Chronic Disease Management Programmes
A chronic disease is a long-term health condition that needs ongoing treatment and management.
The Structured Chronic Disease Management Programme is for patients who have a medical card, GP Visit card or a Health Amendment Act card and have a specified chronic disease: cardiovascular disease, COPD, asthma and type 2 diabetes.
The Annual chronic disease management prevention programme is for adults who have a medical card, GP Visit card or a Health Amendment Act card and have a diagnosis of hypertension or who are at high risk of cardiovascular disease or diabetes, and if diagnosed with gestational diabetes or pre-eclampsia since January 1, 2023.
The prevention programme is designed so that you and your GP can work together on reducing your risk of developing cardiovascular disease, diabetes or both.
If you do not have the Medical/GP Visit/ Related Cards, your routine care here for any longterm conditions continues.
Benefits of the Programme
The programmes can help you and your GP to reduce your risk of developing further illnesses & manage your condition and prevent hospital admissions through:
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Structured reviews of your chronic disease with your GP or practice nurse
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A review of your care plan and medicine by your GP
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Support to self-manage your condition
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Opportunities for structured education and self-management support
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Early detection of any new conditions you may develop
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Early detection of any complications in your condition
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Care in your community, close to your home
Each review includes visits with the practice nurse & GP, including blood tests. You can see your GP and practice nurse during the same review or separately at different times. You will receive a written care plan after each review.
There is no charge for any tests carried out as part of your programme reviews.
You can continue to visit your GP as normal outside of the scheduled chronic disease management reviews.
Care Plan
A care plan is agreed between you and your GP or practice nurse. It outlines the steps that you need to take to manage your condition(s) and the supports available to you. It can include your concerns, agreed goals between your reviews, and advice.
Your GP or practice nurse will give you advice on lifestyle changes that will help you manage your risk factors. They will refer you to support services if you need them. For example, they may refer you to help to stop smoking or to manage your weight.
Registering for the Programmes
Your GP or practice nurse will register you for the programmes if you want to & are eligible.
Your Information
As part of the programme, your GP or practice nurse will record some information about you at each review.
This will include your:
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name and age
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chronic disease diagnosis or diagnoses
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medical history
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details of any symptoms or tests you have had since your last visit
How the HSE use your Personal Information
Your GP will send information to the HSE at the end of each structured review. This will include your name and address, medical or GP card number, and chronic disease history.
This information will help the HSE improve our understanding of chronic diseases. It will improve our ability to detect, treat and prevent chronic diseases in the future. It will help us to deliver an improved service to people with these chronic diseases.
Your personal information is stored in line with current data protection regulations. You will have full and open access to the personal information the HSE keep about you. You can ask for it from the HSE at any time.
Read the privacy statement for the Chronic Disease Management Programme
Opting out of the Programme
It is your choice to take part or not. You can opt out of the chronic disease treatment programme at any time by letting your GP know.
If you opt out, you will not get any reviews and other care planning under the programme from that point. You can always rejoin the programme if you want.
Speak to your GP or practice nurse if you have any questions about the programme.
This content of this page (and links to other sites) is for general information purposes only and does not substitute medical advice. While we endeavour to keep this website up-to-date, errors may occur. We advise all patients to discuss their health concerns with their GP. If you would like to suggest amendments or highlight new information that could be useful to others please don’t hesitate to get in touch.