Chronic Disease Management

 
 
Chronic Disease Management Programs
GP down south are working to improve the health outcomes for people in the south west of WA living with chronic health conditions through the delivery of a range of new and continuing programs.
 
Integrated Chronic Disease Care (ICDC) 
Funded by the WA Primary Health Alliance (WAPHA), the ICDC program focuses on improving the integration and coordination of services for people with chronic conditions within the region.  The program specifically targets those people who are socio-economically disadvantaged and are living with chronic diabetes, cardiology, respiratory or musculoskeletal conditions living in the regions of Augusta, Margaret River, Nannup, Bridgetown, Boyup Brook, Manjimup, Pemberton, Collie and Harvey. 
 
GP down south are working closely with GPs and practice nurses in the region to support the delivery of the program through the provision of enhanced care coordination within the practice setting to improve the management of chronic conditions, facilitate increased engagement of patients and improve patient self-management.
 
The program also aims to improve access to a range of multidisciplinary allied health services within the local regional area.  GP down south collaborates with other agencies including Silver Chain, WA Country Health Services and Diabetes WA to ensure access to Diabetes Education across the South West region. 
 
Diabetes Education Service- Greater Bunbury Region
GP down south employs a credentialed Diabetes Educator to provide diabetes education services within GP practices in the Greater Bunbury Region. General Practitioners can refer newly diagnosed people with diabetes for intensive counselling and advice, and established diabetics may be referred for additional advice or assistance with a range of diabetes related matters.  
 
Comprehensive Primary Care- Practice Collaboratives
GP down south is developing and facilitating professional development and training opportunities for General Practices in the Greater Bunbury and South West regions.   Training will focus on improving care for those people living in our community with chronic conditions and providing the opportunity for the development of collaboratives of practice within the local region.  
 
 
Contact Nicola Hilyard, Program Coordinator Integrated Chronic Disease Care, at GP down south for further information.
P: (08) 9754 3662