Integrated Team Care

The Integrated Team Care program supports Aboriginal people living with chronic health conditions to access the care they need. Many people face barriers in accessing specialist care, allied health services and ongoing support. This program helps coordinate care across services, reduce access barriers and provide practical assistance. By working through local Aboriginal Medical Services, it ensures support is culturally appropriate, coordinated and focused on improving long-term health and wellbeing.

The program uses a care coordination model delivered through Aboriginal Medical Services. Care coordinators work with patients, general practitioners, specialists and allied health providers to develop care plans, connect people with services and provide practical assistance to support treatment and self-management

The program has been shaped through ongoing engagement with Aboriginal Medical Services, care coordinators, community members and Aboriginal Health Partnership partners. Reviews of the program and service model have incorporated feedback from providers and communities to ensure the service reflects local needs and priorities

• Care coordination for people with chronic and complex health conditions

• Support to access specialist and allied health services

• Assistance with referrals, appointments and navigating the health system

• Provision of eligible supplementary supports and medical aids

• Patient education and self-management support

• Coordination between multiple healthcare providers

• Improve management of chronic disease

• Increase access to specialist and allied health services

• Reduce barriers to receiving healthcare

• Improve coordination between health providers

• Support patients to manage their own health and wellbeing

• Improve long-term health outcomes for Aboriginal people