Patient enrolment

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Enrolling a patient in a Health Care Home will be a new process for practices, doctors, and for patients themselves. The following steps are an outline of how enrolment may be undertaken.

Eligible patient identified

The practice identifies a potentially eligible patient via:

  • the risk stratification software used by the practice.
  • assessment of a patient during a consultation.
  • or if a patient asks about enrolling in Health Care Homes.

Patient is introduced to Health Care Homes

  • The doctor, practice nurse or other staff member talks to the prospective patient about Health Care Homes.
  • The practice gives the patient a brochure about Health Care Homes.

Risk stratification

  • The Health Care Home completes the second stage of the risk stratification tool for the patient, based on information provided by the patient during the consultation.
  • The patient is confirmed as eligible and assessed as either Tier 1, 2 or 3.

Patient consent

  • The doctor gives the patient an enrolment and consent form; and a patient consent for data provision form.
  • The practice gives the patient a resource pack with detailed information about Health Care Homes.

Patient registration

  • The practice registers the patient with HPOS.
  • The enrolled patient will be assigned to a lead clinician. which can be changed according to the patient's preference via HPOS. The nominated clinician is expected to be able to provide long term support.
  • A GP Registrar undertaking an approved program placement (eg. 6-12 months) could take on the role as a patient’s nominated clinician to gain a greater understanding of this model of care.
  • Bundled payments start from the date the patient is enrolled with the practice.