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Chronic disease (Multidisciplinary ambulatory consulting service)


The Multidisciplinary Ambulatory Consulting Service (MACS) clinic provides outpatient services to patients living in the Central Adelaide Local Area Health Network (CALHN).

MACS is a multidisciplinary service consisting of physicians specialising in medication management, nursing, pharmacists, and a psychologist supporting patients who are at risk of being hospitalised from their chronic conditions, including, but not limited to, patients with Long COVID, polypharmacy and multiple chronic conditions.

The service combines evidence based clinical guidelines, patient centred practice and a shared care approach with general practitioners to enable patients to optimise their health and wellbeing and reduce hospital admissions.

+ New service available: Long COVID Assessment Clinic.

Appointment location – Outpatients

Ground Floor
18 North Terrace, Adelaide 5000 (Building opposite side of the road to the RAH)

137 East Tce, Adelaide 5000 (from Wakefield Rd/Wakefield St) (Entry through door to the right of the premises)

Appointment enquiries including new, review or change of appointments contact: (08) 7074 2701 MACS department

Please refer to the outpatient map below and present to your designated clinic on the day of your appointment.

  • Outpatient map – RAH

Criteria for referral

Patients that have one or more of the following:

  • medication optimisation and or review of medication related complications
  • require medical management due to multimorbidity
  • would benefit from holistic care management with multidisciplinary input
  • coordination of care, as they see multiple medical specialists and would benefit from case management.
  • further health education and support for effective self-management.

Some examples of the type of patients we see, include:

  • frequent acute exacerbations of chronic conditions, that potentially results in emergency presentations and /or hospital admissions
  • patients with complications related to polypharmacy
  • young adults transitioning from paediatric chronic care management to the adult system.
  • When treatment of one condition affects the treatment of another
  • patients who are experiencing suspected Long COVID syndrome, when symptoms have not resolved after 12 weeks.

For patients in residential care facilities please contact our team directly to discuss the most suitable follow-up options which may include discussion with other services.

Please view the MACS outpatient services in CALHN web page for more information.

Referral process

  • Clinic fax (for referrals): (08) 84296070
  • Named referrals are accepted. Please state the reason for referral.
  • Comprehensive referrals including medications and a problem list assist with triaging
  • Triage categories include:
    • Immediate appointment (please call if the referral is urgent)
    • Category 1 (<4 weeks)
    • Category 2 (1-3 months)
    • Category 3 (>3 months)

Bulk bill clinics

A named referral or colleague is required (e.g. Dr Rami Tadros or Colleague).

  • Dr Sepehr Shakib
  • Dr Rami Tadros
  • Dr Josephine Thomas
  • Dr Tam Le Cong
  • Endocrinologist (please phone the clinic number for the Dr ‘s name)
  • Cardiologist (please phone the clinic number for the Dr ‘s name)

Referral forms

General information

  • If the patient, or their general practitioner, is concerned about deterioration in the medical condition, and assessment is required earlier than planned, a phone call to the MACS Nursing staff on 0434362390 or to RAH Clinical Pharmacology Department on (08) 7074 2701 will allow this to be discussed with one of the team members.

Post discharge guidelines

  • Patients will be discharged once their medical conditions have stabilized. If re-assessment is required, a new referral, preferably a named referral (see consultant list), should be faxed to the clinic fax (08) 84296070

Appointment location – Outpatient

Royal Adelaide Hospital (RAH) — Wednesday afternoons and Friday afternoons

  • RAH 1 Port Road, Adelaide SA 5000

Sefton Park Intermediate Care Services — Tuesday all day

  • 221 Main North Road Sefton Park 5083

Contact details


  • For all appointment enquiries including review/change:
    contact (08) 7074 2701

Department location

  • Clinical Pharmacology Department/ MACS Team
    Level 8, RAH, 1 Port Road, Adelaide SA 5000
    Telephone: (08) 7074 2701
    Fax: (08) 8429 6070

Multidisciplinary team members

Medical staff

  • Dr Nicholas Farinola (Clinical Pharmacologist, General Physician)
  • Professor Sepehr Shakib (Clinical Pharmacologist, General Physician)
  • Associate Professor Josephine Thomas (General Physician)
  • Dr Rami Tadros (Clinical Pharmacologist, General Physician)
  • Dr Tam Le Cong (General Physician)
  • Dr Alice O’Connell (General Physician)
  • Dr Angela Molga (Clinical Pharmacologist, Geriatrician)
  • (Endocrinologist)
  • (Cardiologist)
  • (Clinical Pharmacology Registrar)
  • (General Medical Registrars)

Case coordinators

  • Allyson Rappensberg (Chronic Disease Nurse Consultant)
  • Georgina Walker (Chronic Disease Clinical Nurse)

Allied Health

  • Marie Dow (Psychologist)


  • Natalie Soulsby (RAH and HMR’s)
  • Lynette Kirkwood (Sefton Park)


  • Todorka Grammatopoulos

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