The Care Coordination Service helps adults with complex health and care needs stay well at home.
This service is designed for people over 18 who have a GP in Ealing and live within 1 mile of the borough. If you have one or more long-term conditions (such as diabetes, asthma, COPD, coronary vascular disease, Alzheimer’s, or dementia), and need help navigating health and social care services, this service is here for you.
What we offer:
- Personalised support from a named care coordinator who works closely with your GP, carers, and family.
- Help understanding and making the most of health and social care systems.
- Coordination of different services involved in your care, ensuring everyone works together for your benefit.
- Support with communicating effectively with health and social care professionals.
- Collaboration with social prescribing link workers to connect you with local voluntary organisations and community support.
Care is provided at GP locations across Ealing’s 8 primary care networks (PCNs), with each PCN having a dedicated care coordinator.
How to access the service:
- You can be referred by your GP or another healthcare professional.
- Sometimes, the team may proactively offer support if your needs are identified through your use of health and care services.
- GPs can access referral forms via SystmOne and send them to the referral hub.
Contact us for more information or to discuss a referral:
- Phone: 0300 123 4544
- Email: ealingcommunity.referrals@nhs.net
There is no cost for this NHS service.
Categories:
Leaving hospital
Drugs advice and support
Carers support groups
Health advice
Healthy lifestyle
Information and advice
Managing a long-term health condition
Services for older people
Support for carers
Support with housing
Transport and getting around