Long Term Conditions and Health/Wellbeing Coach

Manage and prioritise a caseload, in accordance with the health and wellbeing needs of the PCN population through taking an approach that is non-judgemental, based on strong communication and negotiation skills, while considering the whole person when addressing existing issues. Where required and as appropriate, the LTC and Health/Wellbeing Coach will refer people back to other health professionals within the PCN Utilise existing IT and MDT channels to screen patients, with an aim to identify those that would benefit most from health coaching Provide personalised support to individuals, their families, and carers to support them to be active participants in their own healthcare; empowering them to manage their own health and wellbeing and live independently through: Coaching and motivating patients through multiple sessions to identify their needs, set goals, and supporting patients to achieve their personalised health and care plan objectives Providing interventions such as self-management education and peer support; Supporting patients to establish and attain goals that are important to the patient; Supporting personal choice and positive risk taking while ensuring that patients understand the accountability of their own actions and decisions, thus encouraging the proactive prevention of further illnesses Working in partnership with the social prescribing service to connect patients to community based activities which support them to take increased control of their health and wellbeing Increasing patient motivation to self-manage and adopt healthy behaviours; Work with patients with lower activation scores to understand their level of knowledge, skills and confidence (their Activation level), when engaging with their health and well- being and subsequently supporting them in shared decision-making conversations Utilise health coaching skills to support people with lower levels of activation to develop the knowledge, skills, and confidence to manage their health and wellbeing, whilst increasing their ability to access and utilise community support offers Explore and support patient access to a personal health budget, where appropriate, for their care and support. Develop collaborative relationships and work in partnership with health, social care, and community and voluntary sector providers and multidisciplinary teams to holistically support patients wider health and wellbeing, public health, and contributing to the reduction of health inequalities Provide education and specialist expertise to PCN staff, supporting them to improve their skills and understanding of personalised care, behavioural approaches and ensuring consistency in the follow up of peoples goals with MDT input Raise awareness within the PCN of shared-decision making and decision support tools. Promote the service within the PCN, both for users and clinicians, building positive working relationships Playing an active role in MDT meetings if required (regular practice meetings to discuss high risk and / or complex patients) by gathering information and being prepared to update the team on patient progress towards goals etc. (as per their care plan) Actively collect and maintain data that will demonstrate patient improvement in key areas. Ensure delivery of best practice in clinical practice, caseload management, education, research, and audit, to achieve corporate PCN and local population objectives. Contribute to PCN meetings and Projects

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