Titan PCN Care Coordinator

Care Coordination • Identify and proactively engage patient groups experiencing health inequalities • Provide ongoing patient-facing support to individuals throughout their healthcare journey, ensuring continuity of care and helping patients understand and engage with their treatment plans and available services. • Act as a central point of contact for PCN patients, ensuring coordinated and timely support • Coordinate long-term reviews for residents in care homes. • Facilitate regular medication reviews to ensure effective management of prescriptions for residents in care homes. • Coordinate patient recall programmes (e.g. Cancer Screening and Vaccinations) Patient Support • Promote shared decision-making and support patients to make informed choices about their care • Support patients to navigate healthcare systems and access appropriate services, appointments, and interventions. • Provide information and guidance to patients and their carers • Facilitate appropriate referrals and connections to services • Identify barriers to engagement and work proactively with patients to improve access, attendance, and health outcomes Multidisciplinary Team Working • Work collaboratively with GP practices, MDT colleagues, and the Clinical Director • Support delivery of PCN Directed Enhanced Service (DES) requirements • Contribute to the ongoing development and improvement of PCN services Administrative and Data Responsibilities • Maintain accurate patient records and ensure appropriate clinical coding (training provided) • Ensure all patient information is handled confidentially and in accordance with UK GDPR, Data Protection legislation, NHS Information Governance standards, and PCN policies and procedures. • Monitor and track patient activity, recalls, and outcomes • Support data collection, audits, and reporting requirements • Assist with general administrative duties as required General Responsibilities • Organise and prioritise workload effectively, working both independently and as part of a team • Provide cross-cover for colleagues during periods of absence • Contribute to a positive, collaborative team environment Job description Job responsibilities Care Coordination • Identify and proactively engage patient groups experiencing health inequalities • Provide ongoing patient-facing support to individuals throughout their healthcare journey, ensuring continuity of care and helping patients understand and engage with their treatment plans and available services. • Act as a central point of contact for PCN patients, ensuring coordinated and timely support • Coordinate long-term reviews for residents in care homes. • Facilitate regular medication reviews to ensure effective management of prescriptions for residents in care homes. • Coordinate patient recall programmes (e.g. Cancer Screening and Vaccinations) Patient Support • Promote shared decision-making and support patients to make informed choices about their care • Support patients to navigate healthcare systems and access appropriate services, appointments, and interventions. • Provide information and guidance to patients and their carers • Facilitate appropriate referrals and connections to services • Identify barriers to engagement and work proactively with patients to improve access, attendance, and health outcomes Multidisciplinary Team Working • Work collaboratively with GP practices, MDT colleagues, and the Clinical Director • Support delivery of PCN Directed Enhanced Service (DES) requirements • Contribute to the ongoing development and improvement of PCN services Administrative and Data Responsibilities • Maintain accurate patient records and ensure appropriate clinical coding (training provided) • Ensure all patient information is handled confidentially and in accordance with UK GDPR, Data Protection legislation, NHS Information Governance standards, and PCN policies and procedures. • Monitor and track patient activity, recalls, and outcomes • Support data collection, audits, and reporting requirements • Assist with general administrative duties as required General Responsibilities • Organise and prioritise workload effectively, working both independently and as part of a team • Provide cross-cover for colleagues during periods of absence • Contribute to a positive, collaborative team environment