Integrated Care Fact Sheet
patients with multiple health problems find themselves working with different
professionals for different bits of their health and social care. The professionals
often focus on just their area of expertise rather than the whole person. The
Ealing Integrated Care Programme plans to change that. It aims to make sure
that patients with one or more long-term condition (like diabetes, mobility
issues, hearing loss, heart conditions, cancer, learning disabilities etc.)
have a well-informed team of people looking after their whole health and
wellbeing. This is done by assigning them a Care Coordinator.
Coordinator works with all the people involved in caring for someone and
helping them remain independent at home. They coordinate that team of
professionals in a way that works well
Who Is The Service For?
over 18, with one or more long term health condition.
was chosen because they rely so heavily on NHS services.
A Joint Care
Team could include the patient’s GP, specialists for particular health
conditions, social workers, friends, family, carers and local community
services. Together with the patient they design and follow a shared care plan.
How Can A Person Access The Service?
Care Coordinators are referred to patients by the individual’s GP.
All Ealing GP's are now part of the scheme
information will updated as the service is rolled out across Ealing
Download the Integrated care briefing from here