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Out of Hospital Care (OHC)

Out of Hospital Care (OHC)

Funded by the NSW Ministry of Health, OHC is a program that can provide you with the best care and support, for up to 6 weeks, in the comfort of your home.

Complete our Out of Hospital Care (OHC) Referral Form 


Through a tailored range of community services, OHC incorporates three key care options:

These three programs support hospital discharges and help prevent avoidable hospital admissions by providing you with responsive short-to-medium-term packages, including:

  • Non-clinical case management
  • In-home care services

The OHC program is only available to eligible patients and their families/carers in New South Wales.

Costs

There is a cost of $10 per week on the ComPacks and SASH program. There is no additional charge for the EoL program. 

 

OHC eligibility

OHC is available to people who are either inpatients of a NSW Health public hospital or have been referred for OHC services by a NSW Health community team member. Each OHC program has specific eligibility requirements. Please see below for more details.

Eligible patients may suffer from acute, chronic health conditions or disabilities impacting their ability to manage activities of daily living. These factors place patients at risk of unnecessary hospitalisation.

OHC is not available for patients who require long-term intensive levels of home care. If you need a permanent home care solution, please speak to our team for guidance on the best option for you.

 
To learn more, contact us on 1300 758 566 and press ‘3’ for Out of Hospital Care.

 

 


OHC program details


Community Packages (ComPacks)

ComPacks aim to facilitate a safe and early discharge through a short-term package of care. Packages provide short-term help and recovery support with daily activities.

We can assist to:

  • Help you maintain your independence while living at home
  • Provide you with personalised support and guidance
  • Connect you with services and support that suit your specific needs
  • Help you save time, as we have already searched and screened service providers for you
  • Assist you in navigating the Aged Care and Disability systems and services

 

How it works

One of our ComPacks Case Managers will work with you over a six-week period to develop a strategy. We’ll address your short-term functional challenges and support you in navigating your way to long-term support if required.

These services and support are delivered in or out of home and include some or all of the following:

  • Meal preparation or connecting to meal services
  • Personal care to help you keep healthy and safe
  • Domestic assistance to assist with jobs around the home
  • Social support to keep you in touch and connected with your family and friends
  • Transport options so you can get out and about safely
  • In-home respite giving you and your carers a well-earned break

 

Accessing ComPacks

You will be referred to our ComPacks program by your hospital clinician. It’s available to people of all ages.

Discuss eligibility with your discharge planner, social worker or member of your medical team. They can help you assess your eligibility while you are in hospital, then refer you for an assessment. We can work with you to develop a tailored care plan ready for when you arrive home.

Eligibility is based on your need for immediate access to case management and community support that can’t be accessed through other channels.

 

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Safe and Supported at Home Packages (SASH)

These packages offer low to medium levels of home care services. Each package is aimed at supporting patients with functional impairments to remain independent and safe at home.

Packages are available for up to six weeks at a time. Following a review of a your care needs, repeat packages may be offered for further support.

 

What’s provided?

You will be allocated a Case Manager who will be your main contact throughout the SASH package. This Case Manager will visit you at home or in hospital to assess your needs. They will coordinate and monitor service provision according to your needs and identified goals.

The following services may be provided depending on the assessment:

  • Domestic assistance/cleaning
  • Laundry and assistance with shopping
  • Personal care assistance with bathing, grooming and dressing
  • Meals assistance / preparation
  • Transport for medical and other appointments
  • Social support
  • Accompaniment to appointments
  • In-home respite to support carers

 

Who can refer someone?

Clinicians from LHD inpatient, outpatient and community teams can identify and refer you. These include chronic care, therapy, mental health and aged care assessment teams.

 

Who is eligible?

A person who:

  • Is aged between 18 – 64 years
  • Has functional impairments that impact their ability to manage daily living activities (this may include a functional, sensory or psycho-social disability)
  • Has no or limited informal support
  • Has commenced the National Disability Insurance Scheme (NDIS) application process and has received a reference number, and
  • Has had their application to the NDIS rejected or requires support while reapplying to the NDIS or appealing an access decision

 

What happens after a SASH package ends?

The Case Manager may:

  • Transition you to an ongoing service via the NDIS or My Aged Care
  • Provide you with information if you wish to engage services at a later date

 

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End of Life Packages (EoL)

EoL packages are non-clinical packages of case management and home care services delivered through the NSW Health OHC Program. Packages provide low to medium levels of home care services for patients who are in the deteriorating or terminal phase of a life-limiting illness or condition.

Packages are available for up to six weeks at a time. Repeat packages may be available to patients who require further support.

 

What’s provided?

Each patient is allocated a Case Manager who will be their main contact throughout the EoL package. A Case Manager will either visit the patient in hospital, at home or if urgent speak with the family/carer via phone to assess their needs.

The following services may be provided depending on the assessment:

  • Personal care assistance with bathing, oral care, hygiene, dressing and grooming
  • Domestic assistance – cleaning, vacuuming, mopping, laundry and shopping
  • Meal delivery or meal preparation
  • Transport for medical and other appointments
  • Social support
  • Accompaniment to appointments, shopping, paying bills
  • In-home respite and support for carers

 

Who can make a referral?

Referrals can be made from NSW public hospitals or LHD community teams. These include specialist palliative care, community nursing, chronic care and aged care.

 

Who is eligible?

A person who:

  • Is experiencing functional decline and is in the deteriorating or terminal phase of a progressive life-limiting illness or condition (this could be three months or less before death)
  • Is of any age*
  • Requires non-clinical home care services for as long as possible
  • Has a carer/family member who requires non-clinical home care services to support the patient to die or remain at home for as long as possible

*While EoL packages are available to people of all ages, they do not generally cater for the specific needs of children. Instead, packages are there to support parents in their caring role.

 

Who is not eligible?

A person who resides in a residential aged care facility and requires home care services to be provided in that facility.

 

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Complete our Out of Hospital Care (OHC) Referral Form

 


 

“Every person, every time, has an opportunity to maximise their independence, but still have a supported recovery.”

Jenny Mulholland, Out of Hospital Care Manager

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