Reshaping Australia's aged-care system

The Royal Commission into Aged Care Quality and Safety 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 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 sociotechnical, legal and ethical standards, it is a highly viable solution for the aged-care industry and Australian consumers.

2. Look to preventative and value-based care

Preventative care should be another area of focus. Statistics from 2018 indicate that 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 and 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 health care, 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 health workers 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 to 1.3 million by 2023 with the Commonwealth Home Support Programme (CHSP) merger, which 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 point to easier pathways into care, changing industry perceptions and migration.  

Training

Training has been addressed to some extent, but 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 working in the industry. 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 staffing targets with locally available resources, 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 that we could explore in more detail, but making changes to infrastructure that enable 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.

Vitality Club Director Ahilan St George. 

Top image credit: ©stock.adobe.com/au/seventyfour