A specialist healthcare service in Australia’s Illawarra-Shoalhaven region is changing how frail older people receive medical treatment, by bringing hospital-level care directly to aged care facilities.

The Aged Care Outreach Service (ACOS) accepted 2,502 referrals during the 2025–26 financial year. Remarkably, 2,393 residents — 95.6% — were treated where they lived without needing to visit an emergency department.

The service, which began in the Illawarra in July 2023 and expanded across the entire Illawarra-Shoalhaven Local Health District in September 2025, brings geriatricians, nurses and other clinicians directly to residential aged care facilities.

Residents can receive treatments including intravenous antibiotics, IV fluids and medication reviews, which might otherwise require a hospital visit.

For frail older people, avoiding hospital can be about more than convenience. Hospitals can be unfamiliar, noisy and stressful environments, particularly for people with vulnerable cognitive health.

In one case, an aged care resident with cellulitis was treated with antibiotics and monitored by clinicians over four days without leaving her familiar surroundings.

The initiative is also helping relieve pressure on busy emergency departments. Between January and March, four major hospitals in the region recorded a combined 42,687 emergency department attendances.

The outreach team has also supported 124 additional patients from emergency departments back into aged care, helping avoid hospital admissions.

Dr John McKenzie, co-director of the local health district’s Division of Aged Care and Rehabilitation Medicine, says the model is not intended to prevent hospitalisation when it is genuinely needed. Instead, it provides another option for older people.

The next ambition is even bigger: extending specialist outreach to frail older people still living in their own homes.

The message is simple but powerful, sometimes better healthcare doesn’t mean taking people to hospital. It means bringing the right care to them.