Neighbourhood Care Coordinator

Support patients and carers by coordinating personalised care plans and facilitating access to health, social care, and voluntary services.

Manage referrals, patient caseloads, and MDT documentation, monitoring patient pathways and outcomes.

Act as the key liaison between GPs, primary care, hospitals, community, mental health, social care, and voluntary organisations to ensure integrated care.

Support system navigation, escalate complex cases, and help remove barriers to effective service delivery.

Maintain accurate patient records using EMIS, SystmOne, and other clinical systems, ensuring compliance with GDPR and safeguarding requirements.

Contribute to service improvement by identifying gaps, monitoring outcomes, and supporting quality initiatives.

Organise stakeholder engagement, training, networking, and community events to promote neighbourhood working.

Build positive relationships with patients, carers, colleagues, and partner organisations, providing professional and compassionate support.

Work flexibly across neighbourhood teams, providing cross-cover and supporting the continuous development of integrated care services.

The Neighbourhood Care Coordinator is responsible for coordinating integrated, person-centred care across health, social care, and voluntary sector services. Working closely with GP Neighbourhood Representatives, Primary Care Networks (PCNs), multidisciplinary teams (MDTs), and community partners, the post holder will support patients with complex needs by coordinating care pathways, facilitating communication between agencies, and ensuring timely access to appropriate services.

The role involves organising and coordinating MDT meetings, managing referrals and patient caseloads, maintaining accurate clinical records, and supporting personalised care planning. The post holder will act as a central point of contact for patients, carers, healthcare professionals, and partner organisations, ensuring seamless communication and collaborative working across the neighbourhood.

The Neighbourhood Care Coordinator will contribute to service improvement by monitoring patient outcomes, identifying gaps in care, supporting quality improvement initiatives, and promoting integrated neighbourhood working. The role also includes organising stakeholder engagement activities, networking events, and community outreach to strengthen partnerships and improve access to local services.

This is a dynamic role requiring excellent organisational, communication, and problem-solving skills, with the ability to work flexibly across multidisciplinary teams while maintaining a compassionate, patient-centred approach to care.

Together First CIC is a community interest company that brings together 31 GP practices across Barking & Dagenham to deliver services at scale for the local population. The organisation works collaboratively to support general practice sustainability while improving access to care. Together First CIC provides a range of services on behalf of the borough, including extended hours GP appointments, diagnostic services, and vaccination programmes, with a strong focus on quality, equality, and continuous improvement.

Experience

Desirable: - Prior experience working within a Primary Care Network (PCN) or integrated multi-agency care setting.

Qualifications

Essential: - NVQ Level 3 in Health and Social Care, or equivalent qualification / equivalent administrative and practical experience.

Desirable: - Specialist interest qualification in health, social care, or integrated working.