The Active Wellbeing Society (TAWS) is a community benefit society and cooperative working to develop healthy, happy communities living active and connected lives.

Our vision is for a society where people have the autonomy, capacity, resources and skills to become the architects of their own destiny; where our individual wellbeing is recognised as being bound up in our collective responsibility to and dependency on each other; and where all of us feel empowered as agents of social change to make a difference – whether at an individual level or more widely.

By working collaboratively with communities we aim to bring about sustainable change on an social, environmental and economic level; to do the social knitting required to create stronger and more resilient communities and to support communities to identify, mitigate and remove the barriers that prevent them from living active and connected lives.

This is an exciting opportunity to be part of a Link Worker Team across the City working with 10 PCNs, as well as Our Health Partnership, one of the largest GP partnerships in the UK.  This post will be one of a team of two link workers in MOBY PCN, offering the chance for joint working and peer support at a PCN level as well as with the wider TAWS team. 

This will allow you to co-design a unique programme and manage referrals as part of a PCN link worker team.

The postholder will also benefit from a peer support infrastructure, working as part of the wider TAWS team, including physical and social activity delivery staff, the Big Feed Programme, community development teams to deliver the highest quality service to practices and patients. The Social Prescribing team are also supported by the Knowledge and Insight function within TAWS to assist with the design of data capture and impact reporting.

Main responsibilities:

1. Receiving, assessing, supporting and signposting patients to improve their wellbeing.
2. Working with the existing link worker, PCN and Practices to co-design a social prescription service that meets the needs of the patients and the practices
3. Working as part of a TAWS/PCN Link Worker team across the city to provide the highest quality service to patients, while being able to work as a team to share ideas, approaches to service delivery, knowledge and peer support to colleagues.
4. Promoting the referral uptake from within GP practices.
5. You will be providing a holistic assessment, co-designing a personalised social prescription to improve health and well-being outcomes for individuals with a longer-term outcome of reducing the number of clinical /medical interventions
6. The role will require managing and prioritising your own caseload, in accordance with the needs, priorities and any urgent support required by patients.
7. Supporting patients to take steps that improve their mental and physical wellbeing, as well as assisting them to access other services
8. Ensure the patient is supported, have basic safeguarding processes for vulnerable individuals and can provide opportunities for the person to develop friendships, a sense of belonging, and build knowledge, skills and confidence
9. Promoting social prescribing, its role in self-management, and the wider determinants of health.

Main outcomes to be delivered by the role:

1. To work within GP Practices to undertake GP referral and self-referrals and holistic assessments and co-design Health and Wellbeing Plans with individual service users, identifying support needs to ensure maximum engagement in improving health and well-being.
2. To provide personalised support to patients/service users with continuity and a co-ordinated experience of support, remaining a point of contact throughout the individual’s social prescription. To take a holistic approach, based on the person’s priorities and the wider determinants of health.
3. Meet patients on a one-to-one basis. Give people time to tell their stories and focus on ‘what matters to me’. Build trust with the person, providing non-judgemental support, respecting diversity and lifestyle choices. Work from a strength-based approach focusing on a person’s assets.
4. Ability and patience to help people over the phone and adjust to changing working environments.
5. To use knowledge of the third sector to accurately signpost and refer patients to appropriate support.
6. To follow up with patients and check that they have benefitted from your service.
7. To embed the link worker role and function within Primary Care Networks and the practices that sit within the network.
8. To ensure that practices have information about relevant services available to their patients
9. Where appropriate, physically introduce patients to community groups, activities and statutory services, ensuring they are comfortable. Follow up to ensure they are happy, able to engage, included and receiving good support.
10. To ensure all data, monitoring and evaluation is kept up to date and reported back as required, highlighting any issues that need resolving.
11. To provide regular reports detailing the progress of the service and updates as and when required by the GP surgeries working with the TAWS team.

Knowledge, skills and abilities

1. Ability to work as part of a team and great interpersonal skills.
2. Demonstration of previous use of initiative, integrity and empathy when supporting patients.
3. A comprehensive knowledge of the third sector and hands on experience dealing with housing, benefits, and mental health.
4. A community, health, social care, counselling or other relevant experience or professional or academic qualification.
5. A good understanding of a holistic approach to supporting patients in behavior change.
6. Skills and experience of providing empowering support to communities/adults in a planned and structured way to improve their health, recovery and well-being outcomes. A doing with rather than to attitude.
7. Knowledge and confidence when using programs such as excel. Knowledge of or ability to learn quickly how to use GP computer systems.
8. Finding new and innovative ways to keep records and report back progress and knowledge to TAWS and the PCN.
9. Proven skill in collating information and data on community resources and organising these in up-to-date and accessible formats for a range of different service users from various communities.
10. Excellent written, verbal, listening and presentation skills.
11. A proven understanding of safeguarding for children and vulnerable adults and ability to implement relevant policies and procedures.
12. The ability to work autonomously where needed and to plan, prioritise work under pressure and adapt to new models of working.
13. Ability to work hours in a flexible way, including occasional evenings and weekends to meet the needs of the service. The ability to work as part of the team to seek feedback, continually improve the service and contribute to business planning.
14. Duties may vary from time to time without changing the general character of the post or the level of responsibility.