Winter Strategy

The purpose of the Living Well, Your Way - General Practice Winter Strategy program is to support proactive care for patients with chronic disease at risk of deterioration over the winter period, specifically Chronic Obstructive Pulmonary Disease (COPD), Congestive Heart Failure (CHF), and Diabetes.

Winter Strategy commenced with a pilot in 2019 in a response to the high level of preventable hospitalisations of patients with COPD, CHF, and Diabetes. Since 2022, the now annual Winter Strategy program has been delivered in collaboration with Murrumbidgee Primary Health Network (MPHN) and Murrumbidgee Local Health District (MLHD) as part of the Living Well, Your Way Initiative.

A total of 55 practices from across the Murrumbidgee (of 89) have participated in one or more programs over the years. Each year new practices come onboard.

From mid-April - September each year, practices are supporting patients through the program with the following interventions: 

  1. Additional primary care appointments (beyond usual care) 

  2. Chronic disease interventions in primary care including vaccinations, chronic disease management plans, spirometry, sick day action plans, and advanced care directives. 

  3. Additional interventions such as nurse-led chronic disease clinics, social and emotional wellbeing support, and referrals to community providers.

Throughout the program, practice staff including doctors, nurses, managers and administrative staff are offered targeted education and training to improve care over winter and to assist them to work at top of scope in the delivery of high quality care.

To register for training and education please click here.

Winter Strategy 2024 sees the introduction of a bonus component called Heart Plan in a Box - a quality improvement toolkit for heart failure management in primary care.

This toolkit is intended to support Quality Improvement (QI) activities using Plan Do See Act (PDSA) cycles to achieve improvements in the care and management of heart failure patients in primary care. Practices participating in this bonus activity are completing two PDSA Cycles.