Heart failure is a condition where the difference between good and average management shows up in hospital admissions. It is looked after here with structured monitoring, regular medication review and doctors who have managed these patients on hospital wards, not only in clinic.
What we look after
- Chronic heart failure with reduced or preserved ejection fraction, shared with your cardiologist where you have one
- The conditions that drive it – high blood pressure, coronary artery disease, atrial fibrillation, diabetes, sleep apnoea, kidney disease
- Monitoring after a hospital admission, including the review in the first week or two home, which is when readmissions happen
- Medication review and up-titration, with the blood tests that have to go alongside it
- Symptom management, fluid and salt advice, and daily weight monitoring
- ECG and Holter monitoring here at the practice, and referral for an echocardiogram or to cardiology when it is needed
What gets monitored
- Weight, daily, at home – the earliest sign of fluid building up, and the one that gives you days of warning. A gain of two kilos or more over two or three days is worth a phone call.
- Symptoms – breathlessness lying flat, waking at night short of breath, ankle swelling, reduced exercise tolerance, fatigue.
- Blood pressure and heart rate – at each visit, and at home where that helps.
- Kidney function and electrolytes – checked with every significant medication change and regularly in between.
- Iron studies, full blood count, thyroid and glucose – iron deficiency and anaemia are common in heart failure and treating them changes how people feel.
- Vaccination status – influenza and pneumococcal cover matter more here than in most conditions.
- Heart rhythm – ECG here at the practice, and a Holter monitor when palpitations, an irregular pulse or unexplained deterioration need a longer look. Atrial fibrillation is common in heart failure and often comes and goes, which is exactly what a Holter monitor is for.
Your care plan
The way Medicare funds this changed on 1 July 2025. The old GP Management Plan and Team Care Arrangement were replaced by a single GP Chronic Condition Management Plan. If you already had a plan under the old system it still counts; it simply moves across at your next review.
What that means in practice:
- You are eligible if you have at least one condition that has lasted, or is likely to last, six months or more. There is no official list of qualifying conditions – it is your doctor’s clinical judgement.
- One plan now covers both the management plan and the referrals to other health professionals.
- The plan needs to be written or reviewed within the last 18 months for you to keep access to the rebated allied health visits.
- With a current plan you can claim up to five individual allied health visits per calendar year (ten for Aboriginal and Torres Strait Islander patients) – for example a dietitian, podiatrist, diabetes educator, physiotherapist or exercise physiologist.
- You can also have up to five services from a practice nurse on your doctor’s behalf.
- If you are registered with us through MyMedicare, your plan is written here, at the practice you are registered with. If you are not registered, your usual GP can still write it.
Care plans and their reviews are bulk billed at Health Nexus. There is no out-of-pocket cost for writing the plan or for reviewing it.
For heart failure the allied health visits are usually spent on an exercise physiologist or a cardiac rehabilitation program, and a dietitian for salt and fluid. Supervised exercise is one of the few things in heart failure with good evidence behind it for how you actually feel day to day.
Much of the monitoring and recall work is done by the practice nursing team alongside your doctor. The nurses run the checks that are due, keep the recalls on schedule and prepare the review so that your appointment with the doctor is spent on decisions rather than data entry. It is also why the reviews actually happen – the most common reason chronic disease care fails is that the review is never booked.
When to seek help urgently
Ring 000 for chest pain lasting more than ten minutes, severe breathlessness at rest, fainting, or a racing heartbeat that will not settle.
Contact the practice the same day for a weight gain of two kilos or more over two or three days, new or worsening ankle swelling, needing extra pillows to sleep, or waking at night short of breath. The practice is open until 8pm on weekdays and every weekend – ring (03) 6351 5610 or use the urgent appointment request.
What to expect
Book a long appointment, and bring your home weight and blood pressure readings, every medicine you take including anything bought over the counter, and any hospital discharge summary or cardiology letter. Anti-inflammatory tablets bought from a supermarket are a common and avoidable cause of deterioration, so tell your doctor about anything you take, not just what was prescribed.
The doctors
All of the doctors who work from Health Nexus manage long-term conditions. Several have substantial hospital experience behind them:
- Dr John Esho – medical registrar in multiple specialties across northern and north-west Tasmanian hospitals, including cardiology and nephrology; internal and general medicine
- Dr Arsalan (Sam) Mahmud – medical registrar in multiple specialties across northern and north-west Tasmanian hospitals; general and emergency medicine, and continues to work in acute care
- Dr Asim Razak – chronic disease, cardiovascular and respiratory conditions
- Dr Sai Tip – chronic disease, respiratory medicine
- Dr Miyulasi Attanayake – chronic disease, diabetes, hypertension, asthma and COPD
- Dr Nadia Khan – chronic disease, diabetes and hypertension
- Dr Nalika Hendawitharana – chronic disease, preventive health
Fees and Medicare
Health Nexus Launceston is a mixed-billing practice. Children aged 12 and under are bulk billed whenever the practice is open, including evenings and weekends. Pension card holders over 65 and DVA Gold Card holders are bulk billed on weekdays between 8am and 5pm. Everyone else pays the consultation fee with the Medicare rebate claimed on the spot. The current fees are on the fees and bulk billing page.
The practice is open 8am–8pm Monday to Friday, 8am–5pm Saturday and 9am–5pm Sunday, every day of the year, and on every public holiday at the standard hours for that day.
Common questions
Do I still need my cardiologist?
Usually yes, and the two work together. A cardiologist sets the direction and does the procedures and imaging; the day-to-day monitoring, medication adjustment, blood tests and the reviews happen here, which is far more practical than waiting for an outpatient appointment each time something changes.
Why weigh myself every day?
Because fluid builds up before you feel it. A steady daily weight is reassuring; a gain of two kilos or more over two or three days usually means fluid, and acting on it early is often the difference between an adjustment at the practice and an admission to hospital.
Is the care plan bulk billed?
Yes. Care plans and their reviews are bulk billed here. It also unlocks Medicare-rebated visits to an exercise physiologist, dietitian or physiotherapist.
Can you arrange an echocardiogram?
An ECG and a Holter monitor are done here at the practice. An echocardiogram needs a sonographer, so your doctor refers you for that and for cardiology review where it is needed, and the results come back here to be acted on.
I was just discharged from hospital. How soon should I be seen?
Within a week if you can. The fortnight after discharge is when most readmissions happen, and an early review to check weights, bloods and medication doses is the most useful appointment in the whole year. Ring and say you have just been discharged.
