Integrated Discharge Patient Care Co-ordinator - Home First

Job overview

The ‘Integrated Discharge Patient Care Co-ordinator’ will carry out therapeutic interventions as requested by Therapists and will have access to a qualified Therapist for advice and direction. This may include gathering information for assessments, implementing therapeutic assessment and treatment plans as requested, making recommendations and ordering of equipment and minor adaptations.

The post holder will need to be flexible and work across all sites of the trust, including the whole geographical area that East Lancashire Hospitals Trust serves within community. The post holder may be required to work a pattern in line with extended service operating hours, over seven days a week to deliver the ‘Discharge to Assess’ model of care.

Main duties of the job

• 1.    Organise and deliver a complete episode of therapeutic intervention as screened and delegated by a qualified therapist. 2.    Contribute to the setting of appropriate treatment goals in liaison with the therapist and patient, for when referring onto other services. 3.    Undertake assessment tasks that have been specifically delegated by Therapists. 4.    Deliver part or all of an assessment / treatment plan as indicated by a qualified Therapist. 5.    Give both verbal and written feedback about the progress of a patient’s assessment and treatment, this will include the typing of comprehensive documentation from visits and clinical input. 6.    Clearly document each intervention in the patient’s case notes, and typed reports as outlined in organisational policy and procedures.

Detailed job description and main responsibilities

• 1.    Use technical and therapeutic skills to promote independence, and provide advice, support and educate patients, carers and other heath professionals. 2.    General Administration duties e.g. collating information, production of clinical reports, ordering of equipment, updating databases etc. 3.    Carry out appropriate assessment of patients’ needs in collaboration with carers and other professionals. 4.    Prescribe equipment / assistive technology and adaptations to facilitate independence within agreed guidelines. 5.    Advise, instruct, and educate patients, carers and other health professionals in the use of standard and specialist assistive technology, and environmental adaptation where appropriate. 6.    Undertake risk assessment, manage and document risk in order to provide appropriate recommendations. 7.    Work across agencies and have a working knowledge and understanding of the pathways and systems across health and social care, in order to facilitate the recommendation of appropriate discharge pathway, and access to correct equipment and services. 8.    Undertake delegated tasks to contribute to safe and smooth running of the Integrated Discharge Service Therapy Team. 9.    Assist with the day to day running of the service. 10. Record patient referrals and contact statistics on the correct systems in a timely manner. 11. Maintain and check equipment prescribed and used to ensure appropriate standard in accordance with health and safety, infection control and other relevant guidance. 12. Gain valid informed consent from the patients for any individual intervention that is carried out.