MONDAY to FRIDAY – 8:30am to 6pm
SATURDAY – 8:30am to 12pm
Suite 6, Ground Floor 32 Florence St HORNSBY NSW 2077
When neither the patient nor doctor can effectively address long-term management of the chronic condition causing the problem.
Evidence shows that chronic disease management (CDM) strategies lead to improved health outcomes for people with chronic conditions. CDM includes planned visits, care coordination, quality links with allied health service, and patient involvement in self-management. A written care plan is a primary tool in this kind of management.
A GP management plan (GPMP) helps record comprehensive, accurate and up-to-date information about a patient’s condition and treatment to help encourage the patient to take responsibility for their care. This is vital in the management of chronic medical conditions.
A chronic medical condition is one that has been (or is likely to be) present for six months or longer, for example, asthma, cancer, heart disease, diabetes, arthritis, diabetes mellitus, mental health conditions (including dementia), and musculoskeletal conditions and stroke.” There is no list of eligible conditions. However, these items are designed for patients who require a structured approach and to enable GPs to plan and coordinate the care of patients with complex conditions requiring ongoing care from a multidisciplinary care team. Your GP will determine whether a plan is appropriate for you.
There are two types of plans that can be prepared by a General Practitioner (GP) for Chronic Disease Management (CDM):
In general practice the GPMP provides an organised approach to care. It is a plan of action you have agreed with your GP, “a process for setting and achieving goals”.
This involves:
If you have a TCAs prepared for you by your GP, you may be eligible for Medicare rebates for specific individual allied health services that your GP has identified as part of your care. The need for these services must be directly related to your chronic (or terminal) medical condition.
If you have a chronic medical condition and complex care needs requiring multidisciplinary care, your GP may also develop Team Care Arrangements (TCAs). These will help coordinate more effectively the care you need from your GP and other health or care providers. TCAs require your GP to collaborate with at least two other health or care providers who will give ongoing treatment or services to you. Let your GP or nurse know if there are aspects of your care that you do not want discussed with other health care providers.
TCAs require your GP to organise
Monday – 8:30am to 6pm
Tuesday – 8:30am to 6pm
Wednesday – 8:30am to 6pm
Thursday – 8:30am to 6pm
Friday – 8:30am to 6pm
Saturday – 8:30am to 12pm
Suite 6, Ground Floor
32 Florence St
HORNSBY NSW 2077
Telephone: (02) 9476 2255
Fax: (02) 9476 3355