Care Coordinators
There are several different models for care co-ordination. However, Care Coordinators can now be employed under the Additional Roles Reimbursement Scheme (ARRS) which is part of the new GP contract. For practices to receive funding for these roles, Care Coordinators must use information about the area’s population to identify those patients that will benefit most from personalised care, supporting them to make decisions about their care. They also need to look at a person’s identified care and support needs, work with them to develop a personalised care and support plan.
What does a Care Coordinator do?
Care Coordinators help people 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, supporting them to take up training and employment, and to access appropriate benefits where eligible.
Care Coordinators use a ‘Patient Activation Measure’ to support people to understand their level of knowledge, skills and confidence when engaging with their health and wellbeing and help patients to access self-management education courses, peer support or interventions that support them in their health and wellbeing.
Care Coordinators work closely and in partnership with other members of the primary health care team, in particular the Social Prescribing Link Workers and Health and Wellbeing Coaches. In conjunction with these other roles, Care Coordinators play an important role in supporting patients to use health services appropriately and effectively.
Inclusion of the Care Coordinator role in the Additional Roles Reimbursement Scheme demonstrates that this role is important to the effective and efficient working of the primary health care team.
Training/Development
Click here for the Minimum Training Standards & Recommended Additional Training.
Care Coordinators require a strong foundation in enabling and communication skills as set out in the core Curriculum for Personalised Care. These can be achieved via a two day health coaching skills course and additional training as guided by NHS England.
Care Coordinators should also access statutory and mandatory training, including but not limited to:
principles of information governance, accountability and clinical governance
maintenance of accurate and relevant records of agreed care and support needs
identify when it is appropriate to share information with carers and do so
the professional and legal aspects of consent, capacity, and safeguarding
Care Coordinators should be familiar with the six components of the universal model for personalised care with a specific focus on:
support for self-management
personalised care and support planning
shared decision making
social prescribing
personal health budgets
Benefits to patients
The patient’s go-to person if their needs change or if something goes wrong with service delivery – The care coordinator ensures that there are no gaps in the patient’s service provision – Many elderly and disabled people with highly complex needs struggle to coordinate with all the relevant services directly on their own – Improved patient education and understanding – Better health outcomes – Patients can eliminate unnecessary appointments, procedures and tests – Patients feel more empowered and actively engaged in their treatment.
Benefits to PCN’s
Ensuring seamless service provision significantly decreases the risk of the patient deteriorating and thereby reduces the overall cost of care and the likelihood that additional interventions will be needed in future. By identifying high-risk patient populations before they incur costlier medical intervention, employers can begin to reduce both practice expenses and total NHS costs – Employers can gain access to additional data that can reveal practice population health levels and risks – Care coordinators glean information about patients’ treatment histories, medication adherence, new symptoms and management of chronic conditions.
Benefits to the wider NHS
Ensuring seamless service provision significantly decreases the risk of the patient deteriorating and thereby reduces the overall cost of care and the likelihood that additional interventions will be needed in future – By identifying high-risk patient populations before they incur costlier medical intervention, employers can begin to reduce both practice expenses and total NHS costs – Employers can gain access to additional data that can reveal practice population health levels and risks – Care coordinators glean information about patients’ treatment histories, medication adherence, new symptoms and management of chronic condition.
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