Key messages

  • Patients presenting outside their area of service must be received with special attention to the principles and standards that apply to out-of-area care.
  • If acutely disturbed older consumers of adolescents cannot be admitted to a service catering specifically to their needs they must be admitted to an adult service.
  • Financial responsibility and practice standards are set out for out-of-area patients.

There are principles and standards in relation to out-of-area placements, including special considerations for psychogeriatric and adolescent placements, financial responsibility and practice standards.

Principles to guide out-of-area placements

There are core principles to guide out-of-area placements:

  • The wellbeing and safety of the patient and community must be considered before anything else.
  • All people who present for admission to an inpatient service must be assessed with regard to their mental status and risk to self and others, regardless of their area of origin.
  • If the person needs to be admitted, and they do not live in the catchment, the area mental health service to which the patient presents is responsible for the person’s immediate management and must notify the person’s area-of-origin service of the situation.
  • If the person is awaiting transport and admission to another hospital, the duty of care lies with the area mental health service to which the person has presented. The area mental health service must determine and provide interim clinical management.
  • If the person’s area-of-origin service has no capacity available, the authorised psychiatrist (or delegate) of the presenting area mental health service must either admit the patient or locate an appropriate service elsewhere at the cost of the patient’s area-of-origin service.

Psychogeriatric and adolescent admissions

If an acutely disturbed psychogeriatric or adolescent patient cannot be safely admitted to a psychogeriatric or adolescent service, and needs to be admitted to an adult service, it is the responsibility of the authorised psychiatrist (or delegate) of the presenting service to either admit the person as an adult inpatient or find an appropriate adult service elsewhere.

The responsibility for the person resides with the service to which the person presents.

Financial responsibility and out-of-area services

Guidelines on financial responsibility for out-of-area services are detailed in the Program Management Circular No. 3/95 ‘Accessing services across regions and areas’.

Practice standards and out-of-area placements

The following practice standards apply to out-of-area placements:

  • All patients who present for admission must receive a thorough and documented assessment of their service needs.
  • If the patient is held over in the presenting hospital, pending transfer to another hospital, all treatment and care must be documented and must meet appropriate standards of practice for inpatient management.
  • Documentation must indicate that the patient’s area-of-origin service has been notified within 24 hours of the out-of-area admission.