The Role

Care coordinators provide extra time, capacity, and expertise to support patients, including the frail and the elderly, in preparing for clinical conversations or in following up discussions with primary care professionals. They work closely with the GPs and other primary care colleagues within the primary care network (PCN) to identify and manage a caseload of identified patients, making sure that appropriate support is made available to them and their carers (if appropriate), and ensuring that their changing needs are addressed. They can also support PCNs in the delivery of Enhanced Health in Care Homes.

Care Coordinators focus on the delivery of personalised care by bringing together all the information about a patient’s care needs and identified support; their role reflects local PCN priorities, health inequalities or at-risk groups of patients.

Benefits for the Practice

  • Supporting personalised care requirements, along with colleagues such as the Social Link Prescriber of Health & Wellbeing Coach.
  • Helping with administrative support
  • Identifying patients that may require additional support.

Benefits for the Patient

  • Supporting patients especially those with long-term conditions, mental health needs, older people and their families and carers by working with them and being a point of contact within the practice.
  • Reviewing patients’ needs and helping them access the services and support they require
  • Helping patients manage their own health and wellbeing,
  • Referring to social prescribing link workers, health and wellbeing coaches, and other professionals where appropriate.


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