciplinary team including GPs, nurses, pharmacists, and allied health professionals.
• Build positive working relationships with colleagues across GP practices and care homes.
• Share relevant information with team members to support safe, coordinated care.
• Advocate for patients needs and preferences where appropriate.
• Contribute to MDT meetings where required.
4. Health Promotion and Patient Support
• Support patients to maintain independence, dignity, and wellbeing.
• Promote healthy lifestyles and provide basic health advice (e.g. hydration, nutrition, mobility).
• Assist in supporting vaccination and screening programmes where appropriate.
• Provide reassurance and emotional support to patients and carers.
5. Service Delivery and Development
• Work flexibly across GP practices and care homes within the PCN.
• Support proactive care teams in delivering high-quality patient services.
• Assist with quality improvement initiatives, audits, and data collection.
• Contribute to maintaining accurate patient records and service outcomes.
• Support the achievement of local and national healthcare targets.
6. Administration and Governance
• Maintain accurate and up-to-date patient records using clinical systems such as EMIS and SystmOne.
• Ensure compliance with relevant policies including:
• Infection prevention and control
• Safeguarding
• Health and safety
• Follow safe working practices and escalate risks appropriately.
• Support effective communication within the PCN and across partner organisations.
7. Professional Development
• Maintain high standards of personal and professional conduct.
• Participate in regular supervision and appraisal processes.
• Undertake mandatory training and continuing professional development (CPD).
• Work within defined competencies and seek support when required.
• Engage in reflective practice and ongoing learning.
General Responsibilities
Attend and contribute to team, practice, and PCN meetings.
Work within all organisational policies, procedures, and NHS standards.
Maintain confidentiality in line with data protection and information governance requirements.
• Carry out any other duties commensurate with the role.
Key Working Relationships
PCN Clinical Director
Proactive Care Team
PCN Clinical Leads
GPs, Practice Managers, nurses and other practice staff
PCN teams: Leadership, Clinical Pharmacists, Social Prescribers, Dietician, Health and Wellbeing Coaches,
Providers of care including acute trusts, independent sector and providers, neighbourhood teams, community services, geriatricians, community matrons, community mental health services
Local Care Partnerships linked to the PCN
Confidentiality
Ensure that confidentiality is adhered to in terms of patient information and the protection of personal and sensitive data.
Health and Safety
Identify risks involved in work activities and undertake activities in a way that manages risks.
Actively report health and safety hazards and infection hazards immediately when recognised.
Maintenance of general standards of cleanliness consistent with the scope of the role.
Equality and Diversity
Act in a way that recognises the importance of peoples rights, interpreting them in a way that is consistent with PCN practice procedures and policies, and current legislation.
Safeguarding
Be familiar with and adhere to PCN practice safeguarding policies, procedures and guidelines for both children and adults at risk of abuse or neglect in conjunction with Multi-agency Safeguarding Children and Safeguarding Adults at risk of abuse and/or neglect policy, protocols, and guidelines.