Solving the workforce crisis

Workforce has been a perennial problem for the aged-care sector for too long.

Relatively low pay, a lack of career progression, fewer training opportunities and the perception that working in aged care is unrewarding and unattractive, all add to a troubling picture.

Back in 2011, the Productivity Commission in its Caring for Older Australians report outlined workforce challenges as demand increases over the next 30 years unless urgent action was taken to address the workforce gap.

The situation had worsened considerably when, in 2018, an independent aged-care workforce taskforce delivered a plan with 14 recommendations for prioritised implementation over a three-year period.

And then COVID-19 hit. Since then our workforce problems have become a genuine crisis.

Providers have struggled to attract skilled staff, they’ve been given no support to improve pay or career progression and many have seen an exodus of experienced, highly trained staff fed up with a lack of resources to do their jobs.

With international borders closed, it has been difficult to find enough candidates of sufficient quality to fill the vacancies. We have seen many qualified staff poached by state health authorities and state-run aged-care homes where they are better paid.

We are not alone in Australia with our workforce issues. A recent LASA virtual forum, From Pandemic to Endemic, heard speakers from North America and New Zealand describe identical issues faced by providers and workers in their respective aged-care sectors.

While in Australia there has been some movement by the federal government in response to sector advocacy and the Royal Commission into Aged Care Quality and Safety, much more is needed.

In its $17.7 billion May Budget response, the government pledged to create 80,000 new home-care packages over two years and to attract and train 13,000 home-care staff. It also announced an increase in the minimum amount of daily staff care time for people in residential aged care.

The new packages and additional care time, while welcome, further increase workforce pressures to breaking point.

In order to meet the required new minimum standards of care at the current rate of aged-care workforce growth, the Committee for Economic Development Australia (CEDA) estimates in its 2021 report, Duty of Care: meeting the aged care workforce challenge, the sector will need an additional 110,000 direct care workers by 2030.

The impact of lockdowns, single-site working arrangements and staff having to be furloughed due to close contacts has further stretched the time available to provide care in aged-care homes. With this being further exacerbated by the growth in administration requirements and compliance. Providers have found just trying to fill a weekly roster a major challenge.

A LASA-Mercer Workforce Benchmarking Survey conducted earlier this year suggests that the number of shifts missed equates to about half an hour of time available per aged-care home resident per week.

In its 2020 Aged Care Workforce Census the ABS identified at least 22,000 vacancies with most in residential aged care (9400), home-care packages (6480) and home-support services (6120).

To add to this picture, the CEDA report projected a further shortfall of at least 17,000 aged-care staff each year for the next 10 years. It also predicted that more than 400,000 additional aged-care workers would be needed by 2050 to cater for our ageing population.

The result of all of this means that existing staff have had to work harder, in many cases for longer hours, as providers struggled to avoid cutting services. Further, the ability of providers to consistently deliver high standards of care and service is being compromised.

Providers and unions are united in their support for a significant increase in wages for staff working in aged care as a work value case proceeds in the Fair Work Commission next year.

There is no question as to the passion and commitment of the women and men who work in aged care who elected to get vaccinated so they could protect the residents they care for and their colleagues, achieving close to 100% full vaccination.

Last month, the Australian Aged Care Collaboration of six major provider representative organisations, which represents more than 1000 aged care providers — LASA, ACSA, UnitingCare Australia, Anglicare Australia, Catholic Health Australia and Baptist Care Australia — called on the government to take urgent action on workforce.

The AACC wrote to the Health Minister and the Minister for Ageing seeking an emergency response to fill gaps in staff in residential and home care to:

• support providers to pay a competitive wage by agreeing to fund the outcome of the Fair Work Commission Work Value Case
• encourage student nurses to consider a career in aged care and encourage personal care and support work as a career
• allow foreign workers to fill vacancies where local workers are unavailable
• develop with states and territories an aged-care VET pathway program for school leavers
• offer a subsidy to enrolled nurses in aged care to become registered nurses.
   

The response to this request has been disappointing. Since the Royal Commission ended in March the government has taken some measures including introducing an aged-care nurse retention bonus, home-care workforce support program and an easing of temporary visa restrictions for care staff.

While these measures are welcome, they do little to address the urgent need to fill unfilled shifts happening daily in services right across the nation. Little is being done to ensure new residents are not turned away or in-home services refused because of staffing shortages. Much more needs to be done right now if we are to meet the demands of an ageing population today and succeed in providing high-quality care that meets the needs of older Australians.

For as we all know, getting workforce right is fundamental to getting care right.

Image credit: ©stock.adobe.com/au/Gabriel Jose