Early interventions for healthy ageing


1 July 2023 – 30 June 2025

Funding Amount:

$3,500,000 (ex. GST)



Hobsons Bay






Melbourne Macedon Ranges Yarra Moonee Valley Darebin Maribyrnong Hobsons Bay Wyndham Brimbank Moorabool Melton Hume Merri-bek


The Australian Government Department of Health and Aged Care funds North Western Melbourne Primary Health Network to support older people to live at home for as long as possible. This will be achieved through commissioning early intervention activities and models of care for chronic disease management to support healthy ageing and reduce pressure on hospitals, aged care and other health services.

NWMPHN commissioned 10 general practices to join the project through an open tender process in April and May 2023. These practices will develop and implement models that aim to:

  • Identify and engage people aged at least 50 (or Aboriginal and Torres Strait Islander adults aged at least 35) who are at risk of or have one or more chronic conditions.
  • Provide a proactive and prevention-focused model of multidisciplinary care for these patients, to promote healthy ageing at no cost to the patient.

The project will run until 30 June 2025, with the potential to extend based on outcomes, reform directions and available funding.


The project will:

  • Examine how to establish and implement an effective multidisciplinary approach to prevention and management of chronic conditions in general practice that considers the social determinants of health.
  • Engage people aged at least 50 (or Aboriginal and Torres Strait Islander people aged at least 35) at risk of or with chronic conditions to optimise their physical health, medication management and mental health ways that matter to them.
  • Support older people to stay well and connected in the community, and to reduce unplanned hospital and aged care admissions.
  • Provide flexible block funding to complement Medicare Benefits Schedule (MBS) fee-for-service funding, enabling an improved multidisciplinary service at no cost to patients.

Further information on outcomes will be provided as the project unfolds.