Expression of Interest - MDT Care Project for Small & Solo General Practices

The Adelaide PHN Multi-disciplinary Team (MDT) Care Project for Small and Solo General Practices aims to support small and solo general practices across the Adelaide PHN region to engage clinical coordination support to facilitate multi-disciplinary team care. This includes funding to engage either a practice nurse or care coordinator to lead patient care coordination one to two days a week, to support the patient and general practitioner to coordinate, communicate and integrate patient care with allied health providers.

The MDT Care Project for Small and Solo General Practices will help to facilitate the support of patients who have complex chronic conditions by delivering care coordination through multidisciplinary team care, enabled by digital technology and engaging with allied health providers.

The Project activity seeks to:

• Reduce the burden on the tertiary health system;
• Strengthen the communication and coordination of care between primary care health professionals, and
• Strengthen health workforce capacity and capability to support patients with complex chronic health conditions in primary care settings, particularly for Small and Solo General Practices.

It is anticipated that MDT Care at the general practice level will form the core service elements drawing on the expertise of practice teams, general practitioners, other clinical staff, and allied health providers. Subject to Adelaide PHN approval, the text set out in the tables below will be uploaded on our tendering portal for online applicant response.

Through this Project, Adelaide PHN is seeking to commission general practices that will collaborate with allied health providers to deliver MDT care to the identified patient cohort. The project services are to be delivered for a period of 30 months from the date of contract execution across the 2025-2028 financial years.

The successful general practices identified to participate in the MDT Care project will receive up to $107,000 (ex. GST) across the entire project delivery period.

The available funds will be allocated for the following:

• provision of $1,000 per patient for up to 25 patients over the 2.5-year period;
• funding to support engagement of or increased capacity of Practice nurse/manager/coordinator (0.2 - 0.4 FTE) to coordinate patients and provide self-management education/behaviour change support; and
• funding for digital technology capability to support effective MDT care including Telehealth hardware, software and capability support.