Chronic Conditions (Integrated Team Care)
The Integrated Team Care (ITC) Program at Puntukurnu Aboriginal Medical Service (PAMS) supports Aboriginal and Torres Strait Islander people living with chronic conditions. The program ensures clients receive timely, coordinated, and culturally appropriate care by connecting them with a team of GPs, specialists, nurses, and allied health professionals.
What we offer
- Care coordination: Helping clients access the right healthcare services when they need them
- Multidisciplinary support: Linking clients to GPs, specialists, nurses, and allied health teams
- Specialist referrals: Organising visits and connecting clients to local and regional specialists
- Financial support: Assisting with gap payments, transport, and accommodation for medical appointments
- Culturally appropriate care: Ensuring all services are respectful, safe, and responsive to community needs
Who can access this service?
This program is available to clients who:
- Identify as Aboriginal and/or Torres Strait Islander
- Have a diagnosed chronic condition requiring ongoing care (e.g., diabetes, cardiovascular disease, chronic respiratory illness, kidney disease, or mental health conditions)
- Are linked to a GP or medical service participating in the ITC Program
- Need assistance with care coordination, specialist access, or financial support
Where services are provided
- Newman
- Jigalong
- Punmu
- Kunawarritji
- Parnngurr
The program also supports clients travelling to Perth, Newman, and Port Hedland for specialist appointments.
Service hours
Services are generally available Monday to Friday, 8:30 am – 4:30 pm.
Care coordinators are available during clinic hours and can provide support for appointments, referrals, and specialist travel arrangements as required.
Funding partner
The ITC Program is funded by the Australian Government Department of Health and Aged Care under the Primary Health Networks (PHN) program. It is ongoing while federal funding continues.
How to access ITC support
To find out more or speak with a care coordinator, phone 9111 1777 or email pams.itcnc@puntukurnu.com