Doctors must have been accredited at Epworth for a minimum of 6 months before they are eligible to participate on an on-call roster. All appropriately credentialed doctors are sent a request for their potential expression of interest in participating in their relevant specialty roster. As some rosters are prepared for 6 month periods, considerable time can pass between distributions of expressions of interest.
Specialists may register to pick up available on-call periods for roster vacancies that may arise prior to the next roster being generated. Credentialed specialists interested in participating in the relevant on-call roster should contact:
Emergency on-call rosters coordinator
The On-Call Rosters Coordinator is responsible for the coordination and management of Epworth HealthCare Emergency On-Call Rosters across various specialities.
Emergency on-call specialities include:
- General Medicine
- General Surgery
- Hospital in the Home
- Infectious Diseases
- Obstetrics Anaesthesia
- Oral & maxillofacial surgery
- Paediatric Surgery
- Plastic Surgery
- Vascular Surgery
On-call rosters for rehabilitation are site specific and not coordinated by the Emergency On-Call Rosters Coordinator.
Eligibility criteria and process
Current credentialing at Epworth as a specialist does not provide automatic entitlement for inclusion in the emergency on-call specialty roster. Eligibility to participate in specialty on-call rosters will be based on current credentialing, including consideration of any limitations on the scope of clinical practice of individual specialists. Other factors taken into consideration include post-graduate training, re-certification, maintenance of clinical competency, professionalism and commitment to Epworth.
Commitment to Epworth may include:
- Current clinical activity at Epworth including an established minimum degree of activity compared with other relevant colleagues and specialists. This will vary between specialities
- Membership of committees and participation in meetings and at other Epworth professional events
- Participation in Clinical Institute activities, including clinical audit
- Participation in under-graduate and post-graduate teaching
At Epworth, there are important considerations for the on-call roster as follows:
1. Level of patient care
The preeminent factor in the provision of an emergency on-call specialty roster is ensuring the level of care given to each Epworth patient is of the highest standard.
All specialists credentialed at Epworth can express interest in participating in the on-call roster. Specialists must have sufficient depth and breadth of clinical experience to offer the appropriate level of care required through participation in the roster.
3. On-call and multiple admission sites
Specialties across multiple sites within Epworth may be covered either by one joint combined roster, or by separate specialty specific site-based rosters. Participation in an on-call roster may see the patient unable to be accommodated with a bed at the specialist's preferred hospital. Patients admitted through Epworth Richmond's Emergency Department may be allocated beds at any site, usually Richmond or Freemasons. The location of the patients bed does not exclude any other criteria mentioned in this protocol.
It is noted that a patient coming to ED after a recent admission or procedure should be looked after by the same consultant when re-admission is directly related to the recent previous admission.
5. The Emergency Department
Emergency physicians will determine the appropriate specialist for a patient's care, factoring in previous affiliations, patient preference and the level of specialisation that may be required to manage a patient's condition. Taking these factors into account, the ED Physician will call the rostered Emergency On-Call Specialist(s) when appropriate.
The Emergency Department will note in the patient record who was called or notified for the patient, including where there were any issues or difficulties with notification. If there is a delay of 30 minutes or more in response by the relevant on-call specialist, then the Emergency Physician will attempt to call another specialist if the case is deemed necessary.
When a patient is referred for possible admission, the prime responsibility for the ongoing care of the patient is transferred to the relevant receiving specialist. While the patient physically resides in the Emergency Department, immediate care needs remain the responsibility of the Emergency Physicians.
Admission of a patient through the Emergency Department and via an on-call specialist does not exclude these patients from participation in eligible clinical trials, admission to which may be facilitated or proposed by either the Emergency Department or the treating specialist with the agreement of the admitting specialist.
Epworth Management has a responsibility to those patients attending the Emergency Department, to ensure optimal levels of care are provided. Management also has a responsibility to the Emergency Physicians and junior doctors to facilitate ease of consultation, assessment and appropriate admission of patients, or transfer to other centres if required. Management also has a responsibility to the specialists to facilitate access to in-patient admission, access to specialist investigations and access to operating theatres and procedural areas.
When on call, a specialist agrees to:
- Be readily contactable via nominated and known phone numbers
- Have experience in treating the majority of presenting conditions within the relevant specialty
- To be able to attend in person to referred patients within an appropriate time-frame
- Deal appropriately with the presenting condition
Refer patients to an appropriate Epworth-credentialed specialist when unexpectedly unavailable and to communicate this clearly to the Roster Coordinator and/or the Emergency Department
The specialist on acceptance of the roster proposal commits to abide by the Emergency Receiving Roster Policies and agrees to participate in emergency roster audit processes.
Medical Specialists may choose to share or re-allocate some of their rostered commitments with colleagues on the roster. Any Specialist who reallocates some of their rostered commitment is not entitled to additional dates in compensation, either in current or future rosters.
Epworth doctors can register an interest in accepting additional days or swap allocated days after the roster is published by ensuring that the Medical Services Roster Coordinator is aware of both their availability and interest. Specialists should note that wherever practical, Saturday and Sunday are rostered together.
Epworth's commitment to equity, consistency and wide access to care for all patients does not allow one to decline referrals under the specialty area for which they are on call. If it is necessary to decline a referral due to lack of relevant expertise, Epworth requires that you to make a referral within clinical guidelines to an appropriate Epworth colleague. Referrals for patients referred from sources outside of Epworth are not limited by this, unless already admitted to Epworth or presented at the Emergency Department.