Job Description

Core Responsibilities Receiving and Managing Referrals:

Take referrals from GP practices within the PCN and support patients using social prescribing methods. Assessing Patient needs and developing care plans tailored to each individual. Coordinating with healthcare providers and support services to ensure comprehensive care. Documenting Patient interactions and progress on the clinical system.



Providing ongoing support and adjusting care plans as necessary. Maintaining a broad knowledge of relevant support services within the local area. Personalised Care: Providing Individualised Support: Work closely with individuals, their families, and carers to help them take control of their health and wellbeing, live independently, and improve their health outcomes. Building Trusting Relationships: Spend time understanding each person's needs, focusing on what matters to them and taking a holistic approach to their health and priorities.

Co-Producing Support Plans:

Collaborate with individuals to develop personalised plans that address their goals and connect them to community groups, activities, or statutory services. Strengthening Community Networks: Support and enhance the capacity of local voluntary, community, and social enterprise (VCSE) organisations to accept social prescribing referrals. Promoting Wellbeing Awareness: Provide information and guidance about wellbeing and preventative approaches to improve overall health. Addressing Wider Determinants of Health: Help individuals identify and address challenges like debt, poor housing, unemployment, loneliness, or caregiving responsibilities that impact their wellbeing.

Facilitating Community Engagement:

When appropriate, accompany individuals to community groups, activities, or services to ensure they feel comfortable and supported. Follow up to ensure their needs are met and they feel included. Offering care plans that are uniquely designed to meet the specific needs and preferences of each Patient. Engaging with Patients to understand their personal history, preferences, and goals.



Ensuring that care services are flexible and adaptable to changing needs over time. Creating a supportive and empathetic environment to foster trust and understanding. Referrals: Accepting referrals from third parties such as healthcare providers, community organisations, and social services. Enabling self-referrals where patients can directly seek assistance without an intermediary.



Evaluating referral sources to ensure appropriate and effective care pathways for all patients.