After Hours Care and Triage Policy

Purpose

The purpose of this policy is to ensure patients have access to safe and appropriate after-hours medical triage and care arrangements when the clinic is closed, while maintaining patient safety through appropriate escalation and referral pathways.

This policy supports continuity of care and outlines the clinic’s after-hours triage process, appointment arrangements, emergency escalation procedures, and billing practices.

Policy

The clinic provides an after-hours triage service for urgent medical concerns that cannot reasonably wait until the next business day.

The after-hours service is not intended to replace emergency medical services or hospital care.

After Hours Service Availability

The clinic provides after-hours triage services during the following times:

• Monday to Friday:

  • 5:00pm to 8:00am

• Weekends:

  • From 5:00pm Friday through until 8:00am Monday

• Public Holidays:

  • Service availability may vary depending on clinician availability

After Hours Triage Contact

Triage Nurse: Michelle Mitchell
Phone: 0415 040 764

The triage nurse will:

• Assess the patient’s presenting concern

• Determine the urgency of the matter

• Provide general nursing advice within scope of practice

• Escalate clinically concerning presentations appropriately

• Arrange a doctor consultation where clinically appropriate

• Recommend hospital or emergency services where required

The after-hours service is intended for urgent matters only and not routine administrative requests.

Examples of non-urgent matters that may be redirected to routine clinic hours include:

• Repeat prescriptions without urgency

• Routine referrals

• Medical certificates

• Routine results discussions

• Ongoing chronic condition reviews without acute deterioration

Results Management After Hours

Urgent and critical pathology and diagnostic imaging results received after clinic hours are managed in accordance with patient safety and clinical escalation requirements.

The clinic’s pathology provider has procedures in place to directly notify the treating doctor or on-call doctor of any urgent or critical results identified after hours.

Where clinically necessary, the doctor will:

Contact the patient directly after hours

Provide appropriate medical advice

Arrange urgent review, treatment, or follow-up as required

Advise the patient to attend an Emergency Department or call 000 where appropriate

Patients are advised that routine or non-urgent results will generally be reviewed and communicated during normal clinic operating hours.

The after-hours service is not intended for routine results enquiries. Patients requiring discussion of non-urgent results may be asked to arrange a routine appointment during business hours.

Emergency Situations

Patients experiencing potentially life-threatening symptoms will be advised to immediately call 000 or attend the nearest Emergency Department.

The clinic will not arrange routine GP appointments for patients requiring emergency assessment or hospital-level care.

Examples of emergency presentations include, but are not limited to:

• Chest pain

• Suspected heart attack

• Severe shortness of breath

• Difficulty breathing

• Signs of stroke:

  • facial drooping

  • arm weakness

  • speech difficulty

• Severe allergic reactions or anaphylaxis

• Loss of consciousness

• Seizures

• Severe bleeding

• Major trauma or significant injury

• Severe head injury

• Sudden severe abdominal pain

• Severe dehydration

• Oxygen saturation concerns or blue lips

• Suspected sepsis

• Acute mental health crisis or suicidal ideation

• Severe burns

• Sudden vision loss

• Pregnancy emergencies including heavy bleeding or severe abdominal pain

Where clinically appropriate, the triage nurse may advise the patient to:

• Call 000

• Attend the nearest Emergency Department

• Attend an Urgent Care Centre

• Arrange ambulance attendance

Non-Emergency After Hours Care

For urgent but non-life-threatening medical concerns, the triage nurse may:

• Arrange a telehealth consultation

• Arrange an in-person appointment where appropriate

• Arrange a next-business-day appointment

• Provide interim self-care advice within nursing scope of practice

Examples of presentations potentially suitable for GP review include:

• Mild infections

• Non-severe respiratory symptoms

• Urinary symptoms

• Mild skin conditions

• Minor injuries

• Medication queries

• Fever without severe symptoms

• Acute worsening of stable chronic conditions

• Follow-up advice

Telehealth Consultations

Where clinically appropriate, consultations may be conducted via telehealth.

Patients may still be advised to attend hospital or attend an in-person consultation where:

• Physical examination is required

• Symptoms suggest a potentially serious condition

• The patient appears clinically unstable

• The treating doctor determines telehealth is unsuitable

Documentation

Clinically significant after-hours interactions should be documented in the patient medical record, including:

• Date and time of contact

• Presenting complaint

• Advice provided

• Escalation actions taken

• Follow-up recommendations

• Whether emergency services or hospital attendance were advised

• Consultation type and billing details where applicable

Scope and Limitations

The after-hours service:

• Is intended for urgent medical concerns only

• Does not replace emergency medical services

• Does not guarantee immediate doctor availability

• May involve telehealth consultations where appropriate

Patients are advised to call 000 immediately in any medical emergency.

Review

This policy will be reviewed annually or earlier if required due to operational, accreditation, legislative, or clinical practice changes.

Fees and Billing

After-hours consultations may attract private fees in accordance with the clinic’s mixed billing policy.

Telehealth Consultations

Before 6:00pm weekdays and before 1:00pm Saturdays

Consultation Type Fee:

Level B Standard Consultation $110

Level C Long Consultation $160

After 6:00pm weekdays, after 1:00pm Saturdays, and all day Sundays

Consultation Type Fee:

Level B Standard Consultation $130

Level C Long Consultation$190

Home Visits:

Home visits are provided at the discretion of the treating clinician and are subject to availability, clinical appropriateness, location, and safety considerations.

Payment may be required prior to attendance where appropriate.

Before 6:00pm weekdays and before 1:00pm Saturdays

Consultation Type Fee:

Level B Standard Home Visit $180

Level C Long Home Visit $250

After 6:00pm weekdays, after 1:00pm Saturdays, and all day Sundays

Consultation Type Fee:

Level B Standard Home Visit $250

Level C Long Home Visit $320

Additional fees may apply for:

• Extended travel distances

• Multiple patient attendance

• Complex procedures

• Public holiday visits

Applicable Medicare rebates may apply for eligible services.

Patients will be informed of any applicable fees where practical prior to consultation.

Bulk billing may be offered at the discretion of the treating doctor for eligible patients, including:

• Pension concession card holders

• DVA patients

• Children under 16 years

• Patients experiencing financial hardship

• Other clinically appropriate circumstances

Medicare eligibility requirements apply to all billable services.