On the surface, aged care reform looks like it’s working. Government figures show direct care minutes per resident have climbed from 187 to 218.87 between the first quarter of 2022-23 and the final quarter of 2024-25, inching toward compliance with the sector’s mandated targets.
But a new national survey from the Australian Nursing and Midwifery Federation (ANMF), based on responses from more than 3,550 frontline aged care workers, suggests those improving numbers are masking a serious structural problem: enrolled nurses (ENs) are disappearing from the sector, and their work is being quietly absorbed by cheaper, less qualified staff.
According to the ANMF’s Pulse Check of the Aged Care Sector report, EN care minutes fell by 3.02 minutes per resident per day over that same period. Scaled across the national aged care system, the union calculates that adds up to roughly 598,000 fewer EN minutes delivered every day, the equivalent of losing approximately 1,840 full-time EN positions.
Meanwhile, RN care rose only slightly as a share of total care, from 18.18% to 20.43%. The overall proportion of nursing care in aged care has stayed essentially flat, even as total “care minutes” climbed.
In the survey itself, 44.07% of respondents rated the number of ENs at their workplace as “poor” or “very poor,” a bigger gap than was reported for either RNs (23.69%) or PCWs (41.35%). In for-profit facilities specifically, that figure jumped to 48.20%.
The ANMF traces the cause back to the design of the Australian National Aged Care Classification (AN-ACC) funding model, which sets targets for total direct care minutes and RN minutes, but historically included no dedicated funding category for ENs. From October 2024, providers have been able to count up to 10% of RN time as delivered by ENs, but the survey suggests this hasn’t stemmed the tide.
Respondents described ENs being reclassified out of clinical roles altogether, absorbed into general care-staff duties, or made redundant outright.
“Most enrolled nurses have left the facility as they were mainly working in direct care roles due the ANACC funding model which does not really have hrs for EN so they are included in care minutes. This is really unfortunate as they were highly skilled workers for aged care,” one aged care manager in Victoria told the survey.
An enrolled nurse in Queensland was blunter still: “Enrolled nurses position has become expendable due to RN hours only required.”
The erosion of the EN role isn’t just a staffing statistic; respondents say it’s reshaping how care is delivered across the board. With fewer ENs providing clinical support, registered nurses report being pulled further from bedside care and into administrative and supervisory work, while personal care workers are increasingly asked to pick up tasks ENs once handled.
“Care staff are picking up the slack from all ENs being made redundant,” one Victorian personal care worker said.
An enrolled nurse in Western Australia connected the dots between funding structure and clinical risk directly: “Due to EN nurses reduced to 10% of clinical care counted minutes in RAC this creates a gap of clinical criteria that needs to attended in which increases more workload and stress and potentially a poor outcome to the client.”
The union argues the fix isn’t more funding within the existing model, but a different model altogether. Its central recommendation is to scrap care minutes as the primary staffing measure and replace them with mandated staff-to-resident ratios, built around a skill mix the ANMF has advocated for since its 2016 National Aged Care Staffing and Skills Mix Project: 30% RNs, 20% ENs, and 50% personal care workers, delivered across a benchmark of 258 minutes of direct care per resident per day, well above the current 215-minute target.
Specifically for ENs, the ANMF is calling for dedicated staffing targets and financial incentives to draw the workforce back into the sector, alongside a broader national strategy to define and protect the EN scope of practice within aged care.
Whether government will revisit a funding model introduced only in recent years, one still being fine-tuned via the 2024 EN minutes adjustment, remains an open question. But the ANMF’s data suggests that, absent structural change, the sector’s most measurable reform success (rising total care minutes) is coexisting with a workforce trend running in the opposite direction.
