Vulnerable Patients

Integrated Care for Vulnerable Patients

Information regarding the joined up way of working between health and social care, being piloted in Sunderland on behalf of the Government, will be displayed on this page:

The Practice Manager and the Advanced Nurse Practitioner as leads, are working with the Washington Locality Practices and the City Wide Sunderland Practices together with:

  • Community Nursing
  • Social Workers
  • Sunderland Carers Centre
  • Hospitals
  • ther care providers

To ensure the most vulnerable patients have a robust care plan agreed with the Patients / Carer to ensure the best care is being providing to help the person to stay at home rather than being admitted to hospital.

GPs and Practice Nurses at the practice play a key role in this and all patients on this journey will have a nominated GP and Care Coordinator (your first point of contact when you need help).