Proactive Care team - Neighbourhood Case Coordinator

Job overview

We are recruiting passionate and proactive Neighbourhood Case Coordinators to join the Hertsmere Neighbourhood Proactive Care Service. An exciting part time opportunity (26.25 hrs per week) to play a key role in a new team delivering community-based, person-centred care for residents. Focusing on holistic assessment, care coordination, addressing health inequalities and delivering the strategic ambition of a ‘neighbourhood health service’. This role has both an administrative and patient facing element. Working as part of a multidisciplinary team supporting a cohort of residents with moderate to severe frailty who have had 2 or more unplanned admissions within the last year, linking them to health, social care and voluntary sector services.

This service will see the shift from reactive care to proactive identification using risk stratification searches within Primary Care records. Searches will identify a cohort of patients who would benefit from targeted intervention to improve outcomes, overall experience and reduce the likelihood of further unplanned admissions. Operating alongside a number of acute and community services, with the ability to step patients up into appropriate services - including the highly successful virtual ward models in South and West Hertfordshire.

As this is a community-based role, there is a requirement to hold a full, UK driving licence with access to a car for business purposes (unless you have a disability as defined by the Equality Act 2010).

Main duties of the job

This Neighbourhood Case Coordinator role is a hybrid clinical/administrative role which would suit a person with experience working as a health care or therapy assistant in community settings who also has good administration skills to support with producing clinic letters, MDT meeting minutes, appointment bookings, etc.

Clinically you will be visiting patients at home or seeing them in clinic based settings to carry out assessment or monitoring of their long term conditions, providing advice and support to enable them to live well and avoid unnecessary hospital admissions, and liaising with health and social care professionals to ensure that care is well coordinated.

Within this role, the post holder will be responsible for:

• Working under delegated authority from a registered nurse or allied health professional (Neighbourhood Case Manager) to support patients on the Proactive Anticipatory Care Service, with the aim of reducing unnecessary admission to hospital by the completion of preventative comprehensive care plans and care coordination across a range of services.
• This support may take the form of virtual consultation and review, face to face assessment or care delivery, professional liaison, and arranging and attending meetings with colleagues from across health and social care.
• Work may be delivered in patient’s own homes, in clinic, or other community settings.

Detailed job description and main responsibilities

Applicants are expected to present clear and relevant evidence of the competencies and responsibilities detailed in the attached Job Description and Person Specification, together with a demonstrated commitment to the Trust’s values of Accountability, Inclusion, Compassion, and Empowerment.

**Please see attached Job Description and Person Specification for full roles and responsibilities.**

Applicant requirements

This post is subject to the Rehabilitation of Offenders Act 1974 (Exceptions) Order 1975 (Amendment) (England and Wales) Order 2020 and it will be necessary for a submission for Disclosure to be made to the Disclosure and Barring Service.