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• Indigenous Chronic
  Disease Package
• Tackling Chronic Disease
  Risk Factors
  • National action to reduce Indigenous smoking rate
  • Helping Indigenous Australians to reduce their risk of chronic disease
  • Local Indigenous community campaigns to promote better health
• Improving Chronic Disease
  Management and Follow up
  • Subsidising PBS medicine co-payments
  • Higher utilisation costs for MBS and PBS
  • Supporting primary care providers to coordinate chronic disease management
  • Improving Indigenous participation in health care through chronic disease self management
  • Increasing specialist and allied health follow up care
  • Monitoring and evaluation
• Workforce Expansion,
  Training and Support
  • Workforce education and training
  • Expanding the outreach and service capacity of Indigenous health services
  • Engaging Medicare Locals to improve Indigenous Access to mainstream primary care
  • Attracting more people to work in Indigenous Health
  • Clinical practice and decision support

GP Resource Kit: Practice detail cards - General Overview

• General Overview

1. Information for General Practitioners on the Indigenous Chronic Disease Package
2. Patient identification
3. Practice Incentives Program (PIP) Indigenous Health Incentive
4. Aboriginal and Torres Strait Islander health assessment items
5. MBS items overview
6. Chronic disease follow-up services
7. Allied health follow-up services
8. Practice nurses/Registered Aboriginal Health Worker follow-up services
9. Pharmaceuticals Benefit Scheme (PBS) Co-payment measure
10. Care Coordination and Supplementary Services Program (CCSS)

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GP Resource Kit

This GP Resource Kit has been developed for doctors, health professionals and their staff working in Aboriginal Community Controlled Health Services (ACCHSs) and other Indigenous Health Services and general practices. It provides information on how to participate in the Australian Government’s Indigenous Chronic Disease Package (ICDP) - the Australian Government’s contribution to the National Partnership Agreement on Closing the Gap in Indigenous Health Outcomes.

Contents of this kit:

10 practice detail cards on the following topics:

1. Information for General Practitioners on the Indigenous Chronic Disease Package
2. Patient identification
3. Practice Incentives Program (PIP) Indigenous Health Incentive
4. Aboriginal and Torres Strait Islander health assessment items
5. MBS items overview
6. Chronic disease follow-up services
7. Allied health follow-up services
8. Practice nurses/Registered Aboriginal Health Worker follow-up services
9. Pharmaceuticals Benefit Scheme (PBS) Co-payment measure
10. Care Coordination and Supplementary Services Program (CCSS)

A GP booklet providing more detailed information on the ICDP and its measures.

This kit is also available online at: www.health.gov.au/tackling-chronic-disease

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Program

Who is this document for?

• General practices
• Aboriginal Community Controlled Health Services and other Indigenous Health Services¹.

Program background

In November 2008, the Council of Australian Governments (COAG) committed up to $1.6 billion over four years to the National Partnership Agreement on Closing the Gap in Indigenous Health Outcomes (NPA). The goal is to close the gap in life expectancy between Aboriginal and Torres Strait Islander people and other Australians within a generation.

The Australian Government’s contribution to the NPA is the $805.5 million Indigenous Chronic Disease Package, which aims to close the gap by increasing the early identification and improving the management of chronic diseases and their risk factors. The Package is supporting the health sector to provide Aboriginal and Torres Strait Islander people with better access to health care.

Components

Prevention

Healthy Lifestyle Workers

A national network of Healthy Lifestyle Workers is being established to work with communities on improving nutrition and physical activity for individuals and families within Aboriginal and Torres Strait Islander communities.

National Indigenous Tobacco Workers

A national network of regional tobacco coordinators and tobacco action workers will work in a teambased approach with Healthy Lifestyle Workers and Aboriginal and Torres Strait Islander communities, families and individuals to reduce the number of people smoking.

Promotion of health assessments for Aboriginal and/or Torres Strait Islander patients – MBS Item 715

The promotion of this health assessment item supports the identification of risk factors for chronic disease in Aboriginal and/or Torres Strait Islander patients and the early detection, diagnosis and intervention for common and treatable conditions that cause morbidity and early mortality. MBS Item 715 is for Aboriginal and/or Torres Strait Islander people of all ages.

Chronic disease management

Practice Incentives Program (PIP) Indigenous Health Incentive

This measure supports general practices and Indigenous Health Services to provide better healthcare for Aboriginal and/or Torres Strait Islander patients with existing chronic disease.

Pharmaceutical Benefits Scheme (PBS) Co-payment measure

This measure gives eligible Aboriginal and/ or Torres Strait Islander people access to more affordable medicines.

Chronic disease self-management accredited training for staff

Chronic disease self-management training will be available for existing health workers on how to support and provide education to Aboriginal and/ or Torres Strait Islander patients to manage their chronic conditions.

Specialist Outreach Programs and Care Coordination

The following three initiatives aim to improve access by Aboriginal and Torres Strait Islander patients with chronic disease to specialist and allied health medical services.

1. Medical Specialist Outreach Assistance Program – Indigenous Chronic Disease (MSOAP-ICD) increases access to primary, allied health and medical specialist services in rural and remote Aboriginal and Torres Strait Islander communities.
2. Urban Specialist Outreach Assistance Program (USOAP) increases access for Aboriginal and/ or Torres Strait Islander people with a chronic disease to medical specialist care in urban areas and inner regional areas.
3. Care Coordination and Supplementary Services Program (CCSSP) assists patients with chronic disease to follow their care plan including ensuring they are able to access allied health and specialist care. When necessary, it may help them meet the costs of some services and assist with local transport to appointments.

Workforce Indigenous Health Project Officers: A resource for GPs

These officers work in Divisions of General Practice, state-based organisations and some National Aboriginal Community Controlled Health Services to improve the capacity of primary care providers in the delivery of culturally sensitive services to Aboriginal and Torres Strait Islander people.

Support for additional health workers

Aboriginal and Torres Strait Islander Outreach Workers in some Divisions of General Practice and Aboriginal Community Controlled Health Services (ACCHSs) and additional health professionals and practice managers in some ACCHSs support access to health care and follow-up services for Aboriginal and/or Torres Strait Islander people. 38 additional GP Registrar training posts and 50 nurse clinical placements in Indigenous Health Services and nursing scholarships for nurses working in Indigenous health.

Further information

You can find more detailed information about this package by visiting our website: www.health.gov.au/ tackling-chronic-disease

1 For the purpose of this GP Resource Kit, an Indigenous Health Service is a practice, Aboriginal Community Controlled Health Services, Aboriginal medical service or a clinic providing primary care services to a predominantly Aboriginal and/or Torres Strait Islander population; and is a provider of Medicare rebate services.

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Page currency, Latest update: 09 December, 2010

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