• Act as a central point of contact for health and social care professionals within the Integrated Neighbourhood Team (INT). 

• Communicate effectively with GPs, acute hospital staff, Social Services, community teams, allied health professionals, voluntary organisations, patients, carers and families. 

• Exchange factual and sensitive information professionally, maintaining confidentiality at all times. 

• Facilitate and support multidisciplinary team (MDT) meetings by preparing agendas, circulating documentation, recording minutes and monitoring actions. 

• Liaise with acute hospitals to support admission avoidance and timely discharge planning. 

• Communicate service capacity information and operational updates to stakeholders across multiple organisations. 

• Provide information, guidance and signposting to patients, carers and professionals regarding available services and support pathways. 

• Escalate concerns relating to safeguarding, deterioration in patient condition, telehealth alerts or other risks in accordance with organisational procedures. 

• Maintain clear and effective communication through telephone, email, digital systems and face-to-face interactions. 

• Collect, analyse and interpret service activity data from multiple systems. 

• Maintain spreadsheets and databases and produce reports to support service monitoring, evaluation and commissioning requirements. 

• Monitor hospital admissions, discharges and service utilisation, identifying trends and communicating relevant information to MDT members. 

• Use established criteria to identify referrals, pathways and patient cohorts requiring intervention. 

• Exercise judgement when managing enquiries and determining the appropriate service, professional or agency for referral or escalation. 

• Support the analysis of telehealth activity and outcomes to inform service improvement and planning. 

• Produce data reports and summaries for presentation at multidisciplinary meetings. 

• Coordinate multidisciplinary care arrangements and community support interventions for patients receiving enhanced care services. 

• Organise MDT meetings, case reviews, home visit schedules and associated administrative processes. 

• Manage referrals and coordinate patient pathways across multiple organisations and services. 

• Prioritise and manage a complex workload independently, responding to changing service demands and competing priorities. 

• Support the planning and coordination of admissions to and discharges from enhanced care services. 

• Ensure appropriate services, equipment and support are available at the right time to facilitate safe patient care. 

• Work flexibly across acute and community settings to meet service requirements. 

• Coordinate telehealth installations, removals and support activities where required. 

• Provide non-clinical coordination support to patients receiving integrated health and social care services. 

• Support the delivery of agreed care plans through effective coordination of services and professionals. 

• Facilitate multidisciplinary involvement in patients' care and treatment pathways. 

• Coordinate home visits and community interventions as directed by clinical teams. 

• Support the delivery of prescribed equipment and medication under clinician direction. 

• Contribute to admission avoidance and early supported discharge initiatives through effective care coordination. 

• Provide patients and carers with information about services and support available within the community. 

• Adhere to Trust policies, procedures, information governance requirements and data protection legislation. 

• Ensure accurate and timely recording of information across all relevant systems. 

• Contribute to the integration of health and social care services through standardised processes and effective information sharing. 

• Support compliance with safeguarding, confidentiality and risk management policies. 

• Participate in service monitoring and evaluation processes through the production of activity and outcome reports. 

• Escalate incidents, risks and governance concerns in accordance with Trust procedures. 

• Contribute to quality improvement initiatives aimed at reducing duplication and improving integrated working. 

• Order equipment and resources required to support patient care and service delivery. 

• Coordinate the distribution and retrieval of telehealth equipment. 

• Maintain accurate records relating to equipment allocation and usage. 

• Support efficient use of health and social care resources by ensuring timely coordination of services. 

• Handle and manage supplies and equipment in accordance with organisational procedures. 

• Contribute to monitoring resource utilisation through data collection and reporting activities. 

• Coordinate activities across multidisciplinary teams to support effective integrated care delivery. 

• Provide information, advice and guidance to colleagues regarding processes, pathways and available services. 

• Support new team members in understanding administrative processes and information systems as required. 

• Act as a key administrative resource for the Integrated Neighbourhood Team. 

• Promote collaborative working relationships across health, social care and voluntary sector organisations. 

• Contribute to service development through sharing knowledge, identifying improvements and supporting implementation of agreed changes.

This involves working with all health and social care professionals, as well as statutory/non statutory agencies, to provide a seamless, integrated service to our service users.  You will be required to work flexibly between the acute and community sites as the role dictates; own transport will be needed for this.