Jun 04, 2019

ANMF hits back at claims staff ratios not needed


The Australian Nurses and Midwifery Federation has hit back at claims its fixed staff ratio model is flawed.

Aged care consulting firm Ansell Consulting issued a submission to the royal commission last month, in which it said the ANMF’s proposed fixed staff ratio model of care is “not appropriate” and “simplistic”.

The report features a 1917 quote from American journalist HL Mencken: “For every complex problem, there is a solution that is neat, simple and wrong”, and goes on to explain why the ANMF’s proposal isn’t realistic.

What is the ANMF’s proposed fixed staff ratio model?

The ANMF’s fixed staff ratio model aims to provide residents with 4.3 hours of care a day by 2025 with a staff skill mix of 30 percent registered nurses, 20 percent employed nurses, and 50 per cent personal care workers.

The proposal recommends a 240 per cent increase in full time equivalent nurses, and for nursing hours to increase from 25 per cent to 50 per cent of the workforce.

Model is not realistic: Ansell Consulting

Ansell’s submission, which relies on international research and interviews with aged care operators and clinical leaders (mainly nurses) from more than 160 private and not-for-profit nursing homes, claims the ANMF’s proposal would require an extra 57,000 FTE nurses, compared with the 24,000 FTE nurses that are currently employed.

Ansell says there are six main reasons fixed staff ratios are not appropriate in aged care:

  • there is a variability in resident needs and staff skills,
  • it would lead to overinvestment in clinical resources,
  • models of care are evolving,
  • there are a scarcity of registered and enrolled nurses,
  • they would create an economic and administrative burden, and
  • they would negatively affect consumer choice.

Ansell report disputes stated economic benefits of staff ratio model

The ANMF commissioned Flinders University to assess its proposal, and while Flinders found the plan would cost $5.7 billion, it said those costs would be offset by indirect and social benefits.

Flinders argued that financial savings, additional tax revenue, and improved quality of life outcomes support the ANMFs proposal on economic grounds.

But Ansell’s report has rebuffed those claims, saying that ‘improved quality of life’ can’t be measured in financial terms.

Ansell also says Flinders University’s claim that increased tax revenue will come from “new” wages is wrong, because those employed will be skilled workers most likely already work in another sector.

Thirdly, Ansell argues there is little evidence to support Flinders’ claim that staff ratios will cut aged care resident hospitalisations by 50 per cent.

“The assertion that additional clinical resources would significantly reduce hospital transfers is to adopt a simplistic view to a complex issue,” the report states.

Ansell Consulting believes the solutions to problems in aged care include:

  • Improved resourcing of home care to reduce pressure on residential aged care,
  • Improved the training, education and recognition of the aged care workforce;
  • And creating partnerships between key aged care stakeholders.

The ANMF has today hit back

The ANMF has today hit back at those trying to “discredit” its proposal, and is attempting to correct which is believes is “misinformation” being circulated in the industry.

The ANMF says, “Those making the claims about ratios and minimum staffing levels have not read or understood the ANMF’s research and reports, that they have also not read or understood the evidence provided by the ANMF to the Royal Commission, and they have not listened to the heartbreaking stories of unnecessary pain and suffering being experienced by some residents in aged care.

“It’s time for each and every provider, accountant, consultant and aged care lobbyist to start listening to the stories of those who live in aged care and the families, who have experienced the system directly, as well as the staff who work with the residents and families directly.”

Image does not reflect actual people or events. Source: iStock.

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  1. Ansells Submission!! Yes you are right there is a variability in residents needs and staff skills ! If you look into it ,its a higher level of care as people are coming in later in life and already at the high care level !!
    Please explain how its likely to lead to overinvestment in clinical care? This is our elders your talking about ! That at least need some clinical care and its not a great treatment for them at this point in time !!!
    Your right ! Models of care are evolving! So tell me ,When is the Aged Care Sector going to realise that?
    You day that Nurses are Scarce?? Well heres an idea , Make Aged Care a place if enjoyment and job satisfaction to attract them and get them to want to stay???
    You say they would create an economic and administrative burden? Where ? How? And why? Again this is our elders your talking about ! They deserve proper nursing care! Along with a well deserved life helped with carers in their twilight years!!!
    You also say they would negatively affect Consumer choice? What a load of poppy cock! At least the consumers would have a choice.
    Seriously I feel sorry for you as you obveously dont get it? At least the ANMF get it !!!

  2. Child care has ratios. If school teachers were teaching 50 or 60 kids at once there would be out rage. I think there’s even ratios in the disability sector. Yet NONE in aged care?? We need ratios and residents PAY for their care. I’d like to see anyone who disagrees with ratios experience a nursing home for a week relying on staff completely for toileting showering eating and even to be taken outside for fresh air! Love to hear their thoughts on ratios after that experience!


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