COVID-19 care pathway re-activated: GPs may start receiving calls about patients

A woman with COVID-19 coughing while isolating at home.
  16 February 2021  NWMPHN   

Victoria recorded two new COVID-19 cases in the last 24 hours, linked to the Holiday Inn and Grand Hyatt outbreaks. This brings the total number of active cases in Victoria at the time of writing to 25.

During these latest outbreaks, some patients are electing to go into Hotel Quarantine for isolation. Hotel Quarantine medical services will manage these people.

Other patients are electing to stay at home and be managed in the community. Patients in this group who live in the North Western Melbourne Primary Health Network (NWMPHN) region will be contacted and enrolled into the North West Melbourne care pathway. During the second wave of the pandemic, 210 practices across the NWMPHN region provided care to patients in the low risk category of this pathway.

Practices should be aware that they may start receiving calls about their patients who have tested positive to COVID-19.

About the pathway

The North West Melbourne COVID-19 care pathway was established during Victoria’s second wave and supports continuity of care with patients’ usual GP. The pathway is designed to provide safe, high quality care, including community-based care, for low risk COVID-19 positive patients, with escalation mechanisms to higher levels of care if required.

cohealth are notified of a positive test result. cohealth then contact the patient to gain consent to be managed in the pathway, perform a clinical assessment, a social and welfare needs assessment and complete a risk stratification to determine the appropriate pathway for the patient.

If the patient nominates a usual GP, cohealth will phone the GP to notify them of:

  • the positive result for the patient
  • the outcome of the clinical assessment
  • the patient’s current risk category (low, medium or high).

Risk stratification

  • Low risk patients are defined in the model as those who have no or mild symptoms and no risk factors and are managed by the patients usual GP.
  • Medium risk patients and high risk patients are cared for by hospitals in the catchment: Royal Melbourne Hospital, Western Health, Djerriwarrh Health Service and Werribee Mercy Hospital.

GP role

  • GPs are asked to perform telehealth check-ins including every second day from day five with all low risk COVID-19 positive patients. The monitoring period for COVID-19 positive patients is until symptom free for three days and at least 10 days post-symptom onset. More details regarding call frequency are available in the model overview.
  • All telehealth consultations will be funded through MBS, as per the MBS guidelines. Please note that there were recent changes to the COVID-19 MBS telehealth items that require a GP to have an established relationship with the patient. This is defined as “having seen the same practitioner for a face-to-face service in that last 12 months, or having seen a doctor or other health practitioner at the same medical practice for a face-to-face service in the last 12 months”. However, this requirement does not apply to the following people:
    • people who are homeless
    • patients receiving an urgent after-hours (unsociable hours) service
    • patients of medical practitioners at an Aboriginal medical Service or an Aboriginal Community Controlled Health Service
    • people living in a COVID-19 impacted area*.

*A COVID-19 impacted area is defined as “one where a person’s movement is restricted by a state or territory public health requirement that applies to the persons location. This includes patents subject to quarantine, and other restrictions intended to support infection control”. Given that patients being managed under the COVID-19 model need to quarantine at home, they would meet these requirements. The NWMPHN Primary Health Care Improvement team will contact GPs who have had a patient enrolled to talk through the model and provide support where required.

More information is available in the information sheet.

HealthPathways Melbourne logoHealthPathways Melbourne

A specific pathway available on HealthPathways Melbourne outlines the model in more detail:

It also includes the numbers for escalation to high and medium risk pathways.

Don’t have access to HealthPathways Melbourne? Request access online or contact


If you have any questions about this model of care, please contact:

  • NWMPHN Primary Health Care Improvement team on 03 9347 1188 or email
  • cohealth Covid-19 Pathway Response Team on 03 9449 5551, or cohealth COVID-19 GP on 03 9448 5717.