Diabetes
 
Program Overview and Rationale
The Central Coast Diabetes Program is a joint initiative of the Central Coast Division of General Practice and Northern Sydney Central Coast Area Health Service.
The aim is to provide and maintain a high quality and systematic approach to diabetes management.
The main objectives of the program are to:
- Improve the management of patients with diabetes
- Provide efficient and effective diabetes management in the general practice setting
- Implement the NSW Health Guidelines for the Management of Diabetes Mellitus
- Improve the capacity of patients with diabetes to better manage their condition
- Provide GPs and practice nurses with access to the latest clinical management strategies for effective management of patients with diabetes
- Enable GPs to access the Annual Cycle of Care SIP for all of their patients as well as Care Plans and Care Plan Reviews for eligible patients.
Duration of Program and how it Operates
The Central Coast Diabetes Program commenced in 1998.
General Practice-based mini clinics are held in which the Division provides a Diabetes Educator / Nurse, who conducts a comprehensive diabetes assessment for each patient, as well as providing one-on-one patient support and guidance in collaboration with the GP. Recent results from pathology requests are used by the Nurse / Educator to review and assess the current level of diabetes management.
How the Program benefits GPs and their Patients
The Diabetes clinics are a support service to GPs. Patients are provided with additional attention by a qualified Diabetes Educator / Nurse, who has the time to motivate and encourage the patient to better self-manage their condition. The Diabetes Educators/Nurses adhere to evidence based best practice management guidelines - better health outcomes are inevitable.
The financial benefits to GPs are available through Care Planning. This has been incorporated into the program. Eligible patients can receive a GP Management Plan (GPMP), and GPMP Reviews and/or a Team Care Arrangement (TCA) and TCA Reviews.
The Educator / Nurse's patient assessment is consistent with the "Annual Cycle of Care" criteria, and as a result, the GP is able to claim the Service Incentive Payment (SIP) for every patient who attends the clinics.
Current level of Program Participation / Utilisation
Currently there are 32 Central Coast GPs participating in the program, although the service has been utilised by almost 190 GPs over the years it has been running.
Almost 7,800 patients have benefited from the Division's Diabetes Clinics during it's time in service.
Co-ordination of the Program
Natalia Barker
Diabetes Clinic Coordinator/Administration Officer
Ph: 4365 2294
Fax: 4365 3836
Email: natalia@ccdgp.com.au
More Information
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