Care Planning
A General Practitioner Chronic Condition Management Plan (GPCCMP), fondly referred to as a Care Plan, is available to patients with a chronic or terminal condition and who would benefit from a structured approach and ongoing care from a multi-disciplinary team. Patients may be eligible for a GP chronic condition management plan if they have at least one medical condition that has been (or is likely to be) present for at least 6 months or is terminal.
A practice nurse, Aboriginal and Torres Strait Islander health practitioner or Aboriginal and Torres Strait Islander health worker can assist with the preparation or review of the plan as appropriate. However, the GPCCMP is a plan between the GP/PMP and their patient. It is a requirement that the GP/PMP sees the patient as part of the service, and they are responsible for the service.
Please see more information on our Care Planning page.
Resources
| Plan Do Study Act (PDSA) | PDSA: Increase number of shared health summaries uploaded to My Health Record (MHR) (docx 296KB) |
| Guides | GP Chronic Conditions Management Plan – guide for Practice Nurses – Practice Connect (docx 223 KB) |
| HealthPathways | HealthPathways |
Support
If you have any questions relating to Care Planning, please contact our Primary Care Engagement Officers.
e. qi@westvicphn.com.au
t. 1300 176 271
Request a visit from your Primary Care Engagement Officer here.