GP partner and Primary Care Network co-lead Dr David Coleman explains the role of a care co-ordinator in general practice and how it can support your Network team
The role of the care co-ordinator is a reasonably new one in the general practice sphere, one that is now being promoted with funding from the Additional Roles Reimbursement Scheme (ARRS).
When we met as a Primary Care Network (PCN) to discuss which ARRS positions we would like to advertise for, there was initially a degree of uncertainty regarding the value of care co-ordinators. Keen to reduce practice workload, the gut reaction was to look to clinicians who could directly take work away from hassled primary care teams and address the clinical aspects of the PCN DES.
We soon learned, however, that this work would need co-ordinating – across ten individual practices in our case, each with different administrative systems and approaches. There are even variations across our patch in terms of which clinical systems practices use. And it isn’t just arranging the work; it is ensuring that the completed tasks are coded appropriately and that a consistency of approach is present to ensure targets are achieved. We made the decision to take on three care co-ordinators, who started in post in September.
Practices have their own work to do and very limited capacity to take on extra work. Many have embraced PCN working, but others are rightfully cautious and keen to prioritise factors that protect their own income and expenditure. This is particularly pertinent in what has been a chaotic and challenging year. This is where the care co-ordinators come in, and where they can add significant value to the PCN; in doing so, they also directly and indirectly benefit the PCN’s member practices.
What does the role involve?
The care co-ordinators are key cogs in the PCN’s Multi-Disciplinary Team (MDT) and are responsible for managing the care of patients registered with the member practices. This means co-ordinating the work of both clinical (chiefly ARRS staff) and non-clinical (social prescribers, volunteers, etc.) team members involved in the care of these patients.
One of the cornerstones of the role is overseeing the care home MDT meetings. By acting as a focal point, the care co-ordinator can improve continuity of care by liaising with care home residents, staff, families and professionals (both MDT members and external specialists). The role here can mirror that of a cancer MDT co-ordinator in the hospital.
Care co-ordinators can also assist with other PCN DES activity as required by member practices. Our PCN has involved the three care co-ordinators in our learning disability annual reviews, for example. Early diagnosis of cancer work could be another avenue to explore.
In the coming months care co-ordinators can also play a key role in the COVID-19 vaccination programme. As expert administrators with strong communication and a growing awareness of the care home residents and learning disability population, they will be well placed to support the delivery of this vital campaign.
How can they benefit practices?
Member practices benefit from a successful PCN. Care co-ordinators have a vital role in ensuring coding is consistent and in tracking achievement to ensure PCNs are on track to hit targets. They have the oversight that individual practices won’t have time to focus on. A well organised PCN, achieving all its DES and Investment and Impact Fund (IIF) targets will generate more income which in turn supports more recruitment. Additional recruitment allows the PCN to further assist practices clinically, so it really is an ‘achieve now, benefit later’ scenario.
A well-oiled care home MDT with care co-ordinators acting as the go-to point should have a benefit on practices. We have found that since the care co-ordinators have taken over the weekly care home rounds, our receptionists no longer have to do the leg work liaising with the homes to find out about new residents, hospital admissions/discharges, and other clinical needs. As the co-ordinators know what is required, it means we don’t have to constantly keep the entire reception team briefed regarding changes in approach.
The same benefit is starting to be felt with the co-ordinators moving to oversee the learning disability register. They will take over recall for these patients, with a move towards ARRS staff performing these. This will create a cohort of skilled ARRS staff who can offer increased continuity of care for this population, while simultaneously freeing up our nursing team to focus on other areas.
What is the pay-scale?
Care co-ordinators are paid at Agenda for Change band 4 (£21,892–£24,157 outside London, £22,987–£28,898 in London), with a maximum reimbursable amount per role under the ARRS of £29,135. There is no limit on the number of co-ordinators recruited. We have three care co-ordinators for our PCN of 66,000. This seems to be an appropriate number, which allows for a degree of cross-cover in case of annual leave/sickness.
Importantly it was one of the easiest roles to recruit, with a far bigger pool of suitable candidates to choose from than with many of the other new ARRS roles.
What qualifications and skills they need?
Appropriate candidates may come from a variety of backgrounds, but essentially a degree of NHS or social care experience, a business administration qualification, strong IT and communication skills and an ability to be organised and work independently are vital. If recruits don’t already have it, they will require essential training such as equality and diversity, safeguarding children and adults (level 2 should be sufficient for the role), PREVENT training, and Mental Capacity Act training. This is not an exhaustive list and other training may be required dependent on roles undertaken.
Are there any drawbacks?
One potential area of difficulty would be if member practices did not agree on the care co-ordinators duties. Some practices feel uncomfortable relinquishing control of certain tasks; it is important that the PCN leadership makes the goals and vision clear to all members in an effort to bring them on the journey, rather than simply try to push a plan through. Timescales are tight and we are all very busy, so this can be trickier than it sounds. But once everyone is on board, the benefits of the role should be clear for all to see and appreciate.
Summary of care co-ordinator role
Dr David Coleman is a GP partner and Primary Care Network co-clinical director in south Yorkshire
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