Aboriginal Chronic Care Program (Integrated Care Services)

Our enrolled nurses and Aboriginal health workers undertake chronic condition screening of every Aboriginal and Torres Strait Islander patient. This includes looking at the patient’s medical history, medication history, respiratory function, cardiovascular function, urinalysis and, where required, relevant blood and liver testing.
Patients identified as having chronic or complex health issues are referred to the relevant services and are enrolled with the Integrated Care Program to ensure the continual monitoring and management of their conditions. Patients who are not identified as having current chronic or complex health conditions at the time of assessment are re-evaluated annually.
Partnerships supporting Aboriginal patients
Justice Health NSW partnered with both Wellington Aboriginal Corporation Health Service (WACHS) and Durri Aboriginal Corporation Medical Service (ACMS) to deliver trauma-informed, culturally safe healthcare to Aboriginal patients in custody in the state’s Central West (WACHS) and to Aboriginal women in custody on the state’s Mid North Coast (ACMS).
The in-reach model, based on the Justice Our Way program, involves local Aboriginal community-based health services delivering support to Aboriginal patients in custody and transitioning to community.
The Justice Our Way program was first implemented in 2014 by the South Coast Women’s Health and Wellbeing Aboriginal Corporation (Waminda) to address a critical gap in support for Aboriginal women transitioning out of the justice system.
This partnership remains in place today. Together, we aim to provide Aboriginal women and their families an opportunity to belong and receive quality health and well-being support, with the aim to reduce family violence in their communities.
Our initiatives
Each year, our centres host various health promotion activities to encourage Aboriginal patients to be engaged and involved in their health. Our commitment to improving health outcomes and closing the gap means that we strive to identify health conditions early and deliver interventions in a culturally responsive manner.
We are dedicated to closing the gap by improving the health care experiences of our Aboriginal patients. Our goal is to foster a culturally safe environment where Aboriginal patients feel valued, respected and understood. Through collaborative partnerships with Aboriginal communities, we strive to develop tailored healthcare programs and services that address the unique challenges and barriers faced by these patients.
We celebrate NAIDOC week each year as an opportunity to share stories and successes.
In past years, these celebrations have involved both staff and patients and have included:
- yarning and gathering groups
- art, music and dance performances
- bush tucker morning teas
- acknowledgement of country and smoking ceremonies.
Justice Health NSW collaborates with Corrective Services NSW in facilitating opportunities to create a more equitable system that ensures every Aboriginal individual receives quality care.
