Care Coordination Service
What is the Care Co-ordination Service (CCS)?
The Care Co-ordination Service will give extra support to those that need it the most. The CCS will work with you to make a plan for your future care that will centre on your goals for your health and well-being as well as what actions you can take to achieve them. We can then work as a team to support you to complete your actions.
The Care Co-ordination Service (CCS) will help the GP Practice and you by:
- Helping to create a care plan tailored to your needs and goals
- Booking and co-ordinating your appointments
- Referring you to the services identified in your care plan
- Being a single contact point for all of your referral, care plan and co-ordination queries
- Assisting you in better maintaining and improving your health and wellbeing
- Checking in with you regularly to see how you are getting on and providing encouragement
- Extra support those who feel their health is getting worse and needs help to improve or maintain it
- Assistance for anyone who is struggling to co-ordinate care for themselves/someone they care for
Who is eligible for this service?
All patients can access CCS to assist them in booking referral appointments in the same way as the now discontinued Patient Referral Service. Extra support through proactive care will be provided to:
- Anyone over the age of 65 years
- Anyone over the age of 18 who has one or more long-term condition
- Anyone whose clinician agrees they would benefit from the service
How can I get the extra support through CCS?
There are two ways:
- Your Practice will contact you as they think you might benefit from the extra help. It will be your decision whether you want to accept the support they offer
- Ask your GP about the service and discover whether it can be offered to you
If you would like to find out more about this service you can contact us on 0333 200 1234 or by emailing us at email@example.com
Primary Care Plus
What is PCP Mental Health Service?
Primary Care Plus (PCP) Mental Health Service is a new service provided by Central London Healthcare. The team provide support to people with mental health related conditions ranging from mild depression to more serious conditions. We offer patients more choice of treatment methods as well as easier and faster access to treatment at a time when it’s most needed.
The PCP Team
The Team is made up of Primary Care Liaison Nurses, a Social Worker and Community Navigators, who triage all referrals and support patients discharged from specialist to primary care. It ensures patients receive the right level of care and support at all stages of their treatment process.
If you would like to find out more about this service you can contact us on 0207 535 8330 or email us at firstname.lastname@example.org or download the Patient Leaflet
Community Independence Service
What is the Community Independence Service (CIS)?
CIS delivers unplanned care to patients via two pathways:
- Rapid Response: for urgent help to support acute illness in the community when it is safe and appropriate to do so (response within 2 hours with input for up to 5 days).
- Rehabilitation and reablement (offered for up to 6 weeks). Rehabilitation provides physical and occupational therapies for housebound people to enable them to achieve functional goals and improve their independence. Reablement services are provided in the home to help a person gain confidence and re-learn the skills to carry out daily activities and practical tasks.
- The CIS Liaison service also works within A&E departments and pre admission units to determine if people can be better supported at home or by other non- emergency services rather than through hospital admission.
The CIS Partnership
The 3 Borough Community Independence Service - is about integrating care faster and more thoroughly by drawing on the talents and experience of all in health and social care across the tri-borough to provide the best service for patients.
- London Central and West Unscheduled Care Collaborative
- Central London Healthcare
- London Medical Associates – West London GP Federation
- Central and North West London NHS Foundation Trust
- West London Mental Health NHS Trust
- Local Authorities in the City of Westminster, Kensington & Chelsea and Hammersmith and Fulham.
Please see further details on how to make a referral here: http://www.cnwl.nhs.uk/service/cis-community-independence-service/
Our Single Point of Referral number is: 0300 033 0333