Criterion GP1.3 – Care outside of normal opening hours

Why this is important

Consumers need to be informed of how they can access care when the practice is not open. This includes when the practice is closed during an after-hours period and during periods that are not specifically ‘after-hours’. This allows consumers to access appropriate healthcare when they need it and may decrease demand on hospital emergency departments. Synchronous care is care delivered to consumers in real-time. This could include telehealth services or face-to-face.

Meeting this Criterion

Informing patients about care outside of normal opening hours

To inform consumers about care outside normal opening hours, the practice could:

• use an out-of-hours message on the practice’s after-hours phone number
• use its consumer information sources (eg on the practice website, email signatures, social media and posters)
• display a clearly visible sign outside the practice of normal opening hours and arrangements for care outside of those hours.

Provision of after-hours care by the practice

For consumers to be able to access care after-hours, the practice could provide after-hours care directly, either during sociable after-hours or for the full after-hours period.

Provision of after-hours care by another provider

After-hours care may also be provided on behalf of the practice by another practice or provider. If the practice uses a third-party provider (including telehealth), the third-party provider’s clinicians need to meet requirements to practice in Australia.

Australian health practitioner obligations

If the practice does not provide care outside normal opening hours, the service to which the practice refers consumers must be provided by Ahpra registered doctors or nurses.

After-hours telehealth and arrangements with third-party providers

All after-hours telehealth consultations need to be synchronous (ie performed in real-time). If the practice engages with an after-hours telehealth provider or medical deputising service, a formal document with the provider could include details of the arrangements and:

• how and when the practice receives documentation and information about care provided to patients after-hours
• how the provider can contact the practice in an emergency or exceptional circumstances
• how the provider delivers safe and quality care that is patient-centred and culturally appropriate and meets its obligations under the Australian Privacy Principles
• the triage and escalation process for patients to consult with a clinician via telehealth after-hours
• how the provider will ensure patients requiring an in-person consultation will be seen either by a practice GP at a clinically appropriate time or referred to the local hospital or facility.

If the practice does not provide after-hours care, the practice could give the third-party the after-hours contact details of one or more GPs from the practice so they can access important information about the patient, particularly in an emergency.

Healthdirect

The practice could refer consumers to healthdirect (a national, 24-hour helpline provided by the Australian government), that can direct consumers to registered health professionals for health advice, including a GP or registered nurse call back or video call when the practice is closed.

Temporary closure periods

Examples of when a practice might be closed for a period that is not specifically ‘after-hours’ may include:

• staff absences
• holiday closures
• emergencies such as floods – refer to Criterion 3.3 – Emergency response plan.

If the way the practice manages these instances differs from regular after-hours arrangements, the practice could consider a separate policy or procedure for this.

Patient health records inclusion

When provided, discharge summaries, reports or notes of after-hours care that is provided by, or on behalf of, your practice must be added to patient record. This helps ensure continuity of care and follow-up by your practice’s clinical team.

Resources

RACGP Guide to providing telephone and video consultations in general practice.
RACGP Telehealth and supervision: A guide for GPs in training and their supervisors.

Meeting each Indicator

GP1.3 A Our patients are informed about how they can access after-hours care.

You must:

To inform patients about care outside normal opening hours, the practice could:

• use an out-of-hours message on the practice’s afterhours phone number
• use its consumer information sources (eg on the practice website, email signatures, social media and posters)
• display a clearly visible sign outside the practice of normal opening hours and arrangements for care outside of those hours.

GP1.3 B Our patients can access after-hours care.

You must:

You could:

• maintain a roster showing which practice team members are on-call for after-hours
• participate in a cooperative arrangement with another practice to deliver after-hours care
• have formal arrangements in place with other providers, such as a medical deputising service, to deliver after-hours care
• have an agreement with local healthcare providers that operate outside of your normal opening hours
• have an after-hours phone message that tells patients where they can access after-hours care
• direct patients to a list of after-hours providers, either on the practice website, social media, after-hours telephone message or posters around the practice.