Primary Options for Acute Care (POAC)


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Primary Options for Acute Care (POAC) is a patient centred service which enables General Practice Teams (GPT) to safely manage acute illness, by accessing an increased range of specified services in the community. This service provides an alternative to referring patients to hospital who would otherwise be sent to the Emergency Department (ED). The aim of POAC is to simplify arrangements for acute care in the community by providing funded care options which are aligned, wherever possible with Collaborative Clinical Pathways (CCP).

The service has been specifically designed to:

  • increase management of acute illness in the community thereby decreasing numbers presenting acutely to hospital
  • enable primary care providers to maximise the management of patients in the community
  • make the best use of available resources within the current workforce
  • integration of primary and secondary services
  • link with other community services that support the overall purpose
  • improve patient experience by providing care closer to home

A range of services are accessible through POAC, these include:

  • Diagnostic procedures, e.g. DVT Ultrasound, Plain Film X-Ray, Urgent Bloods
  • Extended services within the GP surgery (GP/NP/nurse consults, procedures e.g. incision and drainage, intravenous therapy)
  • GP/ NP or nurse home visits
  • Referral to Accident and Medical Centre
  • Home-based Support (Personal Care)
  • Acute Registered Nurse assessment and management (Recovery at Home service)
  • Patient observation

POAC funding is obtainable by completing the POAC claim form within 30 days of completing the episode of care.

While the Doctor or Nurse Practitioner takes full clinical responsibility of their patients who enter into the POAC service, the POAC team will be undertaking regular retrospective clinical audit and case review on specified POAC cases as triggered through the Continuous Quality Improvement (CQI) process. Through this process, feedback will be provided to sites in order to ensure consistency, eligibility criteria are adhered to and that the case was appropriate for POAC.

General Criteria

  • Patient is safely maintained
  • Patient ≥ 16 years of age
  • Only exception is when specified POAC pathways for children are used
  • Patient would otherwise have been referred acutely to hospital in the MidCentral DHB region
  • Services are not funded through another funding stream
  • Patient is resident in NZ, UK or Australia or has a working visa with a continuous stay of two years or more

To be eligible for POAC services, the following criteria applies:

  • Patient ≥ 16 years of age
  • Only exception is when specified POAC pathways for children are used
  • The patient is acutely unwell and has been assessed as clinically safe and appropriate to be managed in the community
  • The patient has given his/ her consent to the recommended treatment
  • The patient has given his/ her consent to their clinical consultation notes being used for auditing and evaluation purposes as part of the data collection process for the POAC
  • The patient is eligible to access funded New Zealand health care services
  • The clinician is able to take responsibility for the patients care, or have handed over the patient to another clinician
  • The clinician can confirm that in their opinion the patient would otherwise have been referred acutely to hospital

Considerations when initiating a POAC episode include:

  • Other applicable funding streams (ACC, maternity, private insurance) should be used in the first instance
  • If referring for Recovery at Home services (R@H), the patient must be >16 years old


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027 274 8106