Social workers are now available for GP Social Work Connect

GP Social Work Connect is a free-to-access, short-term service available to residents within Sydney’s Ryde/Hornsby/Ku-ring-gai Local Government Areas (LGAs), with a GP referral.

Our social workers are available to see patients either via home visits or at the GP’s practice. The GP Social Work Connect program is a resource to assist with:

  • Assessing and addressing psychosocial needs and issues
  • Providing information to patients
  • Liaising with social, welfare and community providers.
  • Arranging referrals and linkage to appropriate supports such as
    -Centrelink (Newstart, DSP, crisis payments etc)
    -My Aged Care
    -Domestic Violence Services
    -NDIS (linking and assisting with applications)
    -Guardianship applications  (both Financial Trustee and NSW Public Guardian)

-Community Mental Health
-Probation and Parole
-Community Nursing and allied health services
-Link with our Plus Social groups.

The GP Social Work Connect program is for people who have:

  • High and/or complex care needs that require support from a range of community care providers
  • Recent and/or recurrent hospitalisations due to their care needs
  • Difficulty navigating and accessing support services, eg: the National Disability Insurance Scheme (NDIS) or the aged care service system
  • A complex family situation which may include family and domestic violence
  • Feelings of loneliness and isolation
  • Support needs and require assistance in their caring role.

How the GP Social Work Connect  program works

After a GP refers you to the GP Social Work Connect program, the team at Primary & Community Care Services will assess your holistic needs and provide further guidance, referral and links to a range of relevant, local services.

The program is best suited to those willing to engage with services. We will listen to your needs and help you take control in making the best choices for you by working closely with your doctors and other primary healthcare providers to help with:

  • Assessing and addressing your physical and mental wellness, as well as your ability to function with day-to-day activities
  • Arranging referrals and linkages to appropriate services in the community
  • Liaising with social, welfare and community providers.
  • Providing advocacy, liaison and support services to patients and the families of patient
  • Support with linking to non-medical services
  • Ensuring the service is person-centred, with a positive experience for the patient and their carers.

Why Primary & Community Care Services?

Our caring and expert team of professionals has a genuine interest in helping make a difference. We have qualifications in medicine, social work, nursing, occupational therapy and psychology.

We also have extensive experience in:

  • clinical assessment
  • care planning and
  • supporting people with psychosocial needs.

Our knowledge of localised health and welfare services and providers is invaluable in helping patients access the support they need to live happy and fulfilled lives.

Language barriers

We aim to cater for people from a non-English speaking background. Some of the languages spoken by our team include: Arabic; Chinese (Mandarin, Cantonese, Wuhanese); Farsi; Filipino (Tagalog); French, Indian (Konkani, Hindi); Laotian; Nepalese (Nepali, Newari); Russian; and Thai.

Home visits are available

Our social workers are available to see you at home or at your GP’s practice.


This service is FREE and HAS NO AGE LIMITS. Anyone can be referred to this service by a GP, including people who have one or more of the following:

• High and/or complex care needs requiring support from a range of community care providers
• Carer stress or burnout – requiring support and assistance in their caring role
• Difficulty navigating and accessing support services e.g. the NDIS, aged care system, Centrelink
• Recent and/or recurrent hospitalisations due to care needs
• Complex family situations, including family and domestic violence
• Alcohol or substance abuse or dependency
• Indicators of loneliness and isolation.

Get referred

You need a GP referral to participate in the program.

Have your doctor complete the GP Social Worker Connect referral form and fax to 1300 067 747.

All referrals will receive a confirmation via ‘secure messaging’ EDI: GPSocial.

For more information, please contact PCCS on (02) 9477 8700 and ask for the GP Social Worker/Intake.

Case study: Teresa’s turnaround

A 62-year-old mother of two, grandmother of three and wife to partner Frank, couldn’t get off her couch.

“As a result of my GP and social worker Sarah working as a team, my health has improved. I feel more alive, I feel better and life is beautiful again. Thanks to my GP and Sarah, Frank and I go out most mornings walking, shopping, watching people and enjoying a cappuccino.”

Read the full story here.

Case study: Helen’s NDIS linking

GP Social Work Connect has supported  several clients successfully with their NDIS applications.

One client, Helen*, had her previously declined application approved by the NDIS within two weeks of our team providing assistance.

The former social worker and Olympic medallist has repeatedly expressed her gratitude to the GP Social Work Connect team for their support and advised she would not have been able to successfully access the NDIS without their intervention.

Helen now has an NDIS plan in place and a support coordinator to assist in its implementation.

*Not her real name

Group activity: Cultural day

“I certainly appreciated the luncheon you gave for me and all the participants. The food was lovely and some were nutritious.

The important thing is that it shows you care for our wellbeing. Recuperation from a stroke and heart attack leaves me feeling a bit isolated and you in some way help my isolation and I hope it helps the others too.

Love and blessings to everybody.”