The Team Lead for Social Prescribing & Link Workers is responsible for the delivery of a professional, efficient and effective co-ordination service through effective management of the team of Social Prescribers and Link Workers. They will coach and support the team to meet their set objectives and KPIs as well as providing effective support and the best possible care for patients.
The post holder will engage with the leadership of other providers supporting the PCNs patients to deliver collaborative solutions that improve patient outcomes and sustainability of PCN / GP services.
Alongside managing the team, the team lead will also be a Social Prescriber Link Worker that will hold his/her own caseload of patients.
Proactively identify and work with vulnerable patients to support their personalised care requirements, using the available decision support aids.
Holistically bring together all of a persons identified care and support needs, and explore options to meet these within a single personalised care and support plan (PCSP), in line with PCSP best practice, based on what matters to the person
Help patients, carers and family members to manage their needs through answering queries, making and managing appointments, and ensuring that people have good quality written or verbal information to help them make choices about their care.
Engage with and act as contact point on behalf of the PCN with other service providers (including health, social, voluntary sector) who support vulnerable patients.
Provide coordination and delivery of Multi-Disciplinary Team meetings for vulnerable patients within the PCN. Including, but not limited to the raising of complex cases or concerns to the MDT.
Liaising with all internal teams to support a vulnerable patients needs.
Provide signposting support to patients, carers and family members on information about a patient condition(s).
Explore and assist people to access personal health budgets where appropriate.
Provide coordination and navigation for people and their carers across health and care services, alongside working closely with social prescribing link workers and other care coordinators.