1. Purpose

This procedure provides guidance for Knight OnCall managers responding to after-hours situations where a person requires attendance at a non-emergency medical appointment, urgent care service, hospital, imaging service, pharmacy, pathology provider, or similar health-related appointment.

The procedure supports safe operational coordination and escalation aligned with:
• NDIS Practice Standards
• Aged Care Quality Standards
• Child Safe Standards and Child Protection obligations
• Work Health and Safety legislation

Knight OnCall provides after-hours triage, operational guidance, escalation, and documentation support only.

2. Scope

This procedure applies to Knight OnCall staff managing after-hours calls involving non-urgent medical attendance within disability, aged care, or child-related support services.

This procedure applies where operational guidance or escalation support is required relating to:
• transport arrangements
• staffing or supervision concerns
• medication support
• hospital or appointment attendance
• family, guardian, nominee, representative, or provider notification
• continuity of care arrangements.

This procedure does not apply to life-threatening emergencies requiring immediate emergency response.

3. Call Classification

Category: Personal Care & Daily Living Issues
Call Type: Non-Urgent Medical Attendance
Priority: Moderate
Emergency Services: Only if condition escalates
Provider Escalation: Case dependent

4. When This Procedure Applies

This procedure applies when:
• a person requires attendance at a GP, urgent care service, hospital, imaging service, pathology provider, pharmacy, or specialist appointment
• staff require after-hours operational guidance relating to attendance arrangements
• support workers require assistance coordinating transport, staffing, supervision, or notifications
• there are concerns regarding safe support during attendance
• a person requires support to attend a non-urgent X-ray, scan, check-up, pathology appointment, or similar routine health-related attendance.

5. Immediate Risk Check

The on-call manager must determine whether the situation remains non-urgent.

Emergency escalation may be required if:
• the person’s condition deteriorates
• severe pain, breathing difficulty, chest pain, reduced consciousness, seizure activity, uncontrolled bleeding, or other acute symptoms emerge
• the person becomes unsafe to transport without emergency support
• staff are unable to maintain safety
• the person requires urgent medical intervention or ambulance attendance.

Where immediate medical risk exists, staff must be directed to contact emergency services.

6. Immediate Information to Obtain

• What is the reason for attendance?
• Is the matter confirmed as non-emergency?
• What symptoms or concerns are present?
• Where is the appointment, hospital, or medical service located?
• Who is supporting the person?
• Is transport available and appropriate?
• Are there mobility, behavioural, communication, or sensory support needs?
• Are medications, health plans, hospital transfer documents, or medical information required?
• Does the person require guardian, family, nominee, representative, or provider notification?
• Will staffing ratios, supervision arrangements, or other persons receiving support be impacted?

7. Immediate Manager Actions

The on-call manager should:
• confirm the person’s immediate safety and wellbeing
• provide operational guidance regarding transport and staffing arrangements
• ensure support staff have access to relevant support plans, health information, or provider instructions where required
• ensure required medications, communication aids, mobility aids, or documentation accompany the person where appropriate
• confirm supervision arrangements during attendance
• consider whether other persons at the service remain safely supported
• assist with escalation to the provider where operational concerns arise
• remain available to support staff during the attendance if required.

8. Sector-Specific Safeguarding Considerations

NDIS / Disability Services
• Consider communication needs, cognitive disability, behaviour support plans, sensory needs, mobility support, and high-intensity support requirements.
• Consider whether attendance affects medication administration, mealtime supports, overnight supports, or other scheduled supports.
• Consider whether the situation may relate to an incident, injury, restrictive practice concern, or possible reportable incident.

Aged Care
• Consider frailty, falls risk, dementia, delirium, medication continuity, mobility support, and hydration or nutrition needs during attendance.
• Hospital attendance may require family, representative, or provider notification in line with the provider’s usual process.
• Consider whether the circumstances leading to attendance may require review under the provider’s incident management or Serious Incident Response Scheme processes.

Child Safety / Youth Services
• Consider supervision requirements, placement rules, transport authorisations, consent, and whether a carer, guardian, caseworker, or placement provider must be notified by the provider.
• Medical attendance for a child or young person may require additional safeguarding oversight, particularly where injury, unexplained harm, absconding, self-harm, assault, or medication concerns are involved.
• The provider remains responsible for child protection notifications and statutory reporting.

9. Escalation Requirements

The on-call manager must escalate where the provider has indicated they wish immediate escalation, consider the following situations:
• the person’s condition deteriorates
• emergency services become required
• staffing levels become unsafe
• a behavioural escalation or safeguarding concern emerges
• consent or decision-making concerns arise
• unexpected admission to hospital occurs
• restrictive practices or high-risk supports are impacted
• family, guardian, representative, or provider notification is required outside the on-call manager’s delegation.

Knight OnCall does not provide clinical direction and does not engage external health professionals directly unless authorised by the provider.

10. Documentation Requirements

The on-call manager must:
• document factual details relating to the attendance
• record the reason for attendance and whether the matter was non-urgent at the time of the call
• record times, locations, staffing arrangements, and advice provided
• document transport arrangements and supervision considerations
• document escalation actions and notifications
• record any identified risks or operational concerns.

Documentation must remain factual and objective.

11. Post-Incident Follow-Up During On-Call Period

During the on-call period Knight OnCall will:
• monitor unresolved operational concerns
• support staffing coordination where required
• provide operational guidance to staff
• escalate ongoing concerns to the provider
• document advice and actions taken
• confirm whether any further on-call support is required once the person returns or is admitted.

12. Handover to Provider

All unresolved matters must be handed over to the provider’s daytime management team.

The handover should include:
• summary of attendance or appointment
• operational issues identified
• staffing or supervision concerns
• escalation actions completed
• current status of the person, if known
• recommended follow-up actions.

13. Knight OnCall Role Boundary

Knight OnCall provides after-hours triage, operational guidance, escalation, and documentation support only.

Responsibility for:
• clinical assessment
• diagnosis
• treatment decisions
• medication prescribing
• hospital management
• ongoing care planning
• family or representative notification unless delegated
• regulatory reporting

remains with the provider and relevant healthcare professionals unless otherwise agreed in writing.