Coordination Model
Defined Responsibilities. Connected Services. Clear Communication.
Care often involves more than one person or service. WARA’s Coordination Model helps organise the responsibilities, communication, and follow-up needed to support a family’s agreed care arrangement.
What Is the Coordination Model?
The WARA Coordination Model defines how people, services, and partners work together to support care.
A family may need everyday assistance at home, agreed check-ins, access to healthcare, or support during recovery. These needs may involve different people and organisations, each with a distinct responsibility.
Coordination helps establish:
- Who is responsible for each agreed activity.
- How care providers and service partners communicate.
- How relevant information reaches the appropriate people.
- How additional support can be arranged when needed.
- How concerns are raised, followed up, and reviewed.
The model connects these responsibilities without making every participant responsible for every part of care.
Care is coordinated through clear responsibilities, not assumptions.
Why Coordination Matters
Even when suitable services exist, families can struggle if the services operate independently without a clear understanding of how they connect.
Without appropriate coordination:
- Families may have to manage every service relationship themselves.
- Responsibilities may overlap or important tasks may be missed.
- Relevant information may not reach the right person in time.
- Additional services may be difficult to arrange.
- Family members may be uncertain about progress and next steps.
A coordination model provides a shared framework for organising these interactions. It does not remove every possible problem, but it helps make responsibilities and communication more explicit.
Coordination connects individual services into a more coherent care arrangement.
The WARA Coordination Approach
WARA organises coordination around three principles.
1. Clear Responsibility
Every agreed activity should have an identifiable responsible person or service provider. The scope of responsibility should be understood before the activity begins.
2. Appropriate Communication
Information should reach the people who need it to fulfil their responsibilities. Families should understand how updates are provided and whom to contact with a question or concern.
3. Connected Service Delivery
When a family needs more than one service, the arrangement should explain how those services relate to one another and how additional support can be explored.
The exact roles, communication channels, records, and escalation procedures depend on the service arrangement and the capabilities available.
Everyone should understand their role, the people they work with, and the limits of their responsibility.
Key Participants in the Coordination Model
Family and Designated Contact
The family explains the care requirement, participates in agreeing the arrangement, and identifies the appropriate contact for communication.
Depending on the arrangement, family members may:
- Share relevant information about the person’s needs.
- Agree on the scope and schedule of support.
- Receive updates through the agreed communication channel.
- Raise concerns or request a review.
- Participate in decisions about changes to the arrangement.
Where several relatives are involved, the family should establish who is authorised to receive information and coordinate decisions, subject to the person’s consent and applicable requirements.
Care Provider or Worker
A care provider delivers the activities assigned within the agreed service scope.
Depending on the role, responsibilities may include:
- Providing agreed everyday assistance.
- Carrying out assigned activities within their competence.
- Communicating relevant observations or concerns.
- Following applicable service procedures.
- Reporting issues through the agreed communication route.
A care provider should not be expected to perform clinical or other specialist responsibilities outside their qualifications and role.
Care Coordinator or Responsible Contact
Where a coordination role is included in the service arrangement, the responsible contact helps connect the people and services involved.
Depending on the agreed scope, this may include:
- Clarifying the requirement and coordinating arrangements.
- Communicating schedules and responsibilities.
- Following up on outstanding coordination tasks.
- Connecting the family with relevant service providers.
- Communicating changes or concerns to the appropriate people.
- Helping arrange a review when circumstances change.
The coordinator facilitates communication and follow-up. This role does not automatically confer clinical authority or responsibility for every provider’s actions.
Healthcare and Specialist Providers
Healthcare professionals and specialist providers deliver services within their respective professional roles.
These may include doctors, diagnostic providers, hospitals, physiotherapists, and other appropriate specialists.
Their responsibilities may include clinical assessment, diagnosis, treatment, diagnostic reporting, or professional rehabilitation services, as applicable.
Clinical decisions remain with qualified healthcare professionals. WARA’s role may include helping families coordinate access, appointments, referrals, or follow-up where such support is available.
Service and Community Partners
Partners may help provide access to services, facilities, local resources, or specialist capabilities that WARA does not deliver directly.
The nature of a partner’s involvement depends on the specific arrangement. Responsibilities, availability, and the scope of any service should be established rather than assumed.
The wider WARA system supports partner relationships through its Partner and DharmaNet dimensions, where relevant.
Learning and Workforce Support
WARA’s Learn and Work dimensions support the wider aim of developing capable people and organising meaningful work.
Learning supports capability development. Work supports workforce participation and service delivery.
These are supporting parts of the WARA system, not separate CareNets and not substitutes for role-specific competence, qualifications, or appropriate supervision.
Different participants contribute different capabilities. Coordination makes their responsibilities easier to understand.
How Coordination Works
The coordination workflow follows the care arrangement from the initial requirement through delivery and follow-up.
Step 1: Understand the Requirement
The family’s situation and requested support are understood. The relevant needs, location, expectations, and constraints are identified.
Step 2: Define Responsibilities
The proposed arrangement identifies the services required, who will provide them, what each participant is expected to do, and how communication should work.
Step 3: Connect the Relevant Services
Where more than one service is required, the relevant providers or partners are identified and the necessary arrangements are discussed.
Step 4: Deliver the Agreed Activities
Each provider carries out the activities within their agreed scope. Relevant coordination tasks are handled through the established communication arrangements.
Step 5: Communicate and Record Relevant Information
Agreed updates, observations, and outstanding matters are communicated to the appropriate people. Records may be maintained through the available processes and tools.
Step 6: Follow Up and Review
Outstanding tasks and concerns are followed up according to the arrangement. If needs change, the family and relevant participants can discuss whether the arrangement should be revised.
Coordination is a continuing process of connecting responsibilities, communicating relevant information, and following through on agreed actions.
Communication Flow
Communication should follow the responsibilities established for the service, rather than relying on informal assumptions.
A typical arrangement may include the following paths:
- Family ↔ Responsible contact: Questions, instructions within the agreed scope, updates, and requests for review.
- Care provider → Responsible contact: Activity status, relevant observations, and concerns requiring follow-up.
- Responsible contact ↔ Service partner: Scheduling, service arrangements, and coordination of agreed tasks.
- Healthcare professional → Authorised recipient: Relevant healthcare information through an appropriate, agreed channel and subject to consent and applicable requirements.
- Care records → Authorised users: Relevant information through the recording and communication arrangements available for the service.
Not every participant needs access to every piece of information. Information should be shared appropriately, respecting privacy, consent, and each person’s responsibilities.
The specific communication channels, response expectations, and record-access arrangements should be established for the service rather than assumed to be standardised across all WARA services.
The Role of the Care Ledger
The Care Ledger is intended to support visibility and accountability by providing a structured place for relevant care records and coordination information.
Depending on the capabilities available and the agreed service arrangement, records may cover:
- Completed care activities or visits.
- Relevant observations and updates.
- Coordination tasks and follow-up.
- Reported concerns and their status.
- Information that authorised family members or participants are entitled to access.
The Care Ledger supports the coordination model; it does not replace communication between responsible people, professional judgement, or agreed response procedures.
Real-time recording, automatic alerts, continuous monitoring, and family access should not be assumed unless those capabilities are available and explicitly included in the arrangement.
[Learn about the Care Ledger](/care/ how-care-works/care-ledger/)
Emergency Coordination
Emergency situations require a clear distinction between routine care coordination and urgent response.
Where an emergency procedure or response arrangement has been established, it should define the relevant contacts, responsibilities, and steps to be followed.
Depending on the arrangement, coordination may involve informing the designated contact, contacting appropriate emergency services, or helping communicate with a healthcare facility.
However, the existence of a coordination model does not by itself guarantee immediate detection, an available ambulance, hospital admission, or a particular response time.
In an urgent or life-threatening situation, the person present should contact the appropriate local emergency service without waiting for routine coordination.
Detailed emergency procedures belong in the dedicated Emergency Response Network documentation and should reflect the capabilities actually available.
Explore the Emergency Response Network
How the Four CareNets Work Together
The coordination model connects WARA’s four distinct CareNets when a family’s needs call for more than one kind of support.
HomeCareNet — Everyday Assistance
Coordinates the agreed scope of practical, physical assistance at home, including relevant daily living support.
ElderCareNet — Check-ins and Family Communication
Supports agreed check-ins, reporting, visibility into care arrangements, and coordination when something needs attention.
HealthCareNet — Healthcare Access
Helps coordinate access to doctors, diagnostic services, referrals, and healthcare follow-up where available.
AyushCareNet — Recovery and Continuing Well-being
Supports appropriate rehabilitation, recovery, physiotherapy, and continuing well-being arrangements, with professional guidance where needed.
These services remain distinct even when they contribute to one person’s care journey. Each service should have a clear scope, responsible provider, and appropriate communication arrangement.
Families do not need to manage the CareNet architecture themselves. They explain their situation, and WARA helps identify the relevant support that may be available.
The Wider WARA Infrastructure
Care coordination is part of a wider system designed to connect service delivery with the people and resources that support it.
- Learn: Develops knowledge and capabilities through learning and training initiatives.
- Work: Supports workforce participation and the organisation of work.
- DharmaNet: Provides a framework for local and community connections that can support Care, Learn, and Work.
- Partner: Connects WARA with relevant organisations and service providers.
These dimensions help support the wider operating model, but they do not automatically assume responsibility for an individual care activity. Responsibilities remain with the people and providers assigned to the agreed arrangement.
A Practical Example: Coordinating Different Services
Consider a family whose elderly parent lives at home and has recently experienced reduced mobility.
The family may need daily assistance, communication about agreed check-ins, and help arranging a healthcare consultation.
A coordinated arrangement could work as follows:
- The family explains the situation and the support required.
- WARA helps identify the appropriate services and clarify their respective responsibilities.
- HomeCareNet support is arranged for agreed daily activities, subject to availability.
- ElderCareNet arrangements may support agreed check-ins and family communication.
- Healthcare access may be coordinated through HealthCareNet if required and available.
- Relevant updates and outstanding tasks are communicated through the agreed channels.
- The family and relevant providers review the arrangement if the person’s needs change.
Each service retains its own responsibilities. Coordination connects the activities without treating all participants as interchangeable or assuming that every capability is available in every location.
Different services. Defined responsibilities. One coordinated care arrangement.
What Makes the Model Dependable?
Clear Accountability
The agreed arrangement identifies who is responsible for each activity and where questions or concerns should be directed.
Structured Workflows
Common steps make it easier to understand how a requirement becomes an agreed service arrangement and how follow-up is handled.
Appropriate Information Sharing
Relevant information reaches authorised people through the agreed channels, supporting communication while respecting privacy and consent.
Defined Escalation
The arrangement identifies how concerns should be raised and which people or services may need to be involved.
Adaptability
When circumstances change, the arrangement can be reviewed and adjusted through an appropriate process.
Reusable Operating Principles
A common coordination model can support expansion to additional services and locations, provided that the necessary people, partners, processes, and operational capabilities are in place.
Reliable coordination depends on defined responsibilities, appropriate communication, and follow-through—not on the assumption that a system will automatically handle everything.
What the Coordination Model Does Not Do
The Coordination Model:
- Does not make every participant responsible for every service.
- Does not replace qualified healthcare professionals or specialist providers.
- Does not guarantee that every service or partner is available everywhere.
- Does not imply that every activity is automatically tracked or monitored.
- Does not guarantee emergency detection or a particular response time.
- Does not remove the need for consent, clear agreements, and appropriate information sharing.
Its purpose is to make the relationships between people and services clearer, so that agreed care can be organised and followed up more effectively.
Begin With Your Family’s Needs
You do not need to understand WARA’s internal coordination structure before asking for help.
Tell us what is happening, what support your loved one needs, and what your family is finding difficult to manage. WARA can help you explore the relevant services and the next step.