Job Responsibilities

• Responsible for day-to-day operation of Transitional Shared Care Programme (TSCP) for cardiology patients, including the following:
• Screen patients in cardiology clinics for suitability for TSCP based on entry criteria for each condition group.
• Approach clinician in‑charge of the patient to review patients suitability.
• Recruit patient into TSCP.
• Liaise with care coordinators in primary care settings (NUP, Primary Care Networks and GPs) for booking of follow‑up appointments.
• Communicate treatment targets of the patient with primary care partners.
• Coordinate follow‑up appointments at cardiology clinics.
• Provide necessary follow‑up with patients who defaulted the appointments.
• Provide support and health counselling to patients.

• Create database to trac...