Health & Wellbeing Coach (Frailty) in Stockport inStockport PUBLISHED MON 10 NOV 2025 Jump to job information section

Job summary
The Health &Wellbeing Coach (Frailty) will support the proactive identification, preventionand management of frailty across the Bramhall & Cheadle Hulme PCNpopulation. The postholder will provide holistic assessments, personalisedwellbeing planning, and motivational coaching interventions that empowerpatients to remain independent and improve their quality of life.Working closely withthe PCN's multidisciplinary teams (MDT), community partners and care homes, therole will contribute to reducing falls, avoidable hospital admissions, andinequalities in health outcomes.This role plays a keypart in delivering the PCN'sHealthy Futures Programmepromotingindependence, early intervention, healthy ageing and community wellbeingthrough proactive, person-centred, and digitally enabled care.

Main duties of the job
Undertake holistic assessments of physical, emotional, social and environmental needs. Manage caseloads from practices and new referrals.Perform blood pressure checks and venepuncture where trained. Carry out falls risk assessments and co-develop care plans with GPs and advanced clinical practitioners.Use digital monitoring tools to support independence, mobility and wellbeing. Educate patients to recognise early signs of deterioration to prevent crises and admissions. Provide person centred health coaching, supporting self management, goal setting and behaviour change.

Address
nutrition, hydration, home safety, mental wellbeing, social isolation and financial security.Facilitate group coaching and encourage peer support networks. Support care homes with falls prevention, mobility and wellbeing reviews, staff training, environmental checks and equipment provision.Work with the multidisciplinary team, secondary care, local authority and voluntary services to ensure continuity of care.Deliver Healthy Futures health checks covering cardiovascular, cognitive and frailty domains.Capture outcomes and contribute to service evaluation, improvement and population health objectives.Comply with governance, safeguarding, confidentiality and data protection.

About us
Bramhall and Cheadle Hulme Primary Care Network (PCN) is a thriving network of GP practices located in the Stockport area, committed to delivering high-quality, patient care. We aim to provide innovative and coordinated care, enhancing services for patients while promoting preventative healthcare and managing long-term conditions.Our network is built on strong collaboration between member practices, local health services, and community partners. By working closely together, we aim to streamline patient care and improve access to essential services.

Details

Date posted
10 November 2025

Pay scheme
Other

Salary
£31,051 a year

Contract
Permanent

Working pattern
Full-time

Reference number
A4536-25-0Job location
sCheadle Hulme Medical Group11 Ladybridge RoadStockportSK8 5LLBramhall Health Centre66 Bramhall Lane SouthBramhallStockportCheshireSK7 2DYThe Village Surgery31 Bramhall Lane SouthBramhallStockportCheshireSK7 2DNBramhall & Shaw Heath Medical Group235 Bramhall Lane SouthBramhallStockportCheshireSK7 3EPHulme Hall Medical Group Handforth166 Wilmslow RoadHandforthWilmslowCheshireSK9 3LF

Job description

Job responsibilities
Clinical and Functional SkillsUndertake comprehensive holistic assessments that are typically 60 to 90 minutes, exploring physical emotional social and environmental needsManage a defined caseload from each practice plus new referrals generated from triage lists frailty registers and LCS Falls & Fractures dataPerform blood pressure checks and venepuncture where trained and delegatedCarry out falls risk assessments and co-develop care plans in collaboration with GPs and advanced clinical practitionersImplement digital monitoring tools to support independence mobility and wellbeingEducate and empower patients to recognise early signs of deterioration or mobility changes preventing crisis episodes and hospital admissionsContribute to proactive health screening and lifestyle interventions including bone health hydration nutrition and physical activity promotionHolistic Wellbeing and CoachingProvide person centred health coaching to support self management goal setting and positive behaviour change

Address
key wellbeing determinants including nutrition hydration home safety mental wellbeing social isolation and financial securityInitiate advance care planning discussions and promote the use of tools to record preferences and wishesUse motivational tools to encourage patients to visualise progress and goalsSignpost or refer patients to appropriate internal or external services including social prescribers dementia support welfare advice community groups podiatry or dieteticsFacilitate group coaching sessions and community based workshops on healthy ageing falls prevention resilience building and physical activityEncourage peer to peer support networks among older adults promoting social connectedness and shared learningActively contribute to digital inclusion supporting patients and carers to use technology for health monitoring appointments and social connectionEmbed the Healthy Futures ethos by focusing on supporting independence hope and purpose in later lifeProvide support to patients on the gold standards framework register contributing to proactive end of life care planningCare Home and Community SupportProvide proactive input to local care homes focusing on falls prevention mobility and wellbeing reviewsReview care plans conduct environmental safety checks and ensure appropriate equipment provisionStrengthen communication and shared learning between care homes community services and primary care network cliniciansSupport staff training or awareness sessions in care homes around hydration nutrition and recognising early signs of frailty or infectionDevelop links with voluntary and community groups to offer outreach wellbeing sessions in community venues such as libraries leisure centres or sheltered housingChampion small sustainable behaviour changes that help residents maintain mobility and purpose aligned with the Healthy Futures prevention first approachCollaborative and System WorkingWork as an integral member of the primary care network multidisciplinary team alongside GPs advanced clinical practitioners nurses social prescribers and care coordinatorsCollaborate with secondary care local authority and voluntary sector organisations to ensure seamless support and continuity of careContribute to the development of frailty pathways population health initiatives and service evaluation within the primary care networkMaintain accurate and timely documentation using approved clinical systemsParticipate in Healthy Futures working groups and contribute to primary care network wide initiatives such as active ageing weeks health promotion campaigns or targeted outreach in identified neighbourhoodsAct as a community connector strengthening relationships between health care and community assets to build resilience and reduce dependency on clinical servicesShare learning and insight across practices to support proactive care planning digital innovation and continuous improvementContribution to Healthy Futures ProgrammeDeliver proactive Healthy Futures health checks for adults covering cardiovascular cognitive and frailty domains in both GP practices and community venuesUndertake and record baseline measures such as blood pressure BMI mobility tests mood and lifestyle indicators escalating clinical findings as appropriateSupport early detection of cardiovascular risk frailty dementia and falls through structured screening toolsProvide lifestyle advice and motivational coaching to empower patients to make sustainable behaviour changes promoting independence and self managementParticipate in community outreach to engage older adults who rarely access primary care tackling social isolation and health inequalitiesContribute to population level risk stratification identifying low moderate and high risk categories and ensuring appropriate follow up or GP referralCollaborate with health care assistants nurses pharmacists social prescribers and the wider multidisciplinary team to ensure joined up delivery of Healthy Futures interventionsSupport delivery of Healthy Ageing Clinics within practices and community settings ensuring every patient receives a person centred holistic

Experience
Capture outcomes patient feedback and activity data aligned to Healthy Futures key performance indicators including completion rates referral outcomes and patient satisfaction measuresContribute to service evaluation continuous improvement and scaling of Healthy Futures activities across the primary care networkAct as an ambassador for prevention and proactive care promoting the Healthy Futures vision of living well for longer across all primary care network programmesProfessional Development and GovernanceWork under the supervision of the primary care network operations manager and clinical director with clinical guidance from the advanced clinical practitioner teamParticipate in regular supervision reflective practice and annual appraisalUndertake relevant continuing professional development in frailty health coaching and personalised careComply with all governance safeguarding confidentiality and data protection requirementsActively contribute to primary care network quality improvement and service evaluation processesPerformance and OutcomesSupport the primary care network in developing measurable outcomes for frailty work including falls reduction improved wellbeing and enhanced patient

Experience
Capture and share qualitative outcomes patient stories and feedback to evidence impactContribute to the primary care network population health management and personalised care objectives

Job description

Person Specification

Experience
Essential

Experience
in healthcare, primary care, community or voluntary sector roles supporting older or vulnerable adults

Experience
conducting holistic assessments and developing individual care or well-being plans

Experience
of multidisciplinary team working

Experience
supporting patients to set and achieve personal goalsDesirable

Experience
within a Primary Care Network or NHS frailty programme

Experience
working in care homes or with housebound patients

Experience
in service evaluation, QI or audit

Qualifications
EssentialGCSE or equivalent English and Maths Grade C/4 or aboveAccredited Health & Wellbeing Coach qualification or willingness to complete within 12 monthsEvidence of training in health coaching, motivational interviewing or behaviour changeFull UK driving licence and access to a vehicle for home and care home visitsDesirableAdditional training in frailty, falls prevention, dementia care or occupational therapy assistant skillsDigital health tools or telehealth trainingKnowledge / Skills / AttributesEssentialExcellent communication and interpersonal skillsAbility to motivate, coach and empower patientsStrong organisational and time management skills; able to manage own caseloadIT literacy - Microsoft Office, EMIS/SystmOne or similar systemsUnderstanding of frailty, ageing, falls risk and social determinants of healthAwareness of safeguarding and confidentiality principlesDesirableKnowledge of the Rockwood Frailty Scale, Advance Care Planning and NHS Personalised Care frameworks

Experience
using digital health or remote monitoring devicesFamiliarity with local community and voluntary sector resourcesPersonal qualitiesEssentialCompassionate, patient-centred and non-judgementalProactive and self-motivated, with the ability to work independently and collaborativelyAdaptable to evolving PCN and service prioritiesCommitment to professional growth and PCN valuesDesirableAbility to contribute to service innovation, training or peer support

Experience
Essential

Experience
in service evaluation, QI or auditAdditional informationEssentialFull-time (37.5 hours per week).The role requires flexibility across all Bramhall & Cheadle Hulme PCN practices and care home settings.The post is subject to an enhanced DBS check.The

Job description
and

Person Specification
will be reviewed annually to reflect service development and PCN priorities.

Person Specification

Experience
Essential

Experience
Essential

Job description
and

Disclosure and Barring Service Check
This post is subject to the Rehabilitation of Offenders Act (Exceptions Order) 1975 and as such it will be necessary for a submission for Disclosure to be made to the Disclosure and Barring Service (formerly known as CRB) to check for any previous criminal convictions.Employer

Details