Job Description

Part time role up to 25 hours per week. Work pattern to include Thursdays.

Band 4

This role would suit an trained HCA as it will involve utilising clinical skills such as phlebotomy, blood pressure checks, dipping urine in patients own home.

We are looking to recruit an additional Care Co-ordinator as part of the multi-disciplinary team in Banbury Alliance Primary Care Network, tackling inequalities in health and social care. This post will work exclusively for Hightown Surgery.

The role will provide opportunities for developing leadership and some basic clinical skills, as well as face to face (and telephone/remote) communication with patients and their families/carers.

This role works closely with our Frailty GP and the local Integrated Neighbourhood Team (INT). INTs are a collaborative approach within the NHS that brings together healthcare providers, social care services, and community resources to deliver coordinated care within a specific geographic area. Their primary goal is to provide holistic, person-centred care, focusing on prevention and addressing the diverse needs of local populations, including those with complex needs or those experiencing health inequalities. In Banbury the focus is on the population living within the deprived areas. This involves integrated working with Cherwell District Council, local volunteer groups, community services, social care and Primary Care.

Main duties of the job

A Care Co-ordinator's role involves orchestrating and navigating care across the health and care system for individuals, especially those with complex needs. They help people connect with the right resources and support at the right time, acting as a point of contact and support for individuals and their families. Care Co-ordinators can also play a role in monitoring and evaluating care plans, and ensuring seamless transition between different services.

The successful candidate will work at Hightown Surgery to manage a caseload of identified patients, making sure that appropriate support is made available to them and their carers/families and assessing their changing needs. You will adopt the principles associated with the delivery of the Comprehensive Model for Personalised Care to improve patients health and wellbeing whilst bringing efficiencies to the delivery of general practice.

A Frailty Care Coordinator is a healthcare professional who works closely with the whole of the GP surgery and Frailty GP focusing on supporting individuals with frailty in the community. They work with patients to develop personalised care plans and empowering individuals to actively participate in their own care. This work includes focus on recently discharged patients.

Key Responsibilities

Assess frailty levels

Personalised care planning

Care Co-ordination

Advocacy and Support

Education and Training

Monitoring and Evaluation

Overview of your organisation

As Care Co-ordinator you will be the first point of contact for our frail patients when they are discharged from hospital, ensuring that the care plan they have in place meets their needs, and arranging any appointments that they may need post discharge, e.g., a pharmacist appointment to discuss changes to their medication.

You will receive referrals from other health care staff to aid patients to access services, ensuring health and care planning is timely, efficient, and patient-centred. You will build relationships with our more vulnerable and complex patients to better understand their needs, enabling you to signpost them to the relevant services.

About us

Hightown Surgery are part of Banbury Alliance Primary Care Network. We have a list size of 12,300 patients.

You will be working as part of our multi-disciplinary team including clinical pharmacists and technicians, physiotherapist and social prescriber.

We are a training practice with strong links to Oxford University Medical Students.

Banbury Alliance PCN is a network of three medium-sized, partnership practices, serving over 29,000 patients and the smallest network in Oxfordshire.

Banbury is a growing market town on the edge of the beautiful countryside of the Cotswolds, close to Oxford, Stratford upon Avon, Warwick and Bicester Village.

Attendance the frailty multidisciplinary MDT meetings Assist with the coordination of referrals for our community teams. Data collection for submission to internal reports and national databases Liaise with General Practitioners, Practice Management and other staff as appropriate. Telephone and face to face meetings with patients as appropriate sometimes in their homes. Occasional requirement to take bloods and collect urine samples and complete basic observations from housebound patients as part of health inequalities for annual reviews.
Job Type: Part-time

Pay: From 12.85 per hour

Expected hours: No less than 25 per week

Benefits:

Free parking On-site parking
Work Location: In person

Application deadline: 04/08/2025