Aboriginal people living in NSW continue to experience greater health risks, poorer health and shorter life expectancies than non-Aboriginal Australians. The NSW Health-funded program, Chronic Care for Aboriginal People, was established from existing initiatives to rethink the way chronic care services were delivered to Aboriginal people in NSW. Refocusing and building on existing projects led to NSW Health providing an evidence base of what was working in Aboriginal communities. A model of care for Aboriginal people with chronic disease has been developed. Recommendations from two evaluations have allowed further improvement for the delivery of chronic care services for Aboriginal people. The Local Health District Service Agreements include relevant indicators and strategic priorities relating to the chronic care program.