Key Takeaways
- Eleven clinical services are 100% government-funded under SAH, using them well is the single biggest 'free upgrade' available.
- Most participants under-utilise clinical services, particularly podiatry, OT and speech pathology.
- Clinical services are paid by the government on top of your operating budget, so they don't reduce your hours of personal care or cleaning.
- Access typically requires a care coordinator referral, a GP plan, or both, your provider should run the process.
- If your provider is reluctant to add clinical services, that's a yellow flag, they're harder to deliver but they're what good aged care looks like.
If you remember nothing else from this site, remember: clinical services under Support at Home are 100% government-funded. Using them does not reduce your operating budget; not using them does not bank the money for later. Every clinical service delivered is, for you as the consumer, free.
This post lists the eleven clinical services that fall in this category, what each one does, and how to access them.
What "clinical" means under SAH
Under SAH, "clinical" services are professional health interventions delivered by registered practitioners. They're separate from "Independence" services (personal care, transport, social support) and "Everyday Living" services (cleaning, meals, gardening).
The key distinction: clinical services are paid for by the Commonwealth on top of your operating budget allocation. They don't deduct from the budget you use for personal care or domestic services.
This is, frankly, the single biggest under-appreciated feature of SAH.
The eleven services
1. Registered nursing
In-home visits by a registered nurse for:
- Medication management and review
- Wound care
- Catheter and stoma care
- Diabetes management (insulin, BG monitoring)
- Post-discharge care after hospital stays
- General clinical observation
Most useful for: participants on multiple medications, those with chronic conditions, post-surgical recovery, end-of-life care.
2. Enrolled nursing
Similar scope to registered nursing but with a more limited prescribing role. Often delivers:
- Medication administration
- Wound care under RN supervision
- Routine clinical visits
- Direct care alongside personal care workers
Most useful for: stable but complex care needs where regular clinical eyes are valuable.
3. Physiotherapy
Movement assessment and treatment, including:
- Gait and balance assessment
- Falls prevention programs
- Strength training, especially after illness or surgery
- Pain management for musculoskeletal conditions
- Post-stroke rehabilitation
- Maintenance therapy
Most useful for: anyone with mobility concerns, post-surgical recovery, falls history, or arthritis.
4. Occupational therapy
Functional assessment and adaptation:
- Home safety assessments
- Recommendations for assistive technology and modifications
- Activities of daily living (ADL) training
- Cognitive functional assessment
- Equipment prescription
- Falls prevention (especially environmental)
Most useful for: post-stroke participants, those with cognitive change, anyone considering home modifications. The OT home visit is one of the highest-value early activities for any new SAH client.
5. Podiatry
Foot health assessment and treatment:
- Routine nail and callus care
- Diabetic foot screening and care
- Wound prevention
- Footwear assessment
- Treatment of corns, calluses, and ingrown nails
Most useful for: anyone with diabetes (essential), arthritis, peripheral vascular disease, or simply older feet that have become hard to self-manage. Podiatry is the most under-utilised clinical service relative to need.
6. Speech pathology
Communication and swallowing assessment and treatment:
- Swallowing safety assessment (especially post-stroke)
- Speech rehabilitation after stroke
- Communication strategies for dementia
- Voice issues
- Cognitive communication
Most useful for: stroke recovery, dementia care, anyone with swallowing concerns.
7. Dietetics
Nutritional assessment and meal planning:
- Nutrition review
- Meal plan development
- Diabetes dietary management
- Renal diet management
- Weight management
- Nutritional support during illness
Most useful for: diabetes, kidney disease, weight changes (loss or gain), recovery from illness, or anyone with a complex medical regimen affecting eating.
8. Psychology
Mental health assessment and treatment:
- Depression and anxiety in older adulthood
- Adjustment disorders (e.g. post-bereavement)
- Cognitive behavioural therapy
- Support during diagnosis of serious illness
- Family carer support
Most useful for: anyone experiencing mental health challenges, adjusting to disability, or supporting a partner with significant illness.
9. Social work
Practical and emotional support including:
- Navigating complex care decisions
- Family mediation around care
- Support for transitions (hospital to home, home to residential)
- Financial counselling and advocacy
- Linkage to community resources
Most useful for: complex family situations, financial concerns, transitions in care.
10. Aboriginal and Torres Strait Islander health worker
Where available, ATSI health workers deliver:
- Culturally appropriate clinical assessment
- Care coordination linked to ACCHOs
- Community linkage
- Health education in culturally appropriate ways
Most useful for: ATSI participants where this resource is available locally.
11. Diabetes education
Specific education and support for diabetes management:
- Self-management training
- Insulin administration training
- Blood glucose monitoring
- Sick-day rules
- Dietary education
Most useful for: anyone newly diagnosed with diabetes or struggling with glycaemic control.
How to access them
Each clinical service requires a different access pathway, but typically:
- Care coordinator referral, your care coordinator initiates a referral within the SAH system
- GP collaboration, your GP may need to provide a chronic disease management plan
- Provider's clinical team, many providers have in-house clinical staff or contracted providers
- Specialist follow-up, for conditions managed by specialists (e.g. cardiologist), the SAH clinical team coordinates follow-up
Quality providers run all these pathways for you. Lower-quality ones expect you to navigate them yourself.
How much you should be using
A reasonable annual baseline for a typical mid-need SAH participant:
| Service | Typical annual use |
|---|---|
| Registered nursing | 4-8 visits (more for high need) |
| Physiotherapy | 12-24 sessions (high in recovery, lower for maintenance) |
| Occupational therapy | 1-3 visits per year |
| Podiatry | 6-9 visits per year |
| Speech pathology | As needed (often for one-off assessment) |
| Dietetics | 1-2 visits per year |
| Psychology | 6-10 sessions if needed |
| Social work | As needed |
| Diabetes education | 2-4 sessions on initial setup, then as needed |
If your annual clinical service use is materially below these numbers, it's worth asking why. You're leaving funded value on the table.
Why providers sometimes downplay them
Clinical services are operationally harder to deliver than domestic services. They require qualified staff, scheduling complexity, and clinical governance. A provider with weak clinical capability has a financial incentive to steer you towards services they can deliver more profitably.
Watch for:
- "You don't really need a podiatrist; we can include nail trimming with personal care." (No, that's a different service)
- "Speech pathology is mainly for kids." (Wrong, adult and geriatric speech pathology is a major field)
- "Allied health is hard to access; let's focus on personal care first." (Sometimes true, but shouldn't be a permanent answer)
If you encounter resistance to clinical services, that's a yellow flag. Quality providers actively offer them.
Set up clinical services on day one
The most common mistake new SAH participants make is delaying clinical services until they're "needed." By then, opportunities for prevention are lost.
In your initial care plan, push for:
- An OT home visit within the first 4 weeks
- A podiatry assessment within 6 weeks
- A nursing review of all medications
- A dietetics assessment if there's any chronic condition
This is the foundation. Build the rest of the year on top.
Compare on clinical depth
Hourly rates matter, but for many participants the more important metric is whether the provider can actually deliver the clinical services you're entitled to. Use the price comparison tool to identify provider rates, then ask explicitly about their clinical capability.
For specific guidance on accessing allied health services, see our allied health under SAH deep-dive.