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  4. SMHS Older Adult Community Integrated Care Hub referrals

SMHS Older Adult Community Integrated Care Hub referrals

SMHS Older Adult Community Integrated Care Hub referrals

WA Health is introducing three Older Adult Community Integrated Care Hubs across Perth to make it easier for older people and their families to access health and wellbeing services in the community.

The hubs will provide coordinated, integrated care developed with clinicians and the community.

The SMHS Older Adult Community Integrated Care Hubs (external site) based in Success opened in early 2026 and is the first hub to open.

Our vision

Older adults living well at home and in the community, supported by coordinated and integrated care.

How we can support you and your patients

  • Short-term stabilisation of the rising risk patient and care coordination.
  • Rapid access to advice and care navigation.
  • Shared care planning.
  • Support for complex patients to reduce both carer strain and hospital presentations.

Our services

The hubs will provide via flexible delivery options:

  • access to specialist and allied health professionals
  • memory and cognition assessment and support
  • assistance to management conditions affecting ability to manage safely at home – for example, geriatric syndromes including falls, cognition, continence and other risk factors contributing to poor health outcomes
  • advance care planning support and advice
  • help navigating aged care and community services
  • coordinated, multidisciplinary care tailored to each person’s needs.

Who can benefit

Consumers living in the SMHS catchment:

  • aged over 65 years (or 50 years for Aboriginal people)
  • with complex/chronic conditions or geriatric syndromes who would benefit with short term multidisciplinary care and/ or care co-ordination to stabilise health and avoid hospital presentation.

Eligibility considerations

  • Functional decline/increased care needs.
  • Frequent health service use/escalation risk.
  • Frailty or multimorbidity.
  • Cognitive concerns.
  • Social factors affecting health and safety.

Alternative services may be more appropriate for consumers:

  • in need of acute, urgent or emergency medical/mental health care
  • under 65 years of age (or under 50 years for Aboriginal people) without geriatric conditions
  • who live permanently in a residential aged care facility.

Alternative service providers for such patients could include:

  • a hospital ED, urgent care clinic, or WA Virtual ED
  • Mental Health Emergency Response Line (MHERL)
  • Hospital in the Home/Home Hospital
  • outpatient services via Central Referral System
  • Residential Care Line.

How to refer

You can either:

  • call 1300 229 080 to speak to a care navigator
  • send a direct referral to via:
    • Healthlink ID (SMHS: oahubsth)
    • secure email (encrypted) to olderadulthubsouth@health.wa.gov.au
    • fax to 6174 2022 with attention to ‘CIC HUB’.

Our location and hours

SMHS Older Adult Community Integrated Care Hub
11 Wentworth Pde, Success inside the Cockburn Integrated Health and Community Facility (above Cockburn Library).

8:30am to 4:00pm, Monday to Friday

Have your say

This brochure is a draft and will continue to evolve as the service develops.

We invite GPs to actively contribute to shaping the model and share feedback to ensure the hubs meet community needs and strengthen primary care.

  • Email the SMHS Older Adult Community Integrated Care Hub
  • Email the NMHS Older Adult Community Integrated Care Hub
  • Email the EMHS Older Adult Community Integrated Care Hub

More information

Call 1300 229 080 for advice.

Last Updated: 27/01/2026

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