GP MANAGEMENT PLAN (MBS ITEM No. 721)
Patient’s Name: [Enter the patient's full legal name as it appears on official documents.] (only include if explicitly mentioned in the transcript, contextual notes, or clinical note, otherwise leave blank.)
Date of Birth: [Enter the patient's date of birth in the format DD/MM/YYYY.] (only include if explicitly mentioned in the transcript, contextual notes, or clinical note, otherwise leave blank.)
Contact Details: [Enter patient’s contact details] (only include if explicitly mentioned in the transcript, contextual notes, or clinical note, otherwise leave blank.)
Medicare or Private Health Insurance Details: [Enter patient’s Medicare number or Health Insurance details, if applicable.] (only include if explicitly mentioned in the transcript, contextual notes, or clinical note, otherwise leave blank.)
Details of Patient’s Usual GP:
[Enter the full name of the patient's usual GP.] (only include if explicitly mentioned in the transcript, contextual notes, or clinical note, otherwise leave blank.)
[Enter the full address of the GP's practice.] (only include if explicitly mentioned in the transcript, contextual notes, or clinical note, otherwise leave blank.)
[Enter the phone number of the GP's practice.] (only include if explicitly mentioned in the transcript, contextual notes, or clinical note, otherwise leave blank.)
Details of Patient’s Carer (if applicable):
[Enter the carer's details, if relevant, including full name and contact information.] (only include if explicitly mentioned in the transcript, contextual notes, or clinical note, otherwise leave blank.)
Date of last Care Plan/GP Management Plan (if done): [Enter the date of the previous GPMP, if applicable.] (only include if explicitly mentioned in the transcript, contextual notes, or clinical note, otherwise leave blank.)
Other notes or comments relevant to the patient’s management plan: [Provide any additional relevant notes, comments, or instructions from the patient's consultation.] (only include if explicitly mentioned in the transcript, contextual notes, or clinical note, otherwise leave blank.)
PAST MEDICAL HISTORY:
[Provide a summary of the patient’s past medical history, including chronic conditions, past surgeries, hospitalizations, and prior treatments.] (only include if explicitly mentioned in the transcript, contextual notes, or clinical note, otherwise leave blank.)
FAMILY HISTORY:
[Provide a summary of the patient's family history, including any relevant hereditary conditions or diseases.] (only include if explicitly mentioned in the transcript, contextual notes, or clinical note, otherwise leave blank.)
MEDICATIONS:
[List all current medications the patient is taking, including medication names, dosages, and frequencies.] (only include if explicitly mentioned in the transcript, contextual notes, or clinical note, otherwise leave blank.)
ALLERGIES:
[Enter any known allergies or sensitivities the patient has, including whether they are related to medications, foods, or other substances.] (only include if explicitly mentioned in the transcript, contextual notes, or clinical note, otherwise leave blank.)
GP MANAGEMENT PLAN:
Patient problems / needs / relevant conditions: [Describe the patient's primary health issues, conditions, or needs. This may include chronic conditions, specific complaints, or any immediate concerns.] (only include if explicitly mentioned in the transcript, contextual notes, or clinical note, otherwise leave blank.)
Goals - changes to be achieved: [State the goals of the management plan for the patient's care. These could include reducing symptoms, improving function, meeting specific health targets, or preventing exacerbations.] (only include if explicitly mentioned in the transcript, contextual notes, or clinical note, otherwise leave blank.)
Required treatments and services including patient actions: [Outline the treatments, services, or interventions that the patient will receive as part of their management plan. This may include medications, therapies, referrals, or lifestyle changes. Also, mention the patient’s role in managing their health, such as following prescribed treatments or engaging in recommended activities.] (only include if explicitly mentioned in the transcript, contextual notes, or clinical note, otherwise leave blank.)
Arrangements for treatments/services (when, who, and contact details):
[Provide details on when and who will be responsible for the treatments or services, including contact details for the involved parties or providers.] (only include if explicitly mentioned in the transcript, contextual notes, or clinical note, otherwise leave blank.)
Copy of GP Management Plan offered to patient? [Enter "Yes" or "No," confirming whether the patient has been offered a copy of the GPMP.] (only include if explicitly mentioned in the transcript, contextual notes, or clinical note, otherwise leave blank.)
Copy / relevant parts of the GP Management Plan supplied to other providers? [Enter "Yes" or "No," indicating whether relevant parts of the GPMP have been shared with other healthcare providers.] (only include if explicitly mentioned in the transcript, contextual notes, or clinical note, otherwise leave blank.)
GP Management Plan added to the patient’s records? [Enter "Yes" or "No," confirming whether the GPMP has been added to the patient’s records.] (only include if explicitly mentioned in the transcript, contextual notes, or clinical note, otherwise leave blank.)
Date service was completed: [Enter the date the service was completed.] (only include if explicitly mentioned in the transcript, contextual notes, or clinical note, otherwise leave blank.)
Proposed Review Date: [Enter the proposed review date for the next GPMP, typically recommended to be 6 months from the completion date.] (only include if explicitly mentioned in the transcript, contextual notes, or clinical note, otherwise leave blank.)
I have explained the steps and any costs involved, and the patient has agreed to proceed with the plan. [Include a brief statement confirming that the patient understands the plan and has agreed to proceed.] (only include if explicitly mentioned in the transcript, contextual notes, or clinical note, otherwise leave blank.)
GP’s Signature: [Enter the GP’s signature or digital confirmation.] (only include if explicitly mentioned in the transcript, contextual notes, or clinical note, otherwise leave blank.)
Date: [Enter the date the GP signed or confirmed the plan.] (only include if explicitly mentioned in the transcript, contextual notes, or clinical note, otherwise leave blank.)
(Never come up with your own patient details, assessment, plan, interventions, evaluation, and plan for continuing care—use only the transcript, contextual notes, or clinical note as a reference for the information included in your note. If any information related to a placeholder has not been explicitly mentioned in the transcript, contextual notes, or clinical note, do not state that the information is not available; simply leave the placeholder blank or omit it completely. Use as many paragraphs as necessary to comprehensively capture all relevant details.)
