After Hours Care Program

After Hours Care is a program developed by Doctors of BC and the Ministry of Health (through the Family Practice Services Committee) with HealthLink BC that provides care to patients when family practices are closed evenings, nights, weekends and holidays.

The purpose of the After Hours Care program is:

1. To provide access to after hours virtual care for attached patients in community with urgent or semi-urgent health concerns as an extension of the longitudinal family physician (FP)/ nurse practitioner (NP) service.
   • Out of scope: Providing support for those residing or currently in facilities and/or unattached patients.
2. To support longitudinal FPs and NPs to better meet their professional obligations to their patients after hours.
3. To support Primary Care Networks (PCNs) to meet core policy attributes with respect to urgent, same-day access and extended hours of service.

• Patients call their family practice clinic to connect with the After Hours Care service. 
• A navigator answers their call, determines the type of assistance the patient is looking for and routes the call appropriately. For example:
  • Administrative issues will be asked to call back when the clinic reopens.
  • Issues or medication-specific questions will be connected with a pharmacist. 
  • Issues regarding symptoms will be connected with a trained registered nurse to be triaged.
• General medical questions will likely be handled entirely by nursing while obvious emergencies will be directed to call 911 or head to the nearest emergency department.
• Urgent non life-threatening issues are transferred to a clinical program support team member, who will set up a chart and arrange for an after hours physician to call back the patient. 
• Once the encounter with the after hours physician is complete, an encounter note will be sent to the patient’s community family physician or nurse practitioner.
• If semi-urgent follow-up is recommended, then the clinical program support will reach out to the clinic the next day to confirm receipt of the encounter note and stress the need for a rapid access appointment.

The principles of the After Hours Care program identify a number of items as out of scope:

• Calls from unattached patients (i.e. those who do not have a longitudinal FP or NP; attending the same walk in clinic is insufficient).
• Calls from patients in facilities (e.g. inpatients, long-term care, emergency department, hospice, addictions recovery).
• Administrative issues and health care system navigation.
• Sick notes and forms as these are non-urgent and most appropriately done by the FP/NP who knows the patient.
• Mental health crisis intervention, however, it is not unreasonable for an After Hours Care physician to speak with the patient to ensure there isn’t an underlying issue that can be managed by the service.
• Prescription renewals unless it is clinically deemed to require an urgent prescription. This is the most challenging area as a prescription renewal may be considered urgent depending on upcoming holidays, travel, type of medication and other issues. In this case, a series of questions is asked of the patient before the call is connected to a physician—the purpose of this service is not to be a prescription refill service.

Q: Are Physicians required to staff the AHCP service if we decide to register?
A: No, there is no requirement to staff the service or take any shifts if you choose not to.

Q: Is there any implication to signing up if I am already a part of an existing on0call group?
A: No, many physicians who are also a part of an existing call =group, have signed up and appreciate the additional support.

Q: Can only a portion of clinic providers join?
A: Yes, absolutely. However, we strongly encourage all providers in a clinic to join in ensure streamlined patient messaging while offering all patients access to after-hours care.

Q: What is the process of signing up or finding out more information?
A: Click here or register online and sign the user agreement HERE.