Chronic disease care

Chronic disease management in Wallan

Living with a long-term condition is easier with a GP who knows your story and a plan that fits your life.

Fully bulk billing practice · for eligible services

Quick answer

Chronic disease care at Wallan Doctors will include ongoing management of diabetes, high blood pressure, heart disease, kidney disease and osteoporosis, chronic wound care, and GP chronic condition management plans that coordinate care with allied health professionals. From April 2027, our GPs and nurses will offer regular reviews, tests and practical support.

Overview

Chronic Disease Care at Wallan Doctors

A chronic condition is one that lasts six months or longer. Diabetes, high blood pressure, heart disease, kidney disease, arthritis and osteoporosis are common examples. They often need regular monitoring, medicines and lifestyle changes, as well as support from several health professionals. Having one GP practice coordinate everything can make a real difference to how manageable it feels day to day, for you and for the people who support you.

At Wallan Doctors, your GP and practice nurse will work with you on a written plan, set goals together and keep track of tests and reviews. Where you'd benefit from a dietitian, diabetes educator or another allied health professional, your GP can refer you and keep the team connected. Reminders for tests and reviews help you stay on track between visits. This care begins in Wallan from April 2027.

What we'll offer

Chronic Disease Care services planned for our Wallan clinic.

01

GP management plans and team care

A written plan that sets out your goals, treatments and the health professionals involved in your care. Eligible patients may be able to access Medicare-supported allied health visits as part of their plan.

  • Written chronic condition plan
  • Goals set together
  • Coordinated allied health referrals
  • Regular plan reviews
02

Diabetes care

Support for people living with type 1, type 2 or gestational diabetes, and for those at risk. Your GP will monitor your blood sugar, kidneys, eyes, feet and heart health over time.

  • Regular HbA1c and kidney tests
  • Foot and eye check reminders
  • Medication reviews
  • Referral to diabetes educators
03

High blood pressure

Ongoing monitoring and management of high blood pressure to reduce the risk of heart attack, stroke and kidney disease.

  • Regular blood pressure reviews
  • Home monitoring advice
  • Medication reviews
  • Lifestyle support
04

Heart disease management

Care after a heart diagnosis or event, working alongside your cardiologist. Your GP will help with medicines, risk factors and cardiac rehabilitation.

  • Shared care with your cardiologist
  • Cholesterol and blood pressure monitoring
  • Cardiac rehabilitation referrals
  • Medicine reviews
05

Kidney disease support

Early detection and monitoring of chronic kidney disease, often alongside diabetes or high blood pressure, with referral to a kidney doctor when needed.

  • Kidney function tests
  • Blood pressure management
  • Medicine dose reviews
  • Referral to nephrology
06

Osteoporosis and bone health

Assessment of bone health and fracture risk, bone density test referrals, and advice on calcium, vitamin D, exercise and falls prevention.

  • Fracture risk assessment
  • Bone density test referrals
  • Falls prevention advice
  • Ongoing monitoring
07

Chronic wound care

Care for wounds that are slow to heal, such as leg ulcers or diabetes-related foot wounds, with regular dressings and reviews by our GPs and nurses.

  • Wound assessment
  • Regular dressings
  • Compression and healing advice
  • Referral when more advanced care is needed

Who it's for

  • People living with diabetes
  • Anyone with high blood pressure or heart disease
  • People with kidney disease
  • Older adults concerned about bone health
  • People with slow-healing wounds
  • Carers supporting someone with a chronic condition
Your visit

What to expect

A clear, unhurried process so you know what's happening at every step.

Wallan Doctors opens in April 2027. In a medical emergency, call 000. For health advice any time, call healthdirect on 1800 022 222.

1

Review your health

Your GP will look at your history, results and medicines, and talk about how your condition affects daily life.

2

Make a plan

Together you'll set goals and agree on treatments, tests and the professionals involved.

3

Coordinate your team

Your GP will arrange referrals and share relevant information with the people caring for you.

4

Regular reviews

Check-ins with your GP and nurse help you track progress and adjust the plan as needed.

FAQ

Chronic Disease Care: common questions

Straight answers about chronic disease care at Wallan Doctors.

A chronic condition management plan is a written plan prepared by your GP for a condition lasting six months or more. It sets out your goals, treatments and the health professionals involved. Eligible patients may also be able to access some Medicare-supported allied health visits. Your GP will explain what applies to you.

Most people with diabetes see their GP every three to six months for reviews, with a more detailed annual cycle of care covering blood tests, kidneys, eyes, feet and heart health. Your GP will recommend a schedule that suits your type of diabetes and how well it's controlled.

Yes. Coordinating care is one of the most important roles of a GP. Your GP can refer you to consultant doctors and allied health professionals, receive their letters and results, and keep everything in one place. This helps everyone involved understand your full picture.

We plan for practice nurses to support our GPs with chronic disease care, including health measurements, wound dressings, education and care plan reviews. Nurse appointments can make regular monitoring more convenient, while your GP oversees your treatment and any changes to your plan.

Yes. When we open in April 2027, you'll be able to transfer to Wallan Doctors. With your consent, we can request your records from your previous practice, and your new GP will review your plan, medicines and results so your care continues smoothly.

Chronic Disease Care is coming to Wallan.

Register your interest and we will let you know when appointments open in April 2027.

Register your interest