Ensuring continuity of care during unexpected closures

Key Takeaways

• Cloud technology is your best insurance policy. If your patient management system (PMS) and phone systems are cloud-based, your team can operate remotely from anywhere, even if your physical clinic is inaccessible due to flood, fire, or power outage. On-premise servers are a critical single point of failure.
• A plan on paper is not enough; drill it. Your business continuity plan (BCP) must be tested. Conduct an annual drill to ensure staff know their roles, data can be accessed remotely, and call forwarding actually works. Accreditation bodies value tested plans, not just documents.
• Prioritise high-risk patient communication. Your immediate response plan must include a method for identifying and contacting high-risk patients (e.g., those expecting urgent test results or requiring critical prescriptions) to ensure no one falls through the cracks.
• Pre-write your communication templates. In a crisis, you won't have time to draft careful wording. Prepare SMS and social media templates in advance for various scenarios (e.g., flood closure, power outage, IT system failure) so you can communicate clearly and quickly.
• Establish a "buddy system" with another practice. Arrange a reciprocal agreement with a nearby clinic to see your urgent patients or access shared resources during a localised emergency. This builds community resilience and supports continuity of care.
• Compliance is non-negotiable for continuity. RACGP standards, OAIC reporting rules, and accreditation requirements mandate a documented and tested business continuity plan. Meeting these obligations protects patient safety, maintains Medicare compliance, and secures your practice’s reputation.

Introduction: When business as usual isn't an option

For Australian healthcare practices in 2025, the threat of unexpected business disruption has never been more real. The increasing frequency and intensity of natural disasters, from devastating floods across Queensland and New South Wales to catastrophic bushfire seasons, have exposed critical vulnerabilities in community infrastructure. Add to this the ever-present risks of cyber-attacks, power failures, or building emergencies, and it becomes clear that "hoping for the best" is no longer a viable strategy.

A sudden closure, even for just 48 hours, can severely impact patient safety, breach professional obligations, and cause significant financial and reputational damage. The Royal Australian College of General Practitioners (RACGP) standards explicitly require practices to have a plan for maintaining continuity of care during emergencies. This article is a practical guide for practice managers on how to build a robust continuity plan that protects your patients, supports your staff, and ensures your practice can weather any storm.

Risk assessment: Understanding your specific vulnerabilities

Before you can write a plan, you must understand your risks. A "one-size-fits-all" template won't work because every Australian practice faces different threats. A clinic in a known flood plain has different priorities from one in a high-rise city building.

Conduct a simple risk assessment by asking:

• Natural Disasters: What are the most likely natural disasters in our specific location (e.g., bushfire, flood, cyclone, severe storm)? How would this affect building access and power supply?
• Infrastructure Failure: What is our contingency if the NBN or local power grid fails for more than 24 hours? How long can our vaccine fridge maintain temperature without power?
• Cybersecurity Threats: What happens if our server is hit by ransomware and our patient records are inaccessible? According to the Office of the Australian Information Commissioner (OAIC), the health sector consistently remains the most targeted industry for data breaches.
• Human Factor: What if a key staff member or solo practitioner becomes suddenly unwell and unable to work for an extended period?
  
  

Your goal is not to predict every possibility, but to identify your top three most likely disruptions.

The technology backbone: Moving from on-premise to accessible everywhere

The single most important factor determining your ability to function during a closure is your technology infrastructure. If your patient data and phone system rely entirely on a physical server sitting in your clinic, your practice ceases to exist the moment you lock the door.

Embrace cloud-based systems

For true resilience, your critical systems must be cloud-based. This means:

• Practice Management System (PMS): A cloud-based PMS allows your doctors and administrative staff to securely access schedules, patient files, and results from any internet-connected device.
• Phone System (VoIP): A Voice over Internet Protocol (VoIP) phone system enables you to redirect calls instantly to mobile phones or laptops. This means patients calling the main clinic number can still get through to a staff member working from home.
  
  

Data backup and security

Even with cloud systems, you need a robust backup strategy. Follow the 3-2-1 rule: three copies of your data, on two different media types, with one copy stored off-site (the cloud automatically handles the off-site component). Ensure multi-factor authentication (MFA) is active on all remote access points to protect against unauthorised access during a crisis.

The communication plan: Preventing panic and managing expectations

In a crisis, clear and timely communication is everything. A lack of information breeds panic among patients and confusion among staff. Your plan must detail exactly who you will contact, what you will say, and how you will say it.

Key Stakeholders and Channels:

1. Staff: Establish a contact tree and a central communication channel (like a dedicated WhatsApp group or team app) that doesn't rely on accessing work computers. Ensure all staff know where to look for updates.
2. Patients: Use an SMS blast function from your PMS to notify all patients with upcoming appointments. Update your website homepage and social media channels with clear information about the closure and how to seek help for urgent matters. Record a new message on your practice's main phone line.
3. External Partners: Notify local hospitals, pharmacies, and allied health providers who regularly share patient care with you.
   
   

A realistic scenario: The unexpected flood closure

A practice in a regional town faces flash flooding overnight.

• Practice A (No Plan): Staff arrive to find roads closed. The on-premise server is unreachable. Phones ring unanswered. Patients with morning appointments drive to the clinic, only to find it inaccessible. Frustration builds, and high-risk patients needing prescription renewals cannot contact their doctor.
• Practice B (With Plan): At 6 AM, the practice manager initiates the BCP.
• Step 1: An SMS blast is sent to all patients booked for the next two days, informing them of the closure and a switch to telehealth appointments where possible.
• Step 2: The VoIP phone system is set to forward all calls to a "continuity team" (receptionists working from home).
• Step 3: Clinicians log into the cloud-based PMS from home to review schedules and identify high-risk patients for proactive outreach.
  
  

Practice B mitigates patient safety risks, reduces financial loss, and demonstrates professionalism under pressure.

Operational continuity: Managing prescriptions and urgent results triage

A critical function of general practice is managing ongoing care, including repeat prescriptions and test results. Your continuity plan must have a clear procedure for these tasks when the clinic is closed.

• Prescription continuity: In Australia, tools like electronic prescribing make this significantly easier. Ensure clinicians have secure access to a remote prescribing system. For high-risk medications, have a protocol for liaising with local pharmacies to provide emergency supplies if a consultation isn't possible.
• Triage of results: Designate a specific clinician or senior nurse responsible for remotely reviewing incoming results and managing recalls. This ensures that critical or abnormal results are actioned even during a shutdown.
• Reciprocal agreements: Formalise a "buddy" agreement with another practice in a different location. In a widespread disaster, this may be difficult, but for a localised issue (like a fire or plumbing failure), a reciprocal arrangement allows one practice to see the other's most urgent patients.

Regulatory obligations and accreditation standards

In Australia, business continuity planning isn’t optional, it’s a compliance requirement for medical practices. Meeting these obligations protects your patients, safeguards your reputation, and supports accreditation and Medicare compliance.

RACGP’s 5th Edition Standards

The Royal Australian College of General Practitioners (RACGP) requires all accredited practices to have a documented and tested business continuity plan (BCP). You must demonstrate:

• How patient care will continue during disruptions.
• Evidence of annual drills or testing.
• Regular plan updates after significant changes, like staffing, infrastructure, or technology.
  
  

Without a compliant BCP, practices risk accreditation issues and potential Medicare disruptions.

Data breach obligations under OAIC

Under the Notifiable Data Breaches (NDB) Scheme, the Office of the Australian Information Commissioner (OAIC) requires clinics to:

• Notify affected patients if a breach may cause harm.
• Lodge a report with the OAIC.
• Maintain robust data protections like multi-factor authentication and secure off-site backups.
  
  

A strong continuity plan that includes cybersecurity safeguards ensures both compliance and patient trust.

Accreditation expectations from AGPAL and QPA

Accreditation bodies such as AGPAL and QPA expect documented evidence of:

• Risk assessments to identify vulnerabilities.
• Tested contingency plans.
• Staff training records and drills.
  
  

These checks form part of ongoing reaccreditation and demonstrate your commitment to patient safety.

Why compliance protects your bottom line

Aligning your BCP with RACGP, OAIC, and accreditation requirements helps you:

• Maintain uninterrupted patient care.
• Protect Medicare rebates and billing processes.
• Strengthen your practice’s reputation and patient confidence.

Conclusion

In Australia, where environmental challenges are becoming more frequent, a robust business continuity plan is no longer a "nice to have", it's an essential component of clinical governance and risk management. By investing time now to build a plan that leverages cloud technology, clarifies communication channels, and empowers your team, you ensure that an unexpected closure remains a temporary disruption, not a catastrophe. This preparation protects your patients, supports your staff, and secures the long-term resilience of your practice.