Vitality Club on Reshaping Australia’s Aged Care System
The Royal Commission has shone a spotlight onto the aged care system and unearthed a plethora of stories about how our system has failed to meet the needs and expectations of the community.
But, how do we address these systemic issues? How do we turn our aged care system from a national disgrace to something to be proud of?
The commission report is a great place to start. With 144 recommendations it paints an aspirational picture of the system of tomorrow. While the government has acknowledged and committed to change in a number of areas, further curial aspects are still being worked through or have been overlooked altogether.
We’ve been vocal about what needs to change, and while our recommendations during the Royal Commission were heard, there’s more that needs to be addressed. Here’s how:
1. Integrated systems for long-term support
Recommendation 4 is around integrated long-term support and care. To achieve this, Australia needs to develop a streamlined process of tracking and managing each client. This tracking should start with an independent assessment, done by an allied health professional, aimed at establishing funding. The tracking and funding should then follow each client through their journey from needing basic services, to complex services, to housing support, and finally to residential care.
This approach starts at the entry point and progresses with the client, no matter where they are on their journey, who their provider is or the services they require. This solution is based around a centralised care plan, with all services reporting into the care plan, reviewable by holistic health providers who can assess that client and how they’ve progressed. This will create an integrated living record, updated by the entire care community.
The most efficient use of resources, and lowest financial impact on Australia, would be to utilise the current E-health infrastructure. By doing so, not only are we making the most out of a $2 billion project, we are saving millions of dollars in lost productivity. This loss of productivity is experienced through inefficiency, duplication of services delivered to an individual client, communication breakdowns and incorrect reporting.
While updates to the existing infrastructure will be needed to ensure the system meets socio-technical, legal, and ethical standards, it is a highly viable solution for the aged care industry and Australian consumers.
2. Look to preventative & value-based care
Preventative care should be another area of focus. Statistics from 2018 indicate more than 50% of hospitalisations and 87% of deaths are due to chronic conditions or disease. By shifting our focus to preventative health strategies we can reduce these conditions and ultimately the pressure on our hospitals & aged care systems.
This can be achieved by delivering allied health in a person-centred approach that focuses on holistic wellbeing. Services could be delivered through multidisciplinary teams and collaborative care arrangements, which are flexible and responsive to changing needs. This all aligns with the principle of Value-based healthcare which is a model that pays providers (at all stages of a care journey) based on patient health outcomes.
Under a Value-Based system, providers would be rewarded based on patient health improvements measured, for example, by fewer medical incidences per client.
3. Workforce Reforms
We currently have a workforce shortage that projects needing 220,000 new Allied Health and nursing staff by 2027. To paint a picture; the current industry has 110,000 across all care sectors.
In 2020, 16,000 people died while waiting to receive a Home Care Package. A system that has failed to cover 100,000 seniors, soon to be growing by 2023 to 1.3 million with the CHSP merger, will only exacerbate waiting times. The additional 80,000 packages the government has suggested won’t provide a solution until the workforce is addressed.
Ways to resolve this issue are around easier pathways into care, changing industry perceptions and migration.
Training - It’s been addressed somewhat but an area for concern is that raising qualifications and requirements, creates barriers for staff who may not have the funds to seek formal education. We also need to ensure moves towards training or industry requirements do not pose additional barriers to culturally and linguistically diverse (CALD) workers, which could be considered discriminatory. While we need to raise care standards, we need to create easier pathways to care, not bigger hurdles. The onus of higher care standards should be on the providers, not the staff.
The Community Professional - as a whole, we need to change the perception of careers in Aged Care, making people proud to be in care akin to nursing or child welfare. An industry-wide campaign matched with better pay and career growth opportunities will get us moving in the right direction.
Migration - If we are unable to meet the staffing targets with resources locally available, Australia will need to update policies and offer opportunities for migrant workers. If we take this avenue, we need to focus on collaboration between stakeholders to ensure workers are looked after and supported. At Vitality club, cultural diversity is incredibly important to us and something we want to positively advocate for.
There are countless areas of the report and response that we could explore in more detail but making changes to infrastructure that enables productivity and improved care, a shift to preventative and value-based care that looks at client improvement and workforce solutions are the most crucial steps to a new care system.
Ahilan St George - Vitality Club Director