Clinics GRP Nursing pathway
Time-limited nursing follow-up after hospital, illness or surgery, connected with rehabilitation when wounds, medicines, monitoring, mobility or confidence need coordinated attention.
Care is subject to referral information, clinical fit, address, required equipment, accepted scope and nurse availability. This is not an emergency or 24-hour response service.
Who it may suit
What nursing can include
The first visit confirms what can be safely delivered, what needs monitoring and who must be informed if the clinical picture changes.
Review the available discharge information, current care plan, medicines context and treating-team instructions.
Identify immediate nursing priorities, practical risks at home and any issue requiring medical review.
Agree a time-limited follow-up plan, communication responsibilities and rehabilitation handover where indicated.
Expected review points
Scope and boundaries
Call Triple Zero (000) for a life-threatening situation. Sudden or severe deterioration, heavy bleeding, acute obstruction, chest pain, severe breathlessness or new stroke-like symptoms require urgent medical assessment rather than a routine website enquiry.
Nurse allocation
Intake confirms the registration, competence and authorised scope required before allocating a nurse.
Communication
With consent, relevant findings and escalation can be communicated to family, GPs, hospitals, providers and other clinicians.
Funding and access
If eligible nursing is included in an approved Support at Home plan, a 0% participant contribution applies to that clinical service. The service still uses available programme funding and remains subject to the service agreement, registered-provider arrangements and accepted nursing scope.
Assessment-led nursing support for acute and chronic wounds, skin tears, pressure injuries and postoperative wound needs, with documented review and escalation when the clinical picture changes.
View pathwayNursing support for authorised medication administration, adherence, injections and clinically indicated observations, with communication to the relevant GP, pharmacist or provider.
View pathwayA structured older-person nursing assessment to identify current clinical priorities, risks, required follow-up, communication needs and an appropriate review plan.
View pathwayTiming depends on the discharge plan, clinical priority, address, required information and nurse availability. Intake confirms whether the requested start can be safely supported.
Yes. One intake pathway can consider both nursing and rehabilitation when clinical follow-up, mobility, strength, balance or confidence need coordinated attention.
No. This is community nursing follow-up after discharge, not a hospital-substitution service. People requiring hospital-level care should use the treating hospital’s pathway.
Your next step
Share the main concern, suburb, preferred timing, current care-plan or provider context and any information needed to understand the requested nursing task.
