GP Management Plan Template with Examples

Dr. Maxwell Beresford

March 24, 2025•10 min read

Fact checked by Dr. Ben Condon

GP Management Plan Template

This detailed, AI-enabled GPMP Notes template (Item 721) guides General Practitioners in creating structured GP management plans for patients with chronic conditions, based on the most recent guidance provided by the Australian government.

Document detailed patient information including medical history, current medications, and allergies.
Identify health issues, treatment goals, and lifestyle factors affecting the patient’s condition.
Outline the care plan, and include agreed actions, responsibilities, and follow-up schedule.
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See Sample PDF

What is a GP Management Plan Template?

A GP Management Plan Template or GPMP template is a structured document that helps General Practitioners (GP) create consistent and comprehensive care plans for patients with chronic or complex medical conditions. It covers key details such as the patient’s health issues, treatment goals, and planned interventions.

In this article, we’ll discuss the importance of GPMP review templates, how GPMP templates differ from TCA templates, and the best practices for creating GP management plans. Additionally, we’ll share free, customizable, and AI-enabled GP management plan templates you can use for your daily practice.

Why are GP Management Plan Templates Important?

GP management plan templates ensure that complex care plans are well-organized and easy to comprehend. They help GPs save time and avoid errors, and they also enhance communications between care teams. A great GPMP template supports better patient outcomes through efficient and coordinated care.

When to Use a GPMP vs. a TCA

Both GP Management Plans and Team Care Arrangements (TCAs) are essential tools for chronic and complex patient cases. While they serve similar purposes, each one has a distinct role in patient care and Medicare billing.

When to use a GPMP

GPMP templates are designed to document information from a single healthcare provider or GP. It’s ideal for managing a single or straightforward chronic condition requiring little to no external input. GPMPs are covered under the Medicare Benefits Schedule - Item 721.

When to use a TCA

TCA templates are ideal when a patient’s condition is complex enough that it requires input from multiple specialists, e.g., dietitian, physiotherapist, etc. A sample complex case could be a post-stroke recovery plan requiring physiotherapy, occupational therapy, and speech therapy. TCAs are covered under the Medicare Benefits Schedule - Item 723.

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Best Practices for GP Management Plans

Following best practices ensures that GPMPs are accurate, comprehensive, and effective tools for chronic disease management. Read through our key tips below for creating clear and efficient GPMPs for high-quality patient care:

Start with Detailed and Accurate Patient Information

Cover the patient’s full details including their name, date of birth, Medicare number, and contact information. Record the date of the current GPMP, and any previous GPMPs completed for tracking purposes. Finally, specify the GP’s details including their full name, qualifications, and contact information for accountability and easy follow-ups.

Conduct and Outline a Thorough Patient Assessment

Document the patient’s medical history, including past surgeries, hospitalizations, and chronic conditions. Record their current medications and known allergies to avoid potential drug interactions and adverse reactions, then list relevant immunization status to inform preventive care.

Set Clear and Measurable Treatment Goals

Define specific health goals e.g., “Achieve and maintain blood pressure below 130/80 mmHg”, and align them with the patient’s overall health status and long-term wellbeing. Ensure that goals are SMART (Specific, Measurable, Achievable, Relevant, and Time-bound) so progress can be easily tracked.

Outline Specific Actions and Responsibilities

Detail the agreed actions and coverage of each party e.g., the GP, the patient, and other health care professionals. Assign responsibilities to specific professionals as well as the patient e.g., “Dietitian to advise on sodium reduction”, “Patient to do 30 minutes of brisk walking 5 days a week.”

Ensure Regular Monitoring and Follow-Up

Set a review date for assessing progress and adjust the management plan as needed. Include regular check-ups for relevant tests e.g., “Kidney function tests every 6 months.” and schedule medication reviews and mental health screenings if deemed necessary.

Encourage Patient Understanding and Engagement

Confirming the patient’s understanding and agreement with the management plan through signatures is crucial for getting them to cooperate. Provide them with educational materials e.g., online resources, and ask for their feedback to encourage their continued participation.

GP Management Plan Template Example

Here’s a free GP management plan template example in PDF and Google Doc form.

Download PDF | Copy Google Doc

GP management plan templates are often completed manually using paper or electronic forms. While they get the job done in most cases, this “traditional” method doesn’t prevent input errors and missing information.

Thankfully, an AI-powered solution now offers a faster and more accurate way to create GPMP plans, helping healthcare providers streamline their documentation process.

Easily Complete GP Management Plan Templates with Heidi

Heidi is our cutting-edge AI medical scribe designed to help healthcare providers complete GPMP templates in real-time. With your patient’s permission, simply hit record and let Heidi work as you go. Here’s how Heidi helps you complete your GPMP documentation:

Transcribe – Open Heidi on your computer or mobile device and press Start so Heidi can capture your conversation in the background. For information that you don’t want to verbalize, you can type them under context notes to be considered later.
Customize – Post-session, simply select your preferred GPMP template and watch as Heidi perfectly transcribes the details of your conversation and context notes in the appropriate format!
Transform – After generating your completed GP management plan templates, you can ask Heidi to give additional documentation including physical exam notes and treatment plans as needed.

Heidi complies with jurisdiction-specific regulations, ensuring data localization for customers in Australia, Canada, the United States, the United Kingdom, and beyond. Read more about our compliance here.

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Free GP Management Plan Templates

GP Chronic Disease Management Plan Template

This narrative-style GPMP Notes template is a comprehensive tool designed to document care plans effectively. It is based on the latest guidance by the Australian Government and captures key details such as patient information, medical history, current health needs, and health management goals.

View Template

GP Management Plan Medicare Template

This template is designed to guide GPs in creating simple GPMPs for patients with chronic conditions. It documents essential info such as patient information, medical history, current medications, and management goals. It also outlines the required treatments and services, ensuring a structured approach to patient care.

View Template

Enhanced Primary Care GP Management Plan Template

This template helps GPs document relevant patient information when creating care plans for chronic conditions. It covers essential details including the patient’s medical history, current medications, as well as agreed actions by health professionals and patients related to quality of life, monitoring of health conditions, mental health and wellbeing, etc..

View Template

FAQs About GP Management Plan Templates

Can a patient have both a GPMP and a TCA at the same time?

Yes, in some instances, a patient may have both a GPMP and a TCA simultaneously if their condition is deemed to require input from multiple healthcare providers at any point during their ongoing treatment. The GPMP covers the patient’s individual care plan, while the TCA ensures coordinated care among the different specialists involved in the management of their chronic condition(s).

What information should be included in a GPMP?

The most important information to include in GPMPs are patient details, medical history, current medications, treatment goals, planned interventions, and the roles of healthcare providers involved. It should also document follow-up dates and care plan adjustments as needed.

How does a GPMP improve care coordination among healthcare providers?

Having accurate and readily-available documentation in the form of GPMP ensures that healthcare providers involved in a patient’s care are aligned on treatment goals and interventions. This addresses potential gaps in care, prevents redundancy in health services, and promotes a unified approach to managing chronic conditions.

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