The Social Work Pathway Coordination (SWPC) service, formerly known as Liverpol Out of Hospital Social Work (LOOHS), has gone through a process of transformation in response to service and pathway changes.
From 31 August 2025, there will be no requirement for the Trust to deliver statutory social work functions as Trusted Assessors on behalf of Liverpool City Council into:
- Liverpool Bed Based 28 day residential/nursing and CHC pathway
- RLUH Frailty Unit and Same Day Emergency Care (SDEC).
There has also been remodelled social work functions aligned to:
- Liverpool ICRAS & Urgent Care Response.
- Longmoor House Liverpool patients.
And increased Social Work functions aligned to:
- Fern Ward Leigh Moss.
- Transfer of Care Hub (ToCH).
The Social Work Pathway Coordination (SWPC) service is made up of staff from ICRAS, Urgent Care Response, Fern Ward Leigh Moss, Longmore House and Transfer of Care Hub.
The Social Work Pathway Coordination Service professional, operational and strategic oversight is aligned to the Director of Social Work and is a distinct stand-alone department that supports service delivery across four pathways:
- Liverpool Integrated Community Reablement and Assessment Service (ICRAS) and Urgent Community Response (UCR)
- Longmoor House
- Leigh Moss Fern Ward
- Transfer of Care Hub (ToCH)
The Social Work Pathway Coordination service is open to service users and carers accessing care and support via UCR/ICRAS pathways and Fern Ward Leigh Moss Hospital, and do not have any current active social work involvement from their local authority where they are ordinary resident.
Social Work Pathway Coordination service will support individuals who face non-medical barriers to returning home safely. The focus is to help people who need additional support that isn’t a medical need, or a need met by the Care Act but could be preventing them from maxamising independence. By connecting people with local voluntary services and community resources, we help reduce social isolation, prevent readmission, and promote long-term wellbeing. Our person-centred approach empowers individuals to regain independence, build resilience, and make informed choices about their care.
The Social Work function is to provide Social Work Pathway Coordination and to undertake case assessments and support planning to facilitate discharge from acute hospitals, Intermediate Care settings and to prevent acute hospital admission.
The social work function is to provide social work pathway coordination and to undertake assessments and support planning to facilitate discharge from acute hospitals, intermediate care settings and to prevent acute hospital admission. The model adopts a strengths-based approach, identifying strengths and assets to achieve goals. Supporting service users to access assets and resources in their communities to improve wellbeing and recognising the strengths that individuals and families bring to their own care and support. And a brokerage approach that focuses assessing needs, creating access too and navigating pathways and services in health, social care and the VCSFE sector.
There is an emphasis on reducing overreliance on formal care packages by adopting a social prescribing model, and ensuring practical, social and financial needs are addressed as part of discharge plans when they are not at a threshold for Care Act eligibility or local authority response or intervention. The aim us to maximise opportunities for rabblement and preventative support through accessing universal services and one-off person health budgets, to provide service users with the support they need to leave hospital safely or remain in the community. Enabling access to personalised support when their needs cannot be met through existing commissioned services or unpaid care
Carer support is a key intervention to ensure carers are involved and that their care needs are met and that NHS Duties towards Carers are fulfilled.
The service provides a gatekeeping function, ensuring eligibility for statutory care and support needs are identified or alternative care options are considered. This is particularly significant in Longmoor House and the Transfer of Care Hub to maximise timely access to services, promote recovery and maintain capacity and flow within the urgent care system. The service reviews barriers of those identified as being delayed / clinically ready for discharge and escalate where necessary to ensure better outcomes and appropriate use of resources.
The Social Work Pathway Coordination Service is aligned to the Trust’s work portfolio of services, which ensures professional, operational and strategic oversight is aligned to the Director of Social Work.
The service supports service delivery across four pathways.
Liverpool Integrated Community Reablement and Assessment Service (ICRAS) and Urgent Community Response (UCR)
The Social Work Enhanced Care Coordination service is co-located with the Liverpool Integrated Community Reablement and Assessment Service (ICRAS) and Urgent Community Response (UCR) Multidisciplinary Team.
- Location: Goodlass Road, Hunts Cross, L24 9HJ.
- Operational hours: Monday to Friday 09.00 to 17.00.
Longmoor House Intermediate Care Unit
The Social Work Enhanced Care Coordination service is co-located with the Longmoor House Intermediate Care Unit Multidisciplinary Team.
- Location: Longmore House, Aintree Hospital, L9 7AL
- Operational hours: Monday to Friday 09.00 to 17.00.
Fern Ward, Leigh Moss Hospital
The Social Work Enhanced Care Coordination service is co-located with the Fern Ward Intermediate Care Unit Multidisciplinary Team
- Location: Fern Ward, Leigh Moss Hospital, L14 5NX
- Operational hours: Monday to Friday 09.00 to 17.00.
Transfer of Care Hub
The Social Work Enhanced Care Coordination service rotates social workers from the Social Work Department into the Transfer of Care Multidisciplinary Team on a sessional basis.
- Location: V7 building, L32 1PJ
- Operational hours: Monday to Friday 09.00 to 17.00.