Health Care Homes are general practices or Aboriginal Community Controlled Health Services (ACCHS) that provide better coordinated and more flexible care for Australians with chronic and complex health conditions.

Helping Manage Chronic Conditions

Chronic disease is on the rise in Australia. One in two Australians now have a chronic disease — such as diabetes, arthritis or heart and lung conditions — and one in four have at least two chronic health diseases1. Health Care Homes help people better manage their conditions by giving them coordinated, integrated care that is tailored to their needs and provided at their usual GP clinic or ACCHS.

The Health Care Homes trial is running until June 2021 and there are a number of Health Care Homes in Western Sydney.

Coordinated Care

Eligible patients were able to enrol to become a Health Care Home patient before 30 June 2019. Together with the patient, a care team at the Health Care Home developed a shared care plan which:

  • Includes comprehensive information about a patient’s care, medications and all the health professionals who care for them
  • Identifies local health care providers best able to meet each patient’s needs and helps coordinate care with these providers 
  • Include strategies to help each person manage their conditions and improve their quality of life

Care team — a committed care team, led by their usual doctor.

Shared care plan — with the support of the care team, the patient will develop a shared care plan. This plan helps them have a greater say in their care; and makes it easier for all the people who look after them, both inside and outside the Health Care Home, to coordinate their care.

Better access and flexibility — with a care team behind them, patients have better access to care. Health Care Homes can also be more responsive and flexible. If the patient wants to talk to someone in their care team, they won’t always need an appointment with their GP. They might call or message the practice team, or the team might call the patient to see how they’re going.

Better coordinated care — the care team will do more to coordinate care from the patient’s usual doctor, specialists and other health professionals.

1AIHW data release on chronic disease (September 2016). 23 per cent of Australians have two or more of the eight selected chronic diseases in 2014-2015.

Progressing Health Now

Find out more about other Programs and Priorities for Western Sydney.