Care Coordination Service

The care coordination service aims to keeps patients with complex health and care needs well at home.

You can access this service if you:

  • Are over 18 years old, have a GP in Ealing and live within 1 mile of the borough
  • Need help to find your way around different health and social care services
  • Have one or more long term conditions, for example, diabetes, asthma, chronic obstructive pulmonary disease (COPD), coronary vascular disease, Alzheimer’s disease or dementia.

How we help

Your care coordinator will:

  • Work closely with your GP, carers and family to ensure you receive the best possible care
  • Help you understand and get the best out of the health and social care system
  • Bring together the different services involved in your care, where needed
  • Help you communicate effectively with health and social care professionals involved in your care
  • Work closely with GPs’ social prescribing link workers who can help you access support from a range of local voluntary organisations.

We provide care at GP locations across Ealing’s 8 primary care networks (PCNs). PCNs are networks of GP practices and each PCN has a named care coordinator.

Referrals

You may be referred for care coordination by your GP or another healthcare professional.

For more information, please contact the community referral hub on 0300 1234 544 or email ealingcommunity.referrals@nhs.net

Return to Locality services (community nursing)