What is this service?
Integrated Team Care (Closing the Gap) supports Aboriginal and Torres Strait Islander peoples living with chronic health conditions to access coordinated, affordable, and culturally appropriate healthcare.
This free service connects you with a dedicated care coordinator who works alongside your GP and other health professionals. Support may include help booking medical appointments, organising transport, accessing medical equipment and linking you with the right local services.
The program also strengthens partnerships between community and general practice to reduce barriers to care and improve long-term health outcomes.
Benefits
Integrated Team Care helps you stay connected to the right care and manage your health with confidence and support.
You’ll benefit if you:
- are an Aboriginal or Torres Strait Islander person living with a chronic condition
- need help coordinating appointments and services
- would like support accessing transport or medical equipment
- want care that is culturally safe and centred around your needs
By improving access to coordinated and multidisciplinary care, the program supports better health outcomes and helps reduce gaps in care.
Eligibility
You may be eligible if you:
- identify as an Aboriginal or Torres Strait Islander person
- have at least one of the following chronic conditions: heart disease, kidney disease, respiratory disease, diabetes or cancer
- are referred by your GP
- have a current GP Chronic Conditions Management Plan
- live in the Blue Mountains, Hawkesbury, Lithgow and Penrith areas.
Funding
This service is funded by the Department of Health, Disability and Ageing.
Referrals
A referral from a GP is required to access this service. Please speak with your GP to discuss whether this service is suitable for you. GPs can find more information and referral details via HealthPathways.
Integrated Team Care (Closing the Gap)
Last updated: May 22, 2026 at: 12:17 pm