Care Coordinators play an important role within a PCN to proactively identify and work with people, including the frail/elderly and those with long-term conditions, to provide coordination and navigation of care and support across health and care services. Care Coordinators could potentially provide extra time, capacity, and expertise to support patients in preparing for or in following-up clinical conversations they have with primary care professionals.

They will work closely with the GPs and other primary care professionals within the PCN to identify and manage a caseload of identified patients, making sure that appropriate support is made available to them and their carers and ensuring that their changing needs are addressed.

This is achieved by bringing together all the information about a person’s identified care and support needs and exploring options to meet these within a single personalised care and support plan, based on what matters to the person.

There are three PCN Care Coordinators. These roles are employed by Primary Care Doncaster.

Clinical Pharmacist work in primary care as part of the professional support team in a patient facing role to clinically assess and treat patients using expert knowledge of medicines for specific disease areas. They may be prescribers, or if not, can complete an independent prescribing qualification following completion of the 18- month Centre for Pharmacy Postgraduate Education (CPPE) pathway.

They work with and alongside the general practice team, taking responsibility for patients with chronic diseases and undertaking clinical medication reviews to proactively manage people with complex polypharmacy, especially for the elderly, people in care homes and those with multiple comorbidities.

The Senior Clinical Pharmacist for North PCN supervises the clinical pharmacy and pharmacy technician teams.  They work with Dr Sukhbinder Deepak who is a GP at Park View Surgery to devise and implement the PCN medicines plan.

Pharmacy Technicians play an important role within General Practice and complement the work of Clinical Pharmacists through utilisation of their technical skillset.

Mental Health Practitioners – From April 2021, every PCN was entitled to a fully embedded full-time mental health practitioner, employed and provided by the PCN’s local provider of community mental health services, as locally agreed. 50% of the funding will be provided from the mental health provider, and 50% by the PCN (reimbursable via the ARRS), with the practitioner wholly deployed to the PCN.

Mental Health Practitioners working in PCNs take on a ‘first contact’ role as this can reduce the workload of GPs in practices. The role will involve liaison with practice clinicians, as well as liaison with secondary care, social workers and voluntary sector staff, where appropriate, and making best use of third sector and other community opportunities for promotion of patient wellbeing and maintenance of mental health.

Physiotherapists are qualified autonomous clinical practitioners who can assess, diagnose, treat and manage musculoskeletal (MSK) problems and undifferentiated conditions and – where appropriate – discharge a person without a medical referral.

Physiotherapists working in this role can be accessed directly by self-referral or by staff in GP practices who can direct patients to them to establish a rapid and accurate diagnosis and management plan to streamline pathways of care.

Physiotherapists providing a first point of contact service means that patients presenting with a musculoskeletal problem for a GP appointment are offered an appointment with a physiotherapist instead. Physiotherapists working in general practice are able to address the needs of a large proportion of the patient population.

They have the clinical expertise and autonomy to assess, diagnose and treat patients with a range of conditions, including MSK, neurological and respiratory conditions.

Physiotherapists can help patients with musculoskeletal issues such as back, neck and joint pain; assessing and diagnosing issues, giving expert advice on how best to manage their conditions, and referring them onto specialist services as and when necessary. It has been estimated that MSK conditions alone account for around one in five GP appointments.

The North PCN is currently supported by four MSK First Contact Physiotherapists who are employed by Pure Physiotherapy which provides clinical supervision.