Jun 19, 2018

How do we promote access to the right care at the right time?

HelloCare Exclusive – part 3 in a series of 4. Read Part 1 and Part 2.

The Aged Care Workforce Strategy, due to be delivered to the Minister for Aged Care, the Hon Ken Wyatt, at the end of this month, lays out pragmatic actions to grow and sustain the aged care workforce. The strategy will be wide-ranging and an opportunity for the industry – working with government and the wider community – to implement lasting change so we can support elderly Australians to live and die well.

In my first article for HelloCare readers, I explained the Taskforce’s community consultations, strategies to address negative stigmas attached to ageing, and developing an industry code of practice.

In the second article, I looked at the Taskforce’s proposals to develop new career pathways in the rapidly evolving and expanding aged care sector.

This third article looks at:

  • implementing industry standards for workforce planning, informed by holistic care plans based on each individual’s care needs
  • better integration between primary, acute care and aged care
  • establishing a Remote Accord to support the special needs of the aged care workforce in remote communities.

Establishing industry standards for workforce planning

The aged care industry does not have a standard approach to workforce planning, including skills mix modelling.

A mindset shift is necessary – from thinking about the workforce and workforce planning in isolation, to having it informed by the consumer’s care needs along with their evolving expectations. This is essential if we are to put people’s quality of life at the fore.

Workforce planning needs to be part of an organisation’s business model. Aligned with an industry-led Voluntary Code of Practice, workforce planning should focus on the principles of living well and integrated care.

Aged care organisations need to be able to clearly demonstrate their care planning approach to consumers and their families and articulate the services they provide, and how these services are provided. It is important care plans are holistic and broader than just clinical care and include:

  • clinical health
  • functional health
  • cognitive health
  • cultural and diversity needs
  • living well
  • morning, afternoon, night time and weekend care
  • advanced care directives
  • model rules (obligations of individual, family and aged care organisations)

We need to recognise consumers have different journeys and multiple entry points. Consumer profiles need to be used as the basis to develop care plans that are tailored to their individual requirements.

This planning is the first step and would need to be monitored to ensure consumer care outcomes are achieved, while ensuring safety and quality standards are upheld. Specific consideration needs to be given to the ongoing mechanisms of assurance, for example through the establishment of an Integrated Care Governance Committee, which reports to the organisations board or governing body. Just as each board would have a finance professional chairing the Audit Committee, it should have a Director with a background in Clinical Governance chairing this committee. Such a committee would be responsible, through periodic assessment, to ensure care plans are being delivered, and the costs to deliver services are being monitored and managed.

By implementing an industry standard to approach workforce planning, including skills mix modelling, we can equip all businesses, regardless of their size and capital base, with a mechanism to better attract, manage and retain their respective workforce.

Where this improved approach to workforce planning is not put into practise, then organisations should consider the body of research globally that reference best practice regarding the number of hours of care and the availability of registered nurses.

Strengthening the interface between primary / acute care and aged care

Older Australians have increasingly complex care needs that frequently require multidisciplinary services drawn from across aged, health and disability care. However, poor coordination of funding across these systems, along with professional silos between them, can make it difficult to access the right care at the right time. The quality of care is compromised, with increased costs for both the consumer and governments.

Better integration of these systems could be achieved by taking a population health approach, which structures care systems around the needs of consumers, rather than around available funding. This requires a whole of industry and government effort. Recognising whole of Government  accountability is key here given the impact across government departments and between national, state and local governments.

The Workforce Strategy will recommend specific ways to improve access to quality primary health care, improve acute services and address local service gaps.

Establishing a Remote Accord

During consultations in remote Australia, it became clear there needs to be a tailored approach to aged care workforce issues in remote and very remote settings, and that all levels of government, industry and community need to work together to achieve this.

A Remote Industry Accord is a way to give a greater voice to remote providers, leading the industry to address issues such as attracting and retaining aged care professionals, improving the safety and security of workers, training and career pathways and flexible and responsive government funding, policy and programs.

The Accord recognises all elders deserve proper care and to live and die close to home with the care they need and deserve for a life well lived, provided by a workforce they know and trust, which is well supported and trained, and accountable.

This will be a reality when governments, industry and community come together to develop flexible approaches that work in many different communities but achieve the same outcome for the families who live there. It is time to recognise the unique issues facing our remote care services and the need for it to be recognised as requiring a separate and dedicated policy, funding and systems design effort. It’s a gap that must be closed.

Look out for John’s fourth and final article about creating an agenda for change.

By Professor John Pollaers.



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  1. This is a brilliant article, clearly articulating the broad reaching concerns in the aged care industry via workforce driven deficits. The placement of clinical governance into organisational models would seem obvious to many but organisations see this as interfering with the business of homeliness and throughput rather than core to an industry now experiencing greater numbers and greater acuity in client/resident health than ever before. The identification that remote and even some regional centres that are well dispersed, as they are in Qld, is also valuable insight. After over 25 years in this industry, it’s nice to hear logical and well thought out ideas. A warning though, having tried to make innovative change via various projects in the past, the industry is risk averse and slow to change. The impetus needs to be a considerable shift in the tectonic plates of old management styles and old thinking.


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