Care Coordinator - Tonbridge Primary Care Network


Company:	NHS Jobs
Salary:	£13 to £14.50 an hour
Hours:	Full-time
Location:	Tonbridge, TN10 3ET
Job type:	Contract
Posting date:	13 Nov 2026
Closing date:	29 Nov 2026

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Summary

Use population health intelligence, risk stratification tools and clinical system searches to proactively identify and work with agreed cohorts of patients who may benefit from personalised care and support. Work with GPs and other primary care professionals to identify, coordinate and manage an agreed caseload of patients, particularly those living with frailty, people with multiple long-term conditions, care home residents, housebound patients and individuals with complex health and care needs. Support registered clinicians in coordinating Comprehensive Geriatric Assessments (CGA), including gathering relevant patient information relating to functional ability, mobility, falls history, activities of daily living, social circumstances and other agreed assessment areas. Bring together information about a person's identified health, care, social and wellbeing needs to support the development and review of a single personalised care and support plan (PCSP), ensuring that plans reflect what matters to the individual. Work with patients and carers to identify their priorities, understand their needs and explore appropriate options for support. Support the coordination and delivery of PCN multidisciplinary team meetings, particularly for patients with frailty, complex needs, care home residents and housebound patients. Arrange MDT meetings, coordinate dates, prepare agendas, identify patients for discussion in collaboration with the clinical team and circulate invitations and relevant patient information to appropriate professionals. Coordinate and maintain PCN clinic schedules across member practices, hub services and other relevant community settings. Manage patient bookings, cancellations, rebooking and appointment changes, ensuring clinic schedules and appointment systems are kept accurate and up to date.

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