@julieca
No it is not homophobic. I have linked to all the facts I stated. Yes I am surprised a politically aware lesbian in her forties knew none of that.
Unless you think it is homophobic because you believe in a born that way view of sexuality. I don't.
OK Julie: I'm not offended (it takes a LOT to offend me!); but as in previous discussions, you've clearly read some stuff, and lumped it all together and think that means you're informed, when actually you have a little knowledge about something rather than a lot.
You're eliding all sorts of things that don't go together. I'll break some of these down for you.
It is about how services are provided.
So you have lumped together in your post a lot of different ideas and "services". Some of these are valid criticisms; some are misinformed and not accurate at all. One key thing to remember is that social care services are not health care services. Some are private organisations; some are provided by local government (increasingly few); some are healthcare services. In this country healthcare and social care services are separately funded and separately provided. Someone working in the NHS has nothing to do with care homes. Care homes are mostly private providers, as are nursing homes. They are not part of the NHS. So if an "LGBT coordinator" works in NHS healthcare services (or contractors for the NHS), they have nothing to do with care home staffing or training. So providing "LGBT healthcare" to transpeople has nothing to do with whether minimum wage care home staff are homophobic.
For example, providing clear information about whether lesbians need smears and why. Some lesbians think they don't as this was at one time the official stance.
This is about GP training and advice, and the central smear test campaign is actually outsourced to a private company now, who send the reminders. (Would a LGBT coordinator at Cerco or whatever target special letters to lesbians?)
GPs should be giving the most up to date advice to everyone as they can - same for smear tests as for high blood pressure. Lots of healthcare depends on your demographic. This isn't anything new.
Its changing with younger people, but older lesbians are far less likely to be in touch with their families. So do befriending schemes and other schemes aimed at older people meet the needs of this group?
Befriending schemes? 
For this group? I mean, would these be befriending schemes for "cis" or "trans" lesbians? ... I jest, but...
Lots of lesbian and gay people report going back into the closet in care homes because of open anti-lesbian and gay comments. How should this be tackled in a systematic way?
Care homes are a mess. They have been privatised and rely on low paid untrained staff, privately employed. If you can find a way of enforcing the Equality Act within them go ahead. "LGBT healthcare coordinators" would have nothing to do with this.
Plenty of psychiatrists were trained at a time when being a lesbian was seen as a sign of immature development - Freudian. Lesbians still report issues with psychiatrists and mental health wards. How could this be better tackled?
This is very erroneous. Psychiatrists are medical doctors, not psychoanalyst. Freud was a psychoanalyst working in the late 19th and early 20thc., and Freudian psychoanalysis has never had anything to do with medical psychiatry, and has never been part of medical training. In any case, he did not believe that being a lesbian was a sign of immature development - it was a very complex theory which in fact was much kinder to gay people than the medical orthodoxy that replaced it.
Substance misuse is higher, are substance misuse programmes meeting the needs of this group? A lot of substance misuse programmes are mixed-sex and do not meet the needs of women well and probably lesbians even less. Maybe there is a need for more single-sex programmes?
Substance misuse programmes are run partly through healthcare services and partly through charitable and private provision commissioned by the NHS. In any case, they are very strictly controlled, and they are medically focused. The prevalence of substance misuse in a particular demographic is not necessarily related to the group of that demographic. And substance misuse programmes are an entirely different thing.
Heath needs are not met well by just treating everyone as the same.
Needs are not met either by lumping lots of different things all together, and pretending the needs are the same.
Healthcare provision is nothing like training of care home staff. This isn't to say that there aren't changes that need to be made. But an "LGBT coordinator" wouldn't have anything to do with quite a lot of the things you're mentioned.