Chronic Disease Management

GP Management Plans

What is a GP Chronic Condition Management Plan (GPCCMP)?
A GP Chronic Condition Management Plan is a written plan of management developed by your GP and your practice nurse in consultation with you.The GP Chronic Condition Management Plan is a written set of information about what you need in managing your chronic or complex condition.

Who will benefit from a GP Chronic Condition Management Plan?

A GPCCMP is available to patients with at least one chronic condition that has been, or is likely to be, present for at least six months or is terminal.

Examples of chronic conditions include:

Diabetes
Asthma
COPD
Arthritis
Cancer
Heart disease
Osteoporosis

What happens when your doctor organises a Management Plan?
Together we:

Identify your health priorities
List the actions you can take to help manage your condition
Identify what (if any) other health care and community services you need
Determine what results you would like from the GPCCMP to help with your chronic condition

Am I eligible for any allied health referrals?

Yes, if your doctor determines you would benefit from other health care providers or allied health professionals being involved in providing treatment. With your consent, your doctor or practice nurse will ask the relevant allied health professionals to be part of your care plan.

What is an allied health professional?
An allied health professional is a health worker such as:

Physiotherapist
Dietitian
Podiatrist
Audiologist
Diabetes nurse
Occupational therapist
Pharmacist
Asthma nurse
Exercise physiologist

How many visits can I have with an allied health professional?
Persons with a GP Chronic Conditions Management Plan are eligible for 5 visits per calendar year to see allied health professionals.

Will it cost anything to have a Chronic Condition Management Plan done by my GP or practice nurse?
All GP Chronic Condition Management Plans are bulk billed by your GP, so there will be no charge for these services.
You must be My Medicare registered with our practice to receive bulk billing. Please ask our friendly team if you require assistance registering.

Will it cost anything to see an allied health professional with a GPMP and TCA?
Allied health professionals may require you to pay on top of the Medicare rebate. Speak to your allied health professional about any charges.

GP Chronic Condition Management Plan Review (GPCCMP Review)

What is a GP Chronic Condition Management Plan Review (GPCCMP Review)?
Once a plan is in place, it should be regularly reviewed by your GP. This is an important part of the plan cycle, where you, your GP and practice nurse check that your goals are being met and agree on any changes that you may require.
A GP Chronic Condition Management Plan Review is usually undertaken every 3-6 months.
All reviews are bulk billed by your GP. There will be no charge for these services.

FAQ
How long will it take?
The GP Chronic Condition Management Plan appointment will take about 30 minutes with your doctor and practice nurse.
A GPCCMP Review will take about 30 minutes with your doctor and nurse to review your care plan.

Who is eligible?
Your GP will determine if you fulfill the Medicare eligibility criteria prior to preparing the plan.

How can I make an appointment for the allied health professional?
Please contact the allied health professional’s clinic directly to make an appointment.

If you have any questions, ask your doctor or practice nurse

Home Medicines Review (HMR)

Do you know your medicines? If medicines aren’t used properly, or if the wrong ones are used together, the results can be serious. Each year more than 140,000 Australians have to go to hospital with problems caused by their medicine. In up to 69% of these cases, the problem could have been avoided. Older people are particularly at risk.

The Home Medicines Review (HMR) Program was developed in response to this problem. It is funded by the Australian government and managed by the Pharmacy Programs Administrator.

A Home Medicines Review involves your GP and an accredited pharmacist of your choice. Your GP writes a referral to the pharmacist. A pharmacist conducts an interview, preferably in your home, and then writes a report for to the GP. The GP will discuss any recommendations with you and may make appropriate changes to your medicines.

The solutions may involve:

showing you how to take your medicines correctly
explaining why and when to take them
explaining where they should be stored
explaining what to expect when taking them
outlining what problems you should report to the GP
checking that prescription medicines, over-the-counter medicines and vitamins are appropriate to take together
clarifying any confusion with generic medicines
giving you some help so you can remember to take your medicines
changing your medicines.

Who should have a Home Medicines Review?

Reviews are particularly useful for people who:

take more than five medicines a day
have recently spent time in hospital
are concerned about their medicines
are confused about their medicines
do not always remember to take their medicines.

How much does it cost?

The pharmacist’s review and report is paid for by the Australian government, so it will not cost you anything. Your GP may bulk-bill or charge you for the GP consultations.

If you (or someone you care for) might benefit from having a Home Medicines Review, talk to your GP or pharmacist about organising one. They are available in all states and territories.