Healthcare Rights in Guardianship Matters: Participation and Timeliness

MS Patrice Higgins1, Ms Cate Parry1

1ACT Health, Canberra, Australia

When a patient’s decision-making ability is impaired, an alternate decision-maker such as a guardian or financial manager may need to be appointed. This process is often lengthy and complex. For patients at the Canberra Hospital (CH) there was limited opportunity to participate in such processes due to logistical barriers.

Before October 2017, Guardianship and Management of Property applications were heard at the ACT Civil and Administrative Tribunal’s (ACAT) premises in the Canberra City; some distance from the hospital. Logistically it was difficult for patients to attend their hearing due to medical needs; often requiring a staff escort, which was rarely possible. As a result, patients could not fully participate in decision-making processes about themselves and would often wait several weeks in the hospital for their hearing.

For patients requiring a guardianship hearing, this project aimed to:

  • Reduce the length of time from submission of an application to hearing by 50%.
  • Increase patient participation at hearings by 50%.

Twenty file audits were conducted of patients who had a Guardianship hearing between April 2016 and August 2017 for the baseline data. The audit found 35% of patients attended their hearing and it took on average 40 days from submission of the application to hearing.

Collaboration between ACAT and the Social Work Departments at the CH led to fortnightly hearings at the hospital from October 2017. There were 32 applications for hearings between October 2017 and September 2018. Participation rates increased to 88% and the average length of time to hearings decreased to 11 days.

This project provided an increased opportunity for patients to be involved in decision-making, enabling their wishes to be heard and considered; thus, upholding patient’s healthcare rights.

This presentation will outline the project, implementation challenges, areas for improvement and future directions such as supported decision-making.


Patrice is a social worker currently employed as Social Work Manager for Rehabilitation Aged and Community Services, Canberra Health Services. Patrice has an interest in dementia and cognitive impairment, elder abuse and rehabilitation and enabling better access to decision making processes for patients.

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