Chronic Disease

Sunrise Health Service communities have a high burden of Chronic Disease, in particular diabetes, hypertension and heart disease and renal diseases.

We aim to provide improved care for people with chronic and complex care needs through care planning and care coordination model.

The objectives of the chronic disease program are:

  • To prevent and/or delay the onset of chronic disease for individuals and population groups;
  • To reduce the prevalence and complications to chronic disease;
  • To reduce avoidable hospital admissions;
  • To implement best practice in the prevention, early detection and management of chronic diseases;
  • To maximise the wellbeing and quality of life of individuals living with chronic disease and their families and carers;
  • Enhance the capacity of health workers to address chronic disease in their communities.


The care coordination model consists of a:

  • System approach;
  • Team approach; and
  • Chronic disease clinic and care coordination.


The management of chronic diseases has now become an integral part of the Sunrise Health Service core activities.