Care Coordinator and Senior Administrator

Job description

Job responsibilities

Key duties and responsibilities

Care coordination patient tracking and pathway

Maintain the Tier 2 caseload tracker in real time, ensuring every patient on the pathway has a named clinician, an agreed follow-up plan and an accurate risk stratification recorded.

Process new referrals into Tier 2 from primary care, from the existing LCH community waiting-list triage, and as step-down from Tier 4 within agreed SLAs (24 hours acknowledgement for urgent referrals; one week for routine).

Process step-up referrals from Tier 2 into Tier 3 MDT discussion and into Tier 4 specialist pathways, ensuring the correct information accompanies each referral.

Book patients into structured education courses (DAFNE, Confidence with Carbohydrates, DESMOND or equivalent) and into the National Type 2 Path to Remission Programme (Xyla).

Track patient movement through step-up and step-down decisions, ensuring the caseload tracker reflects each transition accurately.

Escalate concerns to the Tier 2 clinical lead when a patient appears to have fallen out of the pathway, has repeated DNAs, or is showing signs of clinical deterioration.

Care coordination patient contact and engagement

Act as a named point of contact for patients on the Tier 2 caseload for practical queries about appointments, transport, interpreters, reasonable adjustments and referral progress.

Coordinate patient communication letters, SMS, phone and digital in line with patient preference and accessibility needs.

Undertake proactive DNA follow-up phoning patients who miss appointments, understanding the barrier, and rebooking rather than discharging where clinically appropriate.

Support outreach to deprivation deciles 13 and named priority groups, working alongside VCSE partners, care navigators and community connectors.

Arrange interpreters, easy-read information and other reasonable adjustments for patients with additional communication needs.

Signpost patients to VCSE and community delivery partners for wider wellbeing, food access, welfare and social support.

MDT and joint-clinic coordination

Coordinate the Tier 2 MDT fortnightly for complex / high-risk cases and 812 weekly for moderate cases including diary invitations, agenda preparation, case-list circulation and minute-taking, and follow-up of MDT actions.

Coordinate the Tier 2 team's contribution to the weekly Tier 3 Clinical Oversight Group MDT, combined with the existing LTHT community diabetes MDT.

Coordinate quarterly joint clinics between the Tier 2 team and the Practice Diabetes Lead in each footprint practice booking clinic slots, sharing case lists in advance and following up on actions.

Coordinate the quarterly TARGET education sessions for Practice Diabetes Leads room booking, attendance, materials and evaluation returns.

Administrative support to the clinical team

Diary management for the Tier 2 team including the Clinical Lead Nurses, Specialist Pharmacist, Specialist Dietitian, Specialist Podiatrist and the Nurse development post.

Correspondence drafting and processing letters to patients, GPs, hospital colleagues and partner agencies; preparing standard letter templates.

Preparation and formatting of clinical, education, service-development and quality-improvement documents.

Meeting support beyond MDT arranging team meetings, workshop days, service planning and workforce meetings; taking and circulating minutes.

Interface with SEL GP corporate services on HR, payroll, procurement and IT queries on behalf of the Tier 2 team.

Ordering supplies, room bookings, travel arrangements and expenses management for the Tier 2 team.

Cover for absent colleagues within the wider SEL GP administrative team where required.

Digital, data and records

Accurate and timely data entry into EMIS and SystmOne, in line with the Programme's data-quality standards and the specification cohort criteria.

Maintain the Tier 2 caseload tracker workbook and support the Programme Manager to generate weekly and monthly reports.

Support the Programme's outcomes and evaluation framework by preparing structured search outputs, dashboards and reports for the Tier 2 team.

Compliance with the Data Protection Act (2018), the Access to Health Records Act (1990) and SEL GP's information-governance policies.

Compliance with Caldicott principles for confidentiality and information sharing.

Attend digital training as required and act as a super-user for administrative aspects of EMIS / SystmOne within the Tier 2 team.

Communication and liaison

Answer telephone and digital enquiries into the Tier 2 team from patients, primary care, hospital colleagues and VCSE partners escalating clinical queries appropriately.

Provide a welcoming, respectful and inclusive first point of contact for the Tier 2 team.

Liaise closely with practice administrative teams at each Tier 1 practice, and with LTHT and LCH administrative teams for interfaces at Tier 4.

Support the Tier 2 team's engagement with VCSE partners diary coordination, minute-taking and follow-up.

Communicate complex or sensitive information with tact, discretion and empathy, adapting language and format to the audience.

Team support and quality improvement

Contribute to team meetings, service reviews and continuous improvement activity within the Tier 2 team.

Contribute to quality improvement projects and clinical audit identifying searchable cohorts, running structured searches, preparing data and presenting findings alongside clinical colleagues.

Provide induction support for new team members on Tier 2 administrative and care-coordination processes.

Support the delivery of the Programme's Year 1 evaluation and Year 2 business-case preparation.

Suggest improvements to administrative and care-coordination processes based on day-to-day experience.

Care Quality Commission, health and safety, and confidentiality

Work with the delivery partners to ensure Programme administrative activity is compliant with CQC standards.

Comply with Health and Safety policies, follow safe working procedures and report incidents through the organisations Incident Reporting Systems.

Comply with the Data Protection Act (2018) and the Access to Health Records Act (1990); respect patient confidentiality at all times.

Understand and apply the safeguarding role appropriate to a senior administrative role recognising concerns and escalating to a clinical colleague or safeguarding lead.

Continuing personal and professional development

Undertake continual personal and professional development, including mandatory training and any additional training identified through appraisal.

Take up development opportunities aligned to your role for example NVQ Level 3 in Business Administration or Customer Service, Care Certificate elements relevant to care coordination, or apprenticeship pathways towards senior administration or care-coordination roles.

Access regular supervision and support the Programme's supervision and reflective-practice culture.

Special working conditions

The post-holder will be based in the community across the Beeston and Middleton & Hunslet footprint, with occasional travel between practices, community sites and system-partner offices.

Working days may include periods of concentrated administrative work, telephone contact with patients and structured MDT / clinic support.

The post-holder may experience occasional distressing conversations for example when contacting patients in difficult social circumstances, or when discussing missed appointments or clinical concerns and will be supported through structured supervision.

Person Specification

Other requirements

• Meets DBS reference standards and has a clear criminal record, in line with the law on spent convictions.
• Adaptable.
• Works effectively independently and as a team player.
• Self-motivated.
• Up to date with safeguarding and other mandatory training.
• Up to date immunisation status.
• Ability to work in different locations across the footprint and to help provide cover for absent colleagues; ability to take part in an extended working day in line with the models flexible-access commitment.
• Access to own transport or reliable means to travel across the multi-neighbourhood footprint.

Skills and knowledge

• Excellent written and verbal communication skills, adapting to a wide range of audiences.
• Excellent organisational skills; able to plan, prioritise and manage a varied workload.
• Competent IT skills including Microsoft Office (Word, Excel, PowerPoint, Outlook, Teams).
• Ability to accurately enter, extract and interpret patient information from clinical systems.
• Understanding of the principles of confidentiality, information governance, safeguarding and Caldicott principles.
• Understanding of the wider determinants of health and their impact on communities.
• Ability to remain calm, respectful and professional in emotionally challenging situations.
• Ability to work autonomously within scope, escalating clinical or safeguarding concerns appropriately.
• Attention to detail and accuracy in data entry, correspondence and record keeping.
• Ability to gain acceptance for recommendations and to influence colleagues to comply with agreed processes.

• Understanding of the Leeds Proactive Care and Integrated Neighbourhood Health frameworks.
• Understanding of quality improvement methodology.

Qualifications

• GCSE English and Mathematics at Grade C / 4 or above (or equivalent).
• NVQ Level 3 in Business Administration, Customer Service, Health and Social Care, or equivalent qualification or equivalent experience.
• Willing to undertake any relevant training identified to develop skills required to carry out duties, including safeguarding, information-governance and digital training.

• Care Certificate.
• Additional qualification or training in care coordination, health navigation, patient experience or equivalent role.
• ECDL, Microsoft Office Specialist or equivalent digital-skills qualification.
• Formal training in health inequalities, trauma-informed care or behaviour-change approaches such as Making Every Contact Count.
• Foundation-degree level study or apprenticeship pathway relevant to health administration or care coordination.

Experience

• Substantial experience in an administrative or care-coordination role in the NHS, general practice, social care or a comparable setting.
• Experience of working with clinical or administrative systems such as EMIS, SystmOne or equivalent.
• Experience of telephone and digital contact with patients or service users, including handling sensitive or difficult conversations.
• Experience of arranging meetings, taking accurate minutes and following up actions.
• Experience of maintaining accurate records and trackers, and generating reports from them.
• Experience of working alongside a clinical multidisciplinary team.
• Experience of working with people affected by health inequalities.
• Experience of work involving diary management, correspondence and general office administration.

• Experience of care coordination, patient tracking or pathway management in a clinical setting.
• Experience of working with VCSE, community or asset-based partners.
• Experience of contributing to quality improvement, clinical audit or service evaluation.
• Experience of preparing dashboards, reports or presentations for a team.
• Experience of supporting or supervising new or less experienced staff.

Personal Qualities & Attributes

• Commitment to reducing health inequalities and proactively working to reach people from all communities.
• Person-centred, trauma-informed approach with a working understanding of the wider social determinants of health.
• Ability to communicate with a wide range of colleagues from the NHS and other organisations, and with patients and their families including good written and oral communication skills.
• Recognises personal limitations and refers to more appropriate colleagues when necessary.
• Able to work under pressure and meet deadlines, managing unpredictable service demands.
• Emotional resilience, self-awareness, humility and curiosity.
• Reliability and integrity in a small MDT where the model depends on trust and close working relationships.
• Ability to organise, plan and prioritise on own initiative with minimal supervision.
• Ability to work flexibly and enthusiastically within a team or on own initiative.
• Comfortable with the ambiguity of a new service willing to iterate, evaluate and adjust.
• Positive and flexible attitude to change; able to respond to changing needs in an appropriate and timely manner.
• Genuine empathy for people whose lives are shaped by health inequalities.
• Cultural competence for supporting patients across the diverse populations of south and east Leeds.
• Confident to challenge and to be challenged in the patients best interest.

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Disclosure and Barring Service Check

This post is subject to the Rehabilitation of Offenders Act (Exceptions Order) 1975 and as such it will be necessary for a submission for Disclosure to be made to the Disclosure and Barring Service (formerly known as CRB) to check for any previous criminal convictions.

Employer details

Employer name

South and East Leeds GP Group

Address

Hosted Employers address

1st Floor Park Edge Practice

Asket Drive

Leeds

West Yorkshire

LS14 1HX

United Kingdom

Employer's website

https://www.seleedsgpgroup.nhs.uk/