PP10 – Care when the practice is not open

To inform consumers about how they can access synchronous care outside normal opening hours, the practice could:

• have an out-of-hours message on the practice’s afterhours phone number
• include the information on its consumer information sources (for example, the practice website, email signatures, social media and posters)
• display a clearly visible sign outside the practice stating the normal opening hours and arrangements for care outside of those hours
• provide information about recognised crisis support services, such as national helplines, as part of the practice’s after‑hours consumer information.

The practice could provide after-hours care directly, either during sociable after-hours or for the full after-hours period.

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

If the practice refers consumer to another service for care outside its normal opening hours, that service must be provided by Ahpra-registered doctors or nurses.

All after-hours telehealth consultations need to be synchronous (ie performed in real-time). If the practice refers patients to an after-hours telehealth provider or medical deputising service, there could be a formal written agreement with the provider to specify details of the arrangements, including:

• how and when the practice receives documentation and information about care provided to patients after-hours
• how the provider can contact the practice in exceptional circumstances, such as an emergency
• how the provider delivers safe and high-quality care that is:
  • person-centred
  • culturally appropriate
  • meets its obligations under the Australian Privacy Principles
• the triage and escalation process for patients who need to consult with a clinician via telehealth after-hours
• how the provider will ensure that patients who need 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
• the after-hours contact details of one or more GPs from the practice, so the third-party provider can access important information about a patient, particularly in an emergency.

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

The practice could refer consumers to an urgent care service when the practice is closed and/or does not have an available appointment, and the patient requires urgent care. This service could be a Medicare Urgent Care clinic, state-run urgent care service or a privately owned urgent care service.

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

• staff absences
• holiday closures
• emergencies such as a flood (See F2 – Response planning).

If the practice manages these instances differently to how it manages regular after-hours arrangements, the practice could consider having a separate policy or procedure for these circumstances.