What is coordinated care?

People receiving Anticipatory Care should have a named care coordinator who can help them understand and navigate the care and support being delivered by a range of professionals and act as a single point of contact.

Care coordinators can help people take an active role in decisions about their care and liaise with professionals on their behalf, via the Multi-Disciplinary Team (MDT).

How do you do it?

Ideally an individual’s care coordinator should be one person who doesn’t change through the period of their care.

This can either be someone in a dedicated care coordinator role or a professional within the individual’s MDT. It is this named coordinator’s role to:

  • support the individual (and their carers or advocates) to understand the intervention and support offer made by the MDT
  • update and review the individual’s PSCP as required
  • support individuals to take as active a role as they wish in decisions about their care
  • improve their experience of accessing health and care services
  • act as a single point of contact for the individual
  • liaise with services to ensure onward referrals are made and care is received
  • provide an oversight of the individual’s care, with full responsibility for that care remaining with the individual’s MDT

Useful tools

Here are some practical tools to help with Coordinated Care:

Case studies