Terms and Conditions

Terms and Conditions

1. Definitions

In these Terms and Conditions, unless the context otherwise requires:

• "We" or "Us" refers to Clinical Assessments Limited, the contract holder.

• "The Service" refers to Primary Options for Acute Care (POAC).

• "Referrer" means the referring clinician.

2. Background

This document constitutes a contractual agreement between Clinical Assessments Limited and Referrers who wish to refer patients to services provided under the POAC programme. A full description of available services is provided on the POAC website: www.poac.co.nz.

3. Objective

The objective of POAC is to improve health outcomes by providing safe, timely, and community-based alternatives to acute hospital admissions, as well as specific planned and proactive care options. This service supports primary care providers to deliver more flexible and responsive care to their patients.

4. Definition of the Service

The services available under POAC are as defined and periodically updated on the POAC website.

5. Qualifying Patients

Patients are eligible for referral if they:

• Are eligible for healthcare funding in New Zealand (as defined on the Health New Zealand website), and

• Meet the specific clinical criteria for the service being referred, as outlined on the POAC website.

6. Qualifying Referrers

Any registered medical practitioner holding a current Annual Practising Certificate and not found guilty of disgraceful conduct under the Medical Practitioners Act 1995 is eligible to refer patients.

7. Medical and Nursing Staff

All medical and nursing staff acting on behalf of the referring clinician must be registered with their appropriate statutory authority and hold a current Annual Practising Certificate.

8. Clinical Responsibility

When a referrer who is not the patient’s usual GP initiates a referral, they retain clinical responsibility until care is appropriately transferred to the patient’s GP. This handover should occur at the earliest practical opportunity, such as the next working day.

9. Patient Consent and Privacy

Referrers must ensure that:

• Patients are fully informed about the referral and the nature of services being accessed under POAC.

• Explicit consent is obtained from the patient before making any referral, including consent for sharing relevant clinical information with third parties such as service providers, diagnostic facilities, and auditing bodies.

• Consent is documented in the patient’s clinical record.

• The referrer complies with the Health Information Privacy Code 2020, the Privacy Act 2020, and all other applicable legal obligations regarding patient privacy.

10. Quality Standards

Referrers must exercise sound clinical judgement, ensuring that patient safety is not compromised. They must comply with POAC clinical policies and follow available clinical pathways where applicable.

11. Scope of Practice

All clinicians must work strictly within their professional scope of practice and only perform tasks they are trained and competent to undertake. Continuing professional development and adherence to relevant regulatory standards are expected.

12. Clinical Records

In addition to standard clinical records, the referrer must complete the appropriate POAC referral documentation and include the correct case reference number on any external service requests (e.g., radiology, urgent care clinics).

13. Indemnity

By using the POAC service, the referrer accepts full clinical responsibility for the management and continuity of care for their patients. The referrer agrees to indemnify Clinical Assessments Limited against any loss, liability, or expense resulting from errors or substandard performance.

14. Audit

The referrer agrees to cooperate with all audit processes as required by Clinical Assessments Limited under its contractual obligations. This includes providing reasonable access to facilities, relevant clinical information, and referred patients or families (with consent), where required for audit purposes. Only a suitably qualified registered medical practitioner will access clinical information for audit.

15. Claiming

Referrers must adhere to the claiming process outlined on the POAC website, including any future amendments. Each referral must be submitted within 24 hours of initiating treatment, and all relevant clinical documentation must accompany the claim, submitted by the 20th of the month following completion of care.

16. Payment for the Service

We agree to fund appropriate and eligible referrals made by referrers. All claims are subject to assessment against POAC funding policies and the current claiming guide available on the POAC website. Adjustments may be made accordingly.

17. Cost Control

Claims are subject to POAC cost-control procedures and applicable service-specific funding schedules. Adjustments will be notified via payment advice.

18. Referrer Acknowledgement

By submitting a referral (electronically or otherwise) or initiating a POAC-funded service, the referrer acknowledges they have read, understood, and agreed to be bound by these Terms and Conditions and any related guidelines or policies published on the POAC website.

19. Clinical Governance

The referrer agrees to comply with POAC’s Clinical Governance processes and any amendments to those procedures.

20. Vulnerable Children Act 2014

In accordance with the Vulnerable Children Act 2014, the referring organisation must have an appropriate child protection policy and undertake worker safety checks in accordance with the legislation.

Note: We reserve the right to modify or limit the availability of POAC services at any time without prior notice.