Community nursing services policy

Overview

This service aims to facilitate an early and convenient discharge from hospital, acting as an alternative to in hospital care for workers to transition home.

The agent will periodically review a worker's entitlement to community nursing services to ensure the treatment and services remain reasonable for the work-related injury or illness and are payable under the legislation.

What are community nursing services

• Nursing care provided as an alternative to a hospital/clinic, hospital outpatient setting in the community, non-hospital based ambulatory clinic or the workers home.
• Nursing care is provided only by a suitably qualified nurse in alignment with care requirements.
• Provides care in line with the clinical framework
• Nursing services can provide but are not limited to:
  • General nursing services
  • Post hospital admission treatment
  • Wound care treatment and management
  • Medical continence care support.
  • Patient education to support self-care
  • Support in training personal care attendants

Community nursing services is a sub-acute service that is intended to be provided to workers in an ambulatory out of hospital setting where short term treatment is to be provided in an aim to enabling patient independence in self-care.

Who can refer for community nursing services

• General Practitioners
• Medical Practitioners
• Hospitals

Agent approval

Prior approval from the agent is not required when all of the below is applicable.

• requested by a medical practitioner (referral for nursing services is provided to the agent)
• required as a result of a work related injury or illness
• reasonable, necessary and appropriate in the circumstances

Who can provide nursing services

Nursing providers and sole practicing community nurse providers must be registered with WorkSafe and have a relevant registration with AHPRA.

In relation to community nursing services what the agent will not pay for

The agent will not pay for:

• services for a condition that existed before the work related injury or illness or that is not a direct result of the work-related injury or illness
• treatment or services where there is no National Health and Medical Research Council level 1 or 2 evidence that the treatment or service is safe and effective. Refer to the Non-established, New or Emerging Treatments and Services Policy
• counselling services provided by nurses

• services that are of no clear benefit to the worker
• non-attendance fees where a worker failed to attend
• the cost of telephone calls and telephone consultations between providers and workers, and between other providers, including hospitals that do not align with WorkSafe's telehealth policy
• treatment or services provided by telephone or other non face to face mediums that do not align with WorkSafe's telehealth policy
• treatment/services subcontracted to a non-registered provider
• services provided outside of Australia without prior approval from the agent
• invoices that do not meet WorkSafe's invoicing requirements

Suspended from providing services to WorkSafe clients

If WorkSafe gives notice to a provider advising them that they are suspended from providing services to WorkSafe clients, WorkSafe will notify the Australian Health Practitioner Regulation Agency or other relevant professional body that regulates the provider, and Medicare Australia of the suspension and the grounds on which the suspension has been issued.