Complex Chronic Disease
The Complex Chronic Disease Team (CCDT) provides a range of services for adults with chronic and complex health conditions. The aim is to provide coordinated and integrated care that improves and supports individual clients to optimise and manage their health and wellbeing within their community.
The service provides access to a multidisciplinary team (medical, nursing and allied health) who will undertake a comprehensive assessment, develop an individualised client care plan and deliver interventions that meet the diverse needs of clients referred.
Complex Needs Service
The complex needs service focusses on clients whose care needs require greater than usual levels of health care management due to a range of interacting physical, psychological and social factors.
Cardiac Rehabilitation
The cardiac rehabilitation service provides an integrated education and exercise program for clients following a recent (within 6 months) cardiac event including NSTEMI or STEMI, PCI, Coronary Artery Bypass Grafting, Cardiac Valve Surgery or clients who have medically stable Heart Failure.
Referral requirements
A referral may be rejected without the following information.
Referrals are made via the Community and Oral Health Central Referral Unit (Tel: 1300 658 252). Referrals are accepted from hospitals, General Practitioners and other Queensland Health community services.
For Complex Needs Service and Pulmonary Rehabilitation, please:
- complete refer (electronic referral) if you are a MNHHS employee, or
- use GP referral system for GPs, or
- complete a paper referral form if you are an external referrer, including other HHS employees and fax to 3360 4822 or call CRU on 1300 658 252
For Cardiac Rehabilitation, please:
- refer via QCOR (electronic referral) if you are a QH employee, or
- call CRU on 1300 658 252 if you are an external referrer
For all referrals, please attach recent investigations and clinical assessments
Out of catchment
Metro North Health is responsible for providing public health services to the people who reside within its boundaries. Special consideration is made for patients requiring tertiary care or services that are not provided by their local Hospital and Health Service. If your patient lives outside the Metro North Health area and you wish to refer them to one of our services, inclusion of information regarding their particular medical and social factors will assist with the triaging of your referral.
- Impact on employment
- Impact on education
- Impact on home
- Impact on activities of daily living
- Impact on ability to care for others
- Impact on personal frailty or safety
- Identifies as Aboriginal and/or Torres Strait Islander
- To establish a diagnosis
- For treatment or intervention
- For advice and management
- For specialist to take over management
- Reassurance for GP/second opinion
- For a specified test/investigation the GP can’t order, or the patient can’t afford or access
- Reassurance for the patient/family
- For other reason (e.g. rapidly accelerating disease progression)
- Clinical judgement indicates a referral for specialist review is necessary
- Presenting symptoms (evolution and duration)
- Physical findings
- Details of previous treatment (including systemic and topical medications prescribed) including the course and outcome of the treatment
- Body mass index (BMI)
- Details of any associated medical conditions which may affect the condition or its treatment (e.g. diabetes), noting these must be stable and controlled prior to referral
- Current medications and dosages
- Drug allergies
- Alcohol, tobacco and other drugs use
- Full name (including aliases)
- Date of birth
- Residential and postal address
- Telephone contact number/s – home, mobile and alternative
- Medicare number (where eligible)
- Name of the parent or caregiver (if appropriate)
- Preferred language and interpreter requirements
- Identifies as Aboriginal and/or Torres Strait Islander
- Full name
- Full address
- Contact details – telephone, fax, email
- Provider number
- Date of referral
- Signature
- Willingness to have surgery (where surgery is a likely intervention)
- Choice to be treated as a public or private patient
- Compensable status (e.g. DVA, Work Cover, Motor Vehicle Insurance, etc.)
Send referral
Hotline: 1300 364 938
Medical Objects ID: MQ40290004P
HealthLink EDI: qldmnhhs
Mail:
Metro North Central Patient Intake
Aspley Community Centre
776 Zillmere Road
ASPLEY QLD 4034
Health pathways
Access to Health Pathways is free for clinicians in Metro North Brisbane.
For login details email:
healthpathways@brisbanenorthphn.org.au
Login to Brisbane North Health Pathways:
brisbanenorth.healthpathwayscommunity.org