Expression of Interest (EOI) - Response Form

After-Hours GP-Led Clinic Models - Dubbo Community (Market Sounding and Industry Engagement) 2026

WNSW PHN is undertaking this market sounding to identify general practices and other suitably qualified providers willing to help strengthen existing GP-led after-hours clinics and services in Dubbo. This may include contributing workforce or operational support, as well as participating in collaborative planning to develop a safe, sustainable service for the whole Dubbo community.

WNSW PHN’s immediate priority is to identify general practices and other organisations able to provide additional workforce or operational capacity to support existing local after-hours services. WNSW PHN also welcomes organisations willing to work alongside existing providers to coordinate services, address service gaps and participate in planning a sustainable longer-term approach. Responses may address one or more of these opportunities, based on the organisation’s interest and capacity.

This EOI is a market sounding and industry engagement exercise only. It is not a request for tender, does not create a contractual relationship and does not guarantee funding, selection or participation in any future procurement opportunity.

EOI responses close at 9.00 am (AEDT) on 13 November 2026.

Where relevant, please provide brief supporting details or evidence to help WNSW PHN understand the basis of your response. This may include current workforce availability, existing after-hours experience, service delivery assumptions, known constraints, partnerships or other relevant information.

1. APPLICATION DETAILS

1.1 Legal Name of Organisation / Practitioner Name: *

1.2 Trading Name of Applicant (if applicable):

1.3 Street address *1.4 Street address line 2

1.5 City *

1.6 State *

1.7 Postcode *

1.8 Do you have an ABN? *

Yes No

1.9 ABN: *

1.10 Are you registered for GST? *

YesNo

1.12 If Other, please specify

2. APPLICATION CONTACT DETAILS

Please provide the details of the primary contact person for this EOI submission. WNSW PHN will use these details for all communication relating to the EOI.

2.1 Application contact person: *

2.2 Application contact person position title: *

2.3 Contact Person's Phone number: *

2.4 Contact Person's Email Address *

3. Professional Registration

3.1 Are you / your practitioners registered? *

YesNo

3.2 Please describe your organisation's professional registration status and relevant accreditations *

3.3 Please outline your current clinical governance arrangements, including clinical oversight, quality assurance, incident management, and risk management processes. *

4. GP Workforce Capacity

4.1 Describe the role your organisation would be willing and able to play in strengthening after hours GP-Led care in Dubbo? *

4.2 Please indicate what it would involve from below: *

4.3 Please outline briefly capacity and support required *

5. Collaboration and Local Planning

5.1 How would your organisation work with existing after-hours clinics, general practices, AMS/ACCHOs, Healthdirect and other local pathways? *

5.2 Describe any workforce, infrastructure, financial or operational constraints? *

5.3 Would your organisation be willing to participate in local planning workshops, stakeholder meetings, and collaborative problem-solving activities? *

Yes No

If yes, please provide any comments regarding your participation.

6. Funding

6.1What funding would be required to commence, sustain or support participation? *

7. Additional Information

7.1 Please provide any other information that may assist WNSW PHN in understanding your organisation's capability, capacity, and interest in supporting after-hours primary care services.

8. DECLARATION

Before submitting this EOI, please review the declaration below and confirm your acceptance.

I declare that:

I am authorised to submit this EOI on behalf of the organisation.
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The information provided in this EOI is true, complete and accurate to the best of my knowledge.
*

Any supporting information provided is correct and not misleading.
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I have read and understood the EOI Guidelines and agree to the EOI Conditions outlined in the Guidelines.
*

I understand that this EOI is a market sounding process only and does not constitute an offer of funding, a request for tender or a commitment by WNSW PHN to procure services.
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I acknowledge that WNSW PHN may seek clarification, verification or additional information regarding this EOI submission.
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I understand that information provided in this EOI may be used by WNSW PHN for planning, market analysis, service design, commissioning and future procurement purposes.
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I confirm that I am authorised to make this declaration on behalf of the organisation.
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Representative Signature *

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Name *

Position Title *

Organisation *

Date: *

Attachment 1: If applicable, please upload any supporting documentation relevant to your EOI submission.

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Examples may include workforce plans, service model documents, clinic information, partnership agreements or letters of support, after-hours service experience, governance frameworks, capability statements, or any other information that may assist WNSW PHN in understanding your proposed model and organisational capability.

Please complete the CAPTCHA challenge below to verify that this submission is being made by a human applicant. *

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