Scope of practice and working on behalf of a GP
Who can do what in virtual care, and how working on behalf of a GP works.
What this is: a plain guide to scope of practice in virtual care, and to services delivered on behalf of a GP.
Who it's for: nurses, Aboriginal Health Workers and Practitioners, GPs, and managers planning who does what.
Start with scope of practice
Scope of practice is what a person is trained, qualified, registered and permitted to do. Everyone on the team works within their own scope, within your service's policy, and within any supervision arrangements that apply.
Virtual care does not change this. It does not expand anyone's scope, and it does not let someone do something over a screen that they could not do in the room. What virtual care does is connect your local team to a clinician who is somewhere else, so the work is shared differently. Getting the roles right is what makes that safe.
Who does what at the patient end
Virtual care in remote and primary settings usually has a clinician on screen and a team supporting the patient in the room. Here is how the roles tend to work.
The person at the patient end is the local hands and the local knowledge. They prepare the patient, set up and operate the equipment, take readings and use the connected tools the consulting clinician asks for, and help the patient feel at ease. This role is often held by a nurse, an Aboriginal Health Worker or an Aboriginal and Torres Strait Islander Health Practitioner.
A few distinctions are worth holding clearly. A registered nurse works to nursing scope and registration. An Aboriginal and Torres Strait Islander Health Practitioner is registered with AHPRA and works to that registration. An Aboriginal Health Worker may not be separately registered but brings essential clinical, cultural and community knowledge. None of these team members is "just an assistant". In community-controlled care especially, Aboriginal Health Workers and Practitioners are central to whether care is safe, trusted and used. Allied health and other staff join as the clinical need requires.
Working on behalf of a GP
A team member can deliver some services on behalf of a GP. This is a specific arrangement, not a loose phrase. The GP keeps clinical responsibility, sets what is to be done, and provides supervision, while a suitably qualified team member carries out the agreed service.
In practice, this is how a practice nurse, an Aboriginal Health Worker or an Aboriginal and Torres Strait Islander Health Practitioner can support chronic condition management, follow up after a health assessment, or carry out agreed tasks between a patient's visits to the GP. Medicare recognises some of these services with their own item numbers, including video versions for virtual care. The amounts and item numbers change, so we keep the billing detail in the funding articles rather than here. The principle to hold onto is that the service must genuinely be one the GP has arranged and supervises, and it must sit within the team member's scope.
Keep it safe and clear
A few habits keep this simple and safe. Write down what each role does, so there is no guesswork on the day. Make supervision real, with a clear line back to the responsible GP. Document who did what, the same as you would for in-person care. And keep everything inside your service's policy and each person's scope. When in doubt about whether a task fits a role, check before the consultation, not after.
Need help?
- Visionflex support: visionflex.com/support | support@visionflex.com | +61 2 8914 4000 (9am to 5pm AEST)
- See also: The patient-end role: being the local hands, Clinical governance and incident management, Virtual care policy template, Standards and regulatory alignment
Visionflex acknowledges the Traditional Custodians of Country throughout Australia and pays respect to Elders past, present and emerging.