Funding arrangements for after hours primary health care
Funding arrangements for after hours service provision were implemented on 1 July 2015 and consist of the PIP After Hours Incentive, funding to support locally tailored after hours services (the Primary Health Networks After Hours Program), and the HealthDirect After Hours GP advice and support line.
Practice Incentive Payment (PIP) After Hours Incentive
The PIP After Hours Incentive has five payment levels, and is available to eligible general practices registered for the PIP. The PIP After Hours Incentive provides payments to accredited general practices that ensure their patients have access to quality after hours care.
The PIP After Hours Incentive is based on a practice's Standardised Whole Patient Equivalent (SWPE).
The 5 payment levels for the PIP After Hours Incentive are:
Level 1 Participation Payment - $1 per SWPE
Practices must have formal arrangements in place to ensure that practice patients have access to care in the complete after hours period (hours outside of 8am to 6pm weeknights; hours outside of 8am to 12pm Saturdays; and all day Sundays and public holidays).
Level 2 Sociable After Hours Cooperative Coverage Payment - $4 per SWPE
Practices must:
- participate in a cooperative arrangement with other general practices that provides after hours care to practice patients in the sociable after hours period (6pm to 11pm weeknights), and
- ensure formal arrangements are in place to cover the unsociable after hours period (11pm to 8am weekdays, hours outside of 8am and 12pm Saturdays and all day Sundays and public holidays).
Level 3 Sociable After Hours Practice Coverage Payment - $5.50 per SWPE
Practices must:
- provide after hours care to practice patients directly through the practice in the sociable after hours period (6pm to 11pm weeknights); and
- ensure formal arrangements are in place to cover the unsociable after hours period (11pm to 8am weekdays, hours outside of 8am and 12pm Saturdays and all day Sundays and public holidays).
Level 4 Complete After Hours Cooperative Coverage Payment - $5.50 per SWPE
Practices must participate in a cooperative arrangement with other general practices that provides after hours care to practice patients for the complete after hours period (hours outside of 8am to 6pm weeknights; hours outside of 8am to 12pm Saturdays; and all day Sundays and public holidays).
Level 5 Complete After Hours Practice Coverage Payment - $11 per SWPE
To be eligible for the Level 5 Complete After Hours Practice Coverage Payment, practices must provide after hours care to practice patients in the complete after hours period (hours outside of 8am to 6pm weeknights; hours outside of 8am to 12pm Saturdays; and all day Sundays and public holidays).
Guidelines setting out the eligibility requirements for the PIP after hours incentive are available at the Services Australia websiteTop of page
Further information on Primary Health Networks.
After Hours GP Advice and Support Line
The After Hours GP helpline is funded by the Australian Government, and was established in 2011. The helpline is a telehealth service, offering GP telephone advice and diagnostic services to the general public; and is accessed through the Health Information Advice Service (HIAS). The After Hours GP helpline draws on information from the National Health Services Directory (NHSD), and directs callers to the most appropriate local services, including alternatives to visiting emergency departments in major cities.
The After Hours GP helpline provides support to those who seek after hours medical advice, and aims to ensure unnecessary presentations to hospital Emergency Departments, and to better enable integration with other primary care services.
The After Hours GP helpline can be accessed by callers:
- outside of major cities
- weekdays from 6pm -7:30am
- Saturdays from midday
- All day Sunday and public holidays
- Within major cities at times when local after-hours GP services are not available
- Weekdays from 11pm -7:30am
- Saturdays from 6pm
- All day Sundays and public holidays
For more information on the AHGP helpline please visit: https://about.healthdirect.gov.au/after-hours-gp-helpline
Primary Health Network (PHN) After Hours Program
The PHN After Hours Program supports PHNs to plan, coordinate, support and commission population-based after hours health care services. The program focusses on addressing gaps in after hours service provision and improving service integration in communities.
To inform future directions of the program, in 2019 Health Policy Analysis undertook a program evaluation. The Evaluation Report was finalised in January 2021.
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