Out of hours: an evaluation of the continuing community cancer care program in western Sydney, CHERE Discussion Paper No 20

The domiciliary after hours nursing service (AHNS) of the 4C program in Western Sydney is registering approximately 550 people per year. In this discussion paper, the results of an evaluation of the AHNS are reported. The service caters for clients with a variety of needs, providing emotional support as well as physical nursing care. Carer satisfaction with the service is high. The availability of the service alone (irrespective of whether it is used) is a source of satisfaction for many carers. However, the service has not succeeded in reducing admissions to hospital or length of stay. The cost of the program is therefore only partially offset by savings in hospital resources. Only a small reduction in hospital use is needed to make the 4C program cost neutral. It is expected that a new drugs policy, allowing better out-of-hours access to pain killing drugs will improve the effectiveness of the service and its efficiency.