Job Description

Job Summary:

You will be working within the Primary Care Network team across four member GP practices in Stoke-on-Trent.

Please note that in the first instance this post is 0830-1630 on Tuesday and one other day to be agreed with the Health and Wellbeing Team Manager to cover maternity leave (Dates tbc)

As a Social Prescriber, you will work as a key part of the primary care network (PCN) multi-disciplinary team to empower people to take control of their health. With a focus on a holistic

'What matters to me' approach to connect and signpost patients to statutory or voluntary services for practical and emotional support within their local community, which will enable them to build knowledge and resilience.

The post holder will work in partnership with their clinical and non-clinical colleagues, management support and the wider PCN to ensure the role delivers the best possible outcomes for our patients. The role is varied, and may include supporting self-management education, peer support, and case management. You will support personal choice, while ensuring that patients understand the accountability of their own actions and decisions.

Social prescribing helps to reduce health inequalities by addressing the wider determinants of health, such as debt, poor housing, and physical inactivity, by increasing patients' awareness of and involvement in their local community, particularly for those with complex social needs, loneliness and isolation and wellbeing issues.

Your role and skills will support and encourage the prevention of developing further illness, or the deterioration of existing long-term conditions.

2. Key Responsibilities

The post holder will:

Take referrals from across the PCN, manage and prioritise a caseload, and provide support, information, and guidance in accordance with the needs of the patient population.

Ensure all interventions designed to empower patients to be active participants in their own healthcare, empower them to manage their own health and wellbeing, and engage with support independently.

Work with the broader MDT to maximise the support available to patients, to connect patients to community-based activities which support them to take increased control of their health and wellbeing.

Work across the four practices within the PCN, including a combination of in person, and telephone appointments for patients

Patient Care and Support:

Build trust and respect with the person, providing non-judgemental and non-discriminatory support, respecting diversity and lifestyle choices. Work from a strength-based approach focusing on a person's assets.

Increase patient motivation to self-manage.

Be a friendly, professional, and engaging source of information about local agencies, organisations and services that can provide support and empower patients and their families to take control of their health and wellbeing.

Work with individuals to co-produce a simple personalised support plan - based on the person's priorities, interests, values and motivations - including what they can expect from the groups, activities and services they are being connected to and what the person can do for themselves to improve their health and wellbeing.

When needed and appropriate facilitate referrals to community groups, activities, and statutory services.

PCN and MDT

Provide education and specialist expertise to fellow PCN staff, ensuring they are aware of social prescribing services and support colleagues to improve their skills and understanding of social prescribing and how this can improve health outcomes, ensuring consistency in the follow up of people's goals where an MDT is involved.

Raise awareness within the PCN of shared decision making and decision support tools and supporting people in shared decision-making conversations.

Engage with and support the new and evolving agendas and service requirements across the PCN, including our work with Care Homes.

As part of the PCN multi-disciplinary team, build relationships with staff in GP practices within the local PCN, attending relevant MDT meetings, giving information and feedback.

System Responsibilities

Develop and maintain effective relationships with the VCSE sector, ensuring that patients can easily move between services and community resources to access additional support.

Work in partnership with all local agencies to raise awareness of health and wellbeing coaching, and how partnership working can reduce pressure on statutory services, improve health access and outcomes and enable an integrated approach to care.

Seek regular feedback about the quality of service and impact of health coaching on referral agencies.

Alongside other members of the PCN multi-disciplinary team, collaborate with all local diverse partners to contribute towards supporting the local VCSE organisations and community groups to become sustainable and that community assets are nurtured, through sharing intelligence regarding any gaps or problems identified in local provision with commissioners and local authorities.

Be proactive in encouraging equality and inclusion, through self-referrals and connecting with all diverse local communities, particularly those communities that statutory agencies may find hard to reach.

Develop collaborative relationships and work in partnership with health, social care, community and voluntary sector providers and multidisciplinary teams to holistically support patients' wider health and wellbeing, public health, and contributing to the reduction of health inequalities.

Data Capture

Work sensitively with people, their families, and carers to capture key information, enabling tracking of the impact of health coaching on their health and wellbeing, including the measures required within the PCN Contract (e.g., PAM measures)

Encourage people, their families, and carers to provide feedback and to share their stories about the impact of social prescribing on their lives.

Support referral agencies to provide appropriate information about the person they are referring. Provide appropriate feedback to referral agencies about the people they referred.

Work closely within the MDT and with GP practices within the PCN to ensure that the relevant codes are captured and inputted into the clinical systems, (as outlined in the Network Contract DES), adhering to data protection legislation and data sharing agreements.

Professional Development

Work with your line manager to undertake continual personal and professional development, taking an active part in reviewing and developing roles and responsibilities.

Training requirements for the role are currently being developed by NHS England; when these are developed, undertake identified coaching and training as required by the Personalised Care Institute.

Adhere to organisational policies and procedures, including confidentiality, safeguarding, lone working, information governance, quality, diversity, inclusion training and health and safety.

Other

Work as part of the healthcare team to seek feedback, continually improve the service and contribute to business planning.

Contribute to the development of policies and plans relating to equality, diversity and health inequalities.

Undertake any tasks consistent with the level of the post and the scope of the role, ensuring that work is delivered in a timely and effective manner.

NB: This job description outlines the key duties that are expected of you within the job role although is not an exhaustive list. It may be amended in line with experience, business requirements and because of any future organisational change.

3. Other Responsibilities:

Health and Safety:

To comply with the Health and Safety at Work etc. Act 1974.

To take responsibility for his/her own health and safety and that of other persons who may be affected by his/her own acts or omissions.

Equality and Diversity

To always carry out his/her responsibilities in line with the Modality Equal Opportunities Policy and Procedures.

Risk Management and Clinical Governance

To work within the Clinical Governance Framework of the practice, incorporating Risk Management and all other quality initiatives.

Confidentiality

To maintain confidentiality of information relating to patients, clients, staff and other users of the services in accordance with the Data Protection Act 1998 and Caldicott Guardian. Any breach of confidentiality may render an individual liable for dismissal and/or prosecution.

Information relating to patients, carers, colleagues, other healthcare workers or the business of the practice may only be divulged to authorised persons in accordance with the practice policies and procedures elating to confidentially and the protection of personal and sensitive data.

General

To undertake any other duties commensurate with the role, within the bounds of his/her own competence.

To work across Hanley Bucknall & Bentilee sites as required.

To work flexibly to accommodate evening meetings as required.

4. Experience, Skills, and Knowledge

(M) Mandatory Minimum; (E) Essential; (D) Desirable

Experience:

Experience of social prescribing or equivalent in adult social care adult health and social care, learning support or public health/health improvement (including unpaid work) (E)

Experience of supporting people, their families and carers in a related role (including unpaid work) (E)

Experience of data collection and using tools to measure the impact of services (E)

Experience of working with the VCSE sector (in a paid or unpaid capacity), including with volunteers and small community groups (D)

Skills:

Ability to actively listen, empathise with people and provide person-centred support in a non-judgemental way (E)

Ability to provide information in a way that inspires trust and confidence, supporting others to be able to engage in decision making (E)

Able to engage and communicate effectively with people, one-to-one or in a group, including adjusting communication and delivery styles to an individual's needs and preferences.

Able to provide a culturally sensitive service, by supporting people from all backgrounds and communities, respecting lifestyles and diversity (E)

Commitment to reducing health inequalities and proactively working to reach people from diverse communities (E)

Ability to communicate effectively, both verbally and in writing, with people, their families, carers, community groups, partner agencies and stakeholders (E)

Ability to identify risk and assess/manage risk when working with individuals (E)

Have a strong awareness and understanding of when it is appropriate or necessary to refer people back to other health professionals/agencies, when what the person needs is beyond the scope of the link worker role - e.g., when there is a mental health need requiring a qualified practitioner (E)

Ability to maintain effective working relationships and to promote collaborative practice with colleagues(E)

Able to work with others to reduce hierarchies and find creative solutions to community issues (E)

Can demonstrate personal accountability, emotional resilience and ability to work well under pressure (E)

Ability to organise, plan and prioritise on own imitative, including when under pressure and meeting deadlines (E)

High standard of written and oral communication skills (E)

Ability to work flexibly and enthusiastically within a team or on own initiative (E)

Knowledge of, and ability to work to, policies and procedures, including confidentiality, safeguarding, lone working, information governance, and health and safety (E)

Knowledge:

Level 6 qualification, working towards or equivalent (M).

Level 3 qualification in, information advice and guidance or similar (D)

Demonstrable commitment to professional and personal development (E)

Knowledge of the personalised care approach (E)

Understanding of the wider determinants of health, including social, economic and environmental factors and their impact on communities, individuals, their families and carers (E)

Understanding of, and commitment to, equality, diversity and inclusion (E)

Knowledge of community development approaches (E)

Knowledge of IT systems, including ability to use word processing skills, emails and the internet to create simple plans and reports (E)

Knowledge of how the NHS works, including primary care (D)

5. Values

Hanley Bucknall & Bentilee PCN uses a range of tools including values-based interviewing to select the best candidates for our organisation. Candidates will need to demonstrate they share our organisational values.

Commitment

This value radiates through our day-to-day care of our patients and our team members. We work with dedication and enthusiasm to deliver the best quality care possible. To us, excellent quality means putting passion into our work, and we always strive to do our absolute best. At the end of the day, being committed to our work means being committed to every one of our patients and team members.

Accountability

We all have willingness to take responsibility for our own actions. Our work means we need to be accountable for what we do and how we do it. We have a duty of care to every one of our patients and team members and we make sure we do this by upholding this value in everything we do.

Respect

Respect is of paramount importance in all we do. We always maintain our patient's dignity and support our team to do the same in their professional practice. We believe respect is mutual with our patients and team members; we treat one another with compassion and empathy.

Excellence

We strive to exceed the expectations of all our patients by committing to deliver excellence in quality and outcomes for all our patients and by education them about their health and empowering them to become partners in their own healthcare.

Job Types: Part-time, Permanent, Temporary, Fixed term contract
Contract length: 12 months

Pay: From 12.25 per hour

Expected hours: 10 - 15 per week

Benefits:

Company pension Free parking On-site parking
Experience:

Administration: 1 year (preferred)
Work Location: In person