Information for Visiting Practitioners


“Local Health District” means the Northern NSW Local Health District (NNSWLHD)

“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 The Tweed Hospital, Murwillumbah District Hospital, Lismore Base Hospital and Grafton Base Hospital.

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

“Peripheral Hospitals” for the purpose of these quinquennium appointments means public hospitals that are not Major Hospitals.

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

“Visiting Practitioner” means a medical practitioner or dentist who is appointed, otherwise than as an employee, to practise as a medical practitioner or dentist in accordance with the conditions of appointment (including HMOs, VMOs and VDOs). The term applies to visiting practitioners appointed otherwise than under a service contract.


  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 (MDAAC). Appointments are to the NNSWLHD with clinical privileges being granted to undertake specific clinical services.
  2. A Visiting Practitioner wishing to vary their clinical privileges should make application through their clinical service manager to the MDAAC and the Chief Executive to have any such variation approved.  No changes to the clinical privileges 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 MDAAC 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 NNSWLHD 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 NNSWLHD.  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 2013 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 NNSWLHD 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 2013, 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 NNSWLHD.


  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 6 weeks 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 NNSWLHD 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 NNSWLHD is responsible for appropriate arrangements for cover whilst the visiting practitioner is on unpaid leave of absence. However, the NNSWLHD 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 NNSWLHD shall be responsible for the appointment of locum Visiting Practitioners to the Local Health District.


  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 NNSWLHD 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 Ministry of Health or the Local Health District. 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 Ministry 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 NNSWLHD promptly after being obtained. Any cancellation or suspension of such certification or registration must be notified to the NNSWLHD 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 Visiting Practitioner’s Clinical Service Manager.
  3. The NNSWLHD 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 Ministry 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 VMO 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.


  1. 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 NNSWLHD management.
  2. Subject to the terms of appointment a Visiting Practitioner may, following an investigation commissioned by the Chief Executive of NNSWLHD 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.
  3. 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 Ministry of Health (MoH) requirements to participate in an annual performance review arrangement with their supervisor. This is in the interest of enhancing professional development and Local Health District 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 Local Health District 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 MoH, AMA, ASMOF, The Rural Doctor’s Association and Local Health Districts.


  1. For VMOs and VDOs only, advertising of positions is not required in circumstances where:
    1. The role and responsibilities for the VMO/VDO remains largely unchanged since their original appointment
    2. There has been a Level 2 review of the VMO/VDO in the penultimate year of the term of their appointment
    3. The performance has been found to be such as to warrant renewal without advertising
    4. The public health organisation has decided that it is appropriate to appoint a specialist VMO/VDO with an existing appointment; for a further term (refer to NSW Health Policy Directives PD2011_010 Visiting Medical Officer Performance Review Arrangements and PD2013_013 Visiting Dental Officers Remuneration and Contract Requirements respectively).
  2. Public health organisations have discretion to apply the performance review arrangements set out in PD2011_010 to general practitioner VMOs.