7. 24/7 access to support

Access to support 24 hours, seven days a week (i.e. 24/7) delivers timely appropriate care interventions and builds partnerships in decision-making with the person, their family and carers. Providing access to urgent clinical advice, medications (prescribing and supply) and support in the after-hours period will support people to be cared for in their preferred place and provide a point of contact for individuals, their family and carers.

Action

Processes are in place to ensure all people receiving end of life and palliative care, as well as their family and carers, have access to appropriate support 24/7, and are informed of how to access this support. In the after-hours period, mechanisms are in place to provide urgent clinical advice and support for people receiving care at home. People have clear information and instructions about how to access this advice.

Evidence

Access to supportive care and advice outside of business hours aims to support high quality provision of care and reduce the burden on families, carers and clinicians in stressful and unfamiliar situations.

Considerations and resources

In the after-hours period, mechanisms are in place to provide urgent clinical advice and support for people receiving care at home. This includes the NSW Palliative Care After Hours Helpline and a local after-hours telephone support and advice line or after-hours home visiting, where available.

Using virtual care

Referrers should consider the questions and use the tools and information below when providing virtual palliative and end-of-life care.

Consider if/how the service model can be provided virtually after-hours? Provide patient, family and carers with after-hours service information and contact numbers. Identify and provide referral pathways and modalities available after hours (e.g. telephone consultation, video consultation), HealthDirect (24/7 phone line 1800 022 222), or would an ambulance be more appropriate?

Consider and provide the equipment required to support the clinical workforce to provide care after hours? Who else needs to attend the appointment? If the patient does not have decision-making capacity, is the person responsible attending the appointment? Is a support person needed? Has the patient identified a family member or carer to be included in their care discussions? Has the clinician considered the multidisciplinary advantages of having the GP, family, specialist, other health professionals and other relevant people to attend the appointment? More on consumer preparation and carer engagement.

Does the patient, family or carer need support to navigate the virtual care platform? Consider the need for an  additional clinician, family or carer to be available to support the patient.  Provide virtual care education resources as required.

What happens if the patient, family, or carer deteriorates, or the technology fails while I’m providing care virtually? Each team should have their own protocols for escalating care or managing technology failures during an appointment. Measures could include:

• Confirming the patient’s address and contact number at the start of any consult
• Being able to call an ambulance or other emergency service
• Organising an urgent visit
• Contacting a family member
• Enacting the backup process if the connectivity is poor or the technology fails

More about consumer support

For more virtual care resources, see:

• Virtual care in practice guide
  Information to support healthcare providers to deliver virtual care.
• Virtual care palliative care resources for clinicians and consumers
  Resources supporting health professionals, patients, families and carers to access and use virtual care as part of palliative care.