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Service coordination and the Service Coordination Tool Templates (SCTT)

Templates to facilitate service coordination.

Service coordination places consumers at the centre of service delivery to maximise their opportunities for accessing the services they need. Service coordination enables organisations to remain independent of each other, while working in a cohesive and coordinated way to give consumers a seamless and integrated response.

Service coordination is underpinned by the following principles:

  • a central focus on consumers
  • partnerships and collaboration
  • the social model of health and the social model of disability
  • competent staff
  • a duty of care
  • protection of consumer information
  • engagement with a broad range of service sectors
  • consistency in practice standards.

Service Coordination Tool Templates (SCTT)

The SCTT have not been updated since 2012 but are provided for agencies to apply and adapt as is useful, or as required for specific programs/activities.

Developed in 2012, the Service Coordination Tool Templates (SCTT) is a suite of templates developed to facilitate service coordination.

They aim to support the collection, recording and sharing of initial contact, initial needs identification, referral, information exchange and care planning information in a standardised way.

The SCTT aim to provide consistent information standards to facilitate sharing of information and to provide a common language between services.

User guide

The SCTT 2012 user guide is a practical resource to assist service providers in using the SCTT. This guide provides:

  • answers to frequently asked questions
  • points for service providers to note in completing SCTT.
Service Coordination Tool Templates User guide 2012
PDF 1.72 MB
(opens in a new window)

Core referral templates

TemplatePurpose
Referral cover sheet and acknowledgement
Word 41.57 KB
(opens in a new window)
To send with a referral or to acknowledge receipt of referral.
Consumer information - Service Coordination form
Word 80 KB
(opens in a new window)
To collect common demographic and other essential consumer information that can be shared with another agency.
Summary and referral information
Word 47.52 KB
(opens in a new window)
To record and share a summary of the consumer’s presenting and identified issues and other information to assist in a referral.

Additional screening templates

TemplatePurpose
Ambulance Victoria referral
Word 162.5 KB
(opens in a new window)
Ambulance Victoria referral
PDF 35.65 KB
(opens in a new window)
Referral out to services that have a partnership agreement with Ambulance Victoria.
Accommodation and safety arrangements
Word 216.5 KB
(opens in a new window)
Accommodation and safety arrangements
PDF 39.65 KB
(opens in a new window)
To screen for consumer's accommodation risk of homelessness and their safety needs, including family violence and personal emergency planning
Alcohol, smoking and substance involvement screening (ASSIST)
Word 551.5 KB
(opens in a new window)
Alcohol, smoking and substance involvement screening (ASSIST)
PDF 48.07 KB
(opens in a new window)
To screen for hazardous, harmful and dependent use of alcohol, tobacco and other psychoactive drugs.
Care relationship, family and social network
Word 298.5 KB
(opens in a new window)
Care relationship, family and social network
PDF 32.87 KB
(opens in a new window)
To assist service providers to understand care relationships and family and support networks such as friends and significant others who are involved in the consumer's life.
Consent to share information
Word 87.51 KB
(opens in a new window)
To record freely given informed consumer consent to share their information with a specific agency/ies for a specific purpose/s.
Functional Assessment Summary
Word 326.5 KB
(opens in a new window)
Functional Assessment Summary
PDF 46.47 KB
(opens in a new window)
This supplementary template is sent with referrals that occur following assessment of the consumer’s functional abilities and need for assistance. The assessing agency may attach additional assessment summaries covering other domains of consumer relevant to the referral.
Health and chronic conditions – Health Literacy
Word 253.5 KB
(opens in a new window)
Health and chronic conditions – Health Literacy
PDF 93.07 KB
(opens in a new window)
To assist service providers to screen for health and chronic conditions
Health and social needs screener – consumer administered
Word 219 KB
(opens in a new window)
Health and social needs screener – consumer administered
PDF 49.73 KB
(opens in a new window)
To assist service providers to screen for a consumer's needs.
Health and social needs screener – service provider administered
Word 70.5 KB
(opens in a new window)
Health and social needs screener – service provider administered
PDF 49.21 KB
(opens in a new window)
To assist service providers to screen for consumer's needs.
Information exchange summary
Word 251 KB
(opens in a new window)
Information exchange summary
PDF 32.43 KB
(opens in a new window)
To exchange summary information with other service providers at key points in the consumer’s pathway to support coordinated care.
Need for assistance with activities of daily living
Word 206.5 KB
(opens in a new window)
Need for assistance with activities of daily living
PDF 32.02 KB
(opens in a new window)
To screen for the consumer's need for assistance with the activities of daily living.
Shared support plan
Word 299 KB
(opens in a new window)
Shared support plan
PDF 41.37 KB
(opens in a new window)
For a consumer who requires multiple services, to support a coordinated approach. It shows who is involved in the consumer’s care, the main issues, agreed goals developed together, planned actions and who is responsible for each action.
PAV Assessment record 2012
Word 250 KB
(opens in a new window)
PAV Assessment record 2012
PDF 406.84 KB
(opens in a new window)
To be used by assessment officers from PAV designated organisations to assess, determine and record the eligibility of applicants for the PAV Service.
Social and emotional wellbeing
Word 253.5 KB
(opens in a new window)
Social and emotional wellbeing
PDF 33.39 KB
(opens in a new window)
To screen for consumer’s social and emotional wellbeing needs, including anxiety and depression.

Updated