Information for Visiting Practitioners


Area” means the Mid North Coast Local Health District (MNCLHD)

Clinical Service” means a health service and includes a hospital, unit, community service or other service at which the visiting practitioner has clinical privileges.

Clinical Service Manager” means the person to whom the practitioner is immediately responsible for the performance of duties and clinical care of patients.

Major Hospitals” for the purpose of these quinquennium appointments means Coffs Harbour Base Hospital, Kempsey District Hospital and Port Macquarie Base Hospital being hospitals included in List 3 of the 1996 Settlement Agreement between NSW Department of Health and Australian Medical Association following the Joint Review under the March 1995 Fee for Service Agreement.  List 3 is a listing of hospitals where VMOs may elect by specialty group between Sessional or Fee-for-Service payments.

Networked Services” means a coordinated clinical service conducted at two or more hospitals or health services by MNCLHD

Peripheral Hospitals” for the purpose of these quinquennium appointments means public hospitals at Bellingen, Dorrigo, Macksville and Wauchope.

Specialist” means a medical practitioner recognised as a Specialist for the purpose of the Health Insurance Act 1973 (Commonwealth)

Visiting Practitioner” means a member of the Visiting Medical or Dental Staff of Mid North Coast Local Health District


  1. Each Visiting Practitioner is appointed by the Chief Executive, with such clinical privileges as are determined by the Chief Executive on the recommendation of the Medical and Dental Appointments Advisory Committee. Appointments are to the North Coast Area Health Service with clinical privileges being granted to specific clinical services within the Area.  Appointment is conditional on the visiting practitioner entering into a service contract with the Area.
  2. A Visiting Practitioner wishing to vary their clinical privileges, or the locations at which any of these privileges are exercised, should make application through their clinical service manager to the Medical and Dental Advisory Appointments Advisory Committee (MDAAC) and the Chief Executive to have any such variation approved.  No changes to the clinical privileges or the locations at which those privileges are exercised are to be made until the approval of the Chief Executive has been obtained, following advice from the MDAAC.
  3. Appointments are subject to the Chief Executive being satisfied, on the advice of the Medical and Dental Appointments Advisory Committee as to the ongoing personal and professional conduct, performance and services of each Visiting Practitioner. The relevant standards of professional conduct for Visiting Practitioners are the NSW Health Code of Conduct (all Visiting Practitioners), the NSW Medical Board’s Code of Professional Conduct (medical practitioners), and the code of conduct issued by a relevant professional college.
  4. An appointment to MNCLHD shall be regarded as a single appointment.  Clinical privileges may extend to more than one hospital or service.  This will be reflected in the contractual arrangements between the appointee and MNCLHD. Resignation by a VMO specialist from a Major Hospital shall relate to the entire appointment.  It cannot be subsequently divided into multiple appointments despite the fact that there may be multiple contracts relating to the services provided at different hospitals which may be necessitated by the different remuneration arrangements required to be put in place at such hospitals.
  5. Resignation in accordance with the Health Services Regulation 2003 from a VMO appointment in which privileges have been provided to a Major Hospital shall automatically trigger the termination of the contingent clinical privileges at any other MNCLHD hospital or service. Specialist VMOs may resign their secondary appointment at Peripheral Hospitals subject to the period of notice provided in their service contract and the Health Service Regulation 2003, without affecting their Major Hospital appointment.
  6. Where VMO Specialists are appointed to Networked Services such appointment is indivisible and conditional upon continuation of the provision of services. VMOs cannot resign from any part of the Networked Services arrangement without resigning from all their appointments with MNCLHD.


  1. Terms and conditions for Visiting Medical Officers and Honorary Medical Officers (except Radiologists and Pathologists) are prescribed in standard Sessional and Fee-for-Service contracts (including form of Fee-for-Service Contract for Rural Doctor Package Hospitals) and related determinations/settlement package including:
    1. Public Hospitals (Visiting Medical Officers – Fee-for-Service Contracts) Determination 2007
    2. Public Hospitals (Visiting Medical Officers – Sessional Contracts) Determination 2007
    3. Rural Doctors Settlement Package


  1. All unpaid leave of absence must receive the prior approval of the clinical service manager. Other than in unforseen circumstances beyond the control of the practitioner, at least three months prior notice of unpaid leave of absence is to be given to the clinical service manager. Applications for unpaid leave of absence should be made in consultation with relevant clinical colleagues and should be made in writing to the relevant clinical service manager.
  2. To provide the Area Health Service with assurance of the continuity of medical care to patients, the visiting practitioner should hand over patients to another medical practitioner prior to commencing unpaid leave of absence.
  3. The Area Health Service is responsible for appropriate arrangements for cover whilst the visiting practitioner is on unpaid leave of absence. However, the Area Health Service would appreciate advice on cover arrangements when applying for unpaid leave of absence, particularly in circumstances where the visiting practitioner is also making arrangements for cover of their private practice.
  4. The Area Health Service shall be responsible for the appointment of locum Visiting Practitioners to the Area Health Service.


  1. The Visiting Practitioner must comply with NSW Health policies prescribed as mandatory for health service staff and Visiting Practitioners including (but not limited to) those relating to the provision of clinical services, code of conduct, occupational health and safety, immunisation, workplace harassment, equal employment opportunity and reporting of criminal convictions or disciplinary findings.  Visiting Practitioners are to also to comply with MNCLHD Policies and By-Laws.
  2. Visiting Practitioners may also be required to take part in training that may, from time to time, be     deemed mandatory by the Department of Health or the Area. This will include relevant training     relating to child protection.
  3. A Visiting Practitioner should also take reasonable steps to comply with requests for information and     other reports required under Department of Health policies and guidelines for supplying information     relating to child protection.


  1. Each Visiting Practitioner will maintain all certification and registration necessary to enable them to provide the clinical services covered by their appointment. Evidence of this must be provided to the Area promptly after being obtained. Any cancellation or suspension of such certification or registration must be notified to the Area immediately.
  2. Adequate professional indemnity cover with a recognised medical defence organisation or insurer     must be maintained by each Visiting Practitioner at all times during the term of their appointment.     Any change in status must be immediately notified to the Area Director Clinical Services.
  3. The Area shall offer each medical practitioner proposed for appointment as a visiting medical officer, who is eligible for professional indemnity cover from the New South Wales Treasury Managed Fund under the applicable policies of the NSW Department of Health as issued from time to time, an approved contract of liability coverage covering the term of the practitioner’s proposed appointment as a visiting medical officer at the same time it provides a written service contract.
  4. A visiting medical officer must have approved professional indemnity insurance in respect of civil liability arising from the officer’s practice of medicine at a public health organisation, including in respect of persons who elect to be private patients, to the extent that such liability is not covered by an approved contract of liability coverage.


  • Should the need arise to counsel or discipline a Visiting Practitioner for minor breaches of their obligations under the terms and conditions of appointment, this will be done in the first instance by the clinical service manager or local Area management.
  • Subject to the terms of appointment a Visiting Practitioner may, following an investigation commissioned by the Chief Executive of North Coast Area Service for that purpose, be suspended or terminated at any time by the Chief Executive where there has been a serious failure by the Visiting Practitioner to observe the terms and conditions of their appointment. Any Visiting Practitioner dealt with under this clause will be afforded due process and procedural fairness.
  • A Visiting Practitioner seeking to resign from their appointment must give at least three months’ (or such lesser period as is agreed by the Chief Executive) notice in writing to the Chief Executive.


  1. Visiting Medical Practitioners will be required, under NSW Department of Health (DOH) requirements to participate in an annual performance review arrangement with their supervisor. This is in the interest of enhancing professional development and Area Health Service objectives by providing regular feedback about performance and identifying appropriate development opportunities, providing an opportunity for two-way feedback, and to identify opportunities for the Area to support the practitioner in maintaining and improving performance and managing issues.
  2. These general principles are the result of extensive consultation between the NSW DOH, AMA, ASMOF, The Rural Doctor’s Association and Area Health Services.