Job Description

Our Care Coordinators will:

Support Clinical Leads and Multi-Disciplinary Teams in the organisation and facilitation of MDT meetings including weekly care home meetings and monthly Mental Health meetings. Run reports to proactively identify eligible patients and work to increase uptake of health checks, health documentation and other services including self-management services. Support with patient's engagement which will include ensuring that information is accessible for all and having conversations with patients and carers to increase understanding, alleviate concerns and increase engagement and self-management. Support people in preparing for or following-up clinical conversations they have with primary care professionals (including health checks) to enable them to be actively involved in managing their care and supported to make choices that are right for them.



Use knowledge of health and social services available in the locality including those offered by the community and voluntary sector to link people up with these and help them overcome barriers they might encounter. The aim is to help people improve their quality of life, avoid unplanned admissions and reduce the effects of long-term conditions on their well-being. Act as a central point of contact to ensure that patients receive the best possible holistic care, and the person is supported to achieve the outcomes that are important to them. This is achieved by bringing together all the information about a person's identified care and support needs and exploring options to meet these within a single personalised care and support plan based on what matters to the person.