Attachment C – Pathways for seeking care in the after-hours period

There are a range of information sources and primary care services available for people in the after-hours period. The Australian Government provides in excess of $1.0 billion annually to support the provision of after-hours primary care services through various programs and incentive payments. Urgent after-hours expenditure currently comprises around a quarter of this expenditure.

There are a range of alternative pathways funded by a combination of Commonwealth, state and territory governments, which a patient can access when they need medical assistance during the after-hours period.

 

  • After-hours telephone helpline through Healthdirect, which provides free access to a GP at night, on weekends and public holidays, when a patient’s regular GP is not available and medical advice is needed. Healthdirect also provide a free helpline for health advice from a registered nurse that is available 24 hours a day, 7 days a week. Authoritative health information and a symptom checker are also available on the website.
  • Extended after-hours clinics are usually regular general practice clinics that offer appointments in the after-hours periods. These clinics typically remain open until 10pm -12pm on weekdays, and are open on the weekend.
  • After-hours home visits are provided by doctors for patients who need medical care in their homes.
  • Pharmacies offer extended trading hours, with pharmacists available for medical advice.
  • Emergency departments provide care 24 hours a day, 7 days a week for patients who require emergency medical assistance.
  • Ambulance services provide emergency and non-emergency transport to patients in the community and at hospital.
  • Self-care at home, if professional medical assistance is not needed.

 

Examples of local initiatives funded through by the Commonwealth and state and territory governments include:

 

  • Urgent Care Centres such as the St John Urgent Care Centres in Western Australia, which allow for patients with non-life threatening injuries or illnesses to be seen by a doctor without the need to attend an emergency department. These centres are open 7 days a week, up to 10pm at night.
  • Nurse walk-in centres such as the Walk-in Centres funded by the ACT Territory Government which provides free one-off advice and treatment for people with minor illness and injury, with no appointment necessary. These centres are usually open seven days a week, from 7:30am to 10pm.
  • Primary Health Networks fund services to provide care to patients in the after-hours period if there is a need. The Hunter GP Access scheme for example, is based in the Hunter Valley of New South Wales and triages and refers patients onto necessary care. They also conduct home visits, and fund transportation of patients when they cannot access a clinic.

Other Commonwealth funding relating to after-hours service provision

The Practice Incentives Program (PIP) After-Hours incentive payments encourage general practices to provide after-hours care for their patients. The incentive payment consists of five payment levels for practices to choose the model of care that best suits their business needs. Large practices providing complete after hours coverage at level five, can receive up to $220,000 per year, however only a very small number of practices would receive this amount. The average after-hours payment to a practice is approximately $15,000 per year.

Funding of up to $5,000 per practitioner is also provided through the Practice Incentives Program Aged Care Access Incentive to encourage GPs to provide care into RACFs. Nationally, 84.9 per cent of general practice activity is undertaken by practices enrolled in the PIP[10].

In addition to incentive payments, the Government provides funding to Primary Health Networks (PHNs) to work with key local after-hours stakeholders to plan, coordinate and support locally-tailored after-hours health services. PHNs focus on addressing gaps in after-hours service provision, targeting solutions for ‘at risk’ populations, and improving service integration, particularly where gaps exist due to a lack of access to general practices registered for the PIP After-Hours payment. In 2015–16 approximately $70 million was provided to PHNs to support after-hours care.

The Commonwealth and states and territories jointly fund Healthdirect. Healthdirect provides people with advice and information from nurses. In 2015–16, there were 761,044 calls handled by the helpline.[11]

For people who require health advice during the after-hours period but do not have access to face to face GP services, the Government provides funding for the after-hours GP helpline, which is an extension of the Healthdirect helpline.

In 2016–17, the Government will provide $17.9 billion in National Health Reform funding to support state health services, including hospital services and public health. This is an increase of approximately $1.0 billion, or 6.2 per cent, from 2015–16. The funding focuses on improving patient safety and the quality of services, and reducing unnecessary hospitalisations.

 


 

 


[10] Source: Report on Government Services 2016, Productivity Commission, Table 10.A.56

[11] Figures provided by Healthdirect Australia as at 30 November 2016