Improve Your Practice

Patients often require medical treatment out of normal working hours. It is therefore important for practice managers to make appropriate arrangements so that after-hours medical care is available for your patients.

Who provides after-hours services?

Fewer doctors provide direct after-hours medical services. Instead, many after-hours medical services are provided by after-hours medical deputising services, co-operatives of local doctors, or by a colleague/s on a roster basis or by hospital emergency departments. For general practices and since July 2013, Medicare Locals are now responsible for the coordination of after-hours medical services within their local areas.

This change in after-hours service arrangements has led to a modification in the requirements of general practices around their obligation to accreditation standards.In response to this, the RACGP is adopting a position in relation to Criterion 1.1.4 of the RACGP 4th Edition Standards as follows:

  • Practices are required to demonstrate that they are aware of the arrangements in place for their patients to access after-hours care; and
  • Practices are required to have processes in place to alert their patients to these arrangements.

Doctor fatigue

All practice managers should be aware of the issues around doctor fatigue and the effect that this has on safety for patients and doctors. Provision of after-hours care should not be at the cost of burnout or risk to the health of those providing the service or the safety of their patients.

Improve your practice

  1. Have a clear process for providing after-hours medical services to your patients.  
  2. Communicate this process to staff and patients. For example, this can be through a practice newsletter, on your website, or on your practice telephone answering service. 
  3. Know the contact details of the after-hours service used at your practice and be able to communicate this to staff and patients, if required.     

Deputising services should keep detailed clinical records and promptly advise the regular doctor/practice as to any services provided to their patients, and particularly if any follow-up is required. Most deputising services will provide a clinical report via secure electronic delivery and/or facsimile to your practice within 24 hours of a visit to any of your patients.    

Further, at times, seriously abnormal pathology or other test results might only be available after hours and in such instances the pathologist/other should be able to contact the referring doctor (or the manager if they are unable to be contacted), either through your deputising service (who would hold your phone number) or directly by the pathology/other provider – which means providing your contact phone number to such services as well as to the deputising service.

Patient needs

The after-hours service you provide will have a lasting impression on all your patients. Your practice may secure good or poor recommendations based on your after-hours care provision.

For specialist practices, each practice will have a different approach to how they manage patient’s need for after-hours care. It is important that the practice has a message on the phone regarding after-hours calls. Some practices may have specific arrangements with their referrers and patients regarding the provision of these services. For example, post-op patients may be given a direct contact number.

For particular types of practices (surgical, obstetrics, etc) it is standard practice to be available after hours to patients you have undertaken a procedure on – either to be available yourself or have a nominated colleague available who has received appropriate handover of information regarding the patients and their procedure. Colleagues who cover practitioners should always comply with their usual standard of practice and be familiar with the procedures for which they are covering. It is important for doctors to remain within their scope of practice.

There may be some instances where a GP needs to be available after hours and the practice manager should have contact details for all doctors in their practice.

Annual leave:

Ensuring your doctors have regular annual leave is important for their health.

Surgeons should schedule their procedures to be completed 7 to 10 days before annual leave to ensure they are available in the immediate post-operative period. In the event that you go on leave after operating, ensure that you have adequately handed over your patients to a colleague or locum.

As a practice manager, you also need to have regular annual leave as it is important for your health.

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This publication is proudly brought to you by Avant Mutual Group. The content was authored by Brett McPherson, reviewed by Colleen Sullivan and Avant Mutual Group.

This publication is not comprehensive and does not constitute legal or medical advice. You should seek legal or other professional advice before relying on any content, and practice proper clinical decision making with regard to the individual circumstances. Persons implementing any recommendations contained in this publication must exercise their own independent skill or judgment or seek appropriate professional advice relevant to their own particular practice. Compliance with any recommendations will not in any way guarantee discharge of the duty of care owed to patients and others coming into contact with the health professional or practice. Avant is not responsible to you or anyone else for any loss suffered in connection with the use of this information. Information is only current at the date initially published. © Avant Mutual Group Limited 2014.

IMPORTANT: Professional indemnity insurance products and Avant’s Practice Medical Indemnity Policy are issued by Avant Insurance Limited, ABN 82 003 707 471, AFSL 238 765. The information provided here is general advice only. You should consider the appropriateness of the advice having regard to your own objectives, financial situation and needs before deciding to purchase or continuing to hold a policy with us. For full details including the terms, conditions, and exclusions that apply, please read and consider the policy wording and PDS, which is available at or by contacting us on 1800 128 268. Practices need to consider other forms of insurance including directors’ and officers’ liability, public and products liability, property and business interruption insurance, and workers compensation and you should contact your insurance broker for more information. Cover is subject to the terms, conditions and exclusions of the policy. Any advice here does not take into account your objectives, financial situation or needs. You should consider whether the product is appropriate for you before deciding to purchase or continuing to hold a policy with us.