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Aged Care Royal Commission progress ‘disappointing’


Michelle Wisbey


14/08/2024 4:23:49 PM

A report says not enough has changed to improve residents’ chances of having their healthcare needs met. 

Elderly woman walking along aged care hallway.
The Royal Commission into Aged Care Quality and Safety made 148 recommendations for change.

Three years after the Royal Commission into Aged Care Quality and Safety handed down its damning findings, a new progress report says there has been a lack of action on many of its recommendations.
 
Released this month, the Inspector-General of Aged Care’s Progress Report is an assessment of the progress made by the Australian Government in implementing the Commission’s 148 suggestions.
 
In this report, Acting Inspector-General Ian Yates said while much has been achieved and even more work is underway, in some key areas he has been left ‘disappointed’ by a lack of progress.
 
He said, despite improvements being introduced, his office heard that ‘little has changed’ to improve people’s chances of having their healthcare needs met while in residential aged care.
 
‘Both consumer peaks and providers who participated in our roundtables raised access to GPs for those in residential care as a concern,’ he said.
 
‘Several spoke of GP shortages in regional and rural areas, while Western Australia was identified as a state with a chronic GP undersupply.
 
‘Noting that the clientele of residential care facilities is becoming increasingly older, with more complex needs, the Inspector-General considers that more needs to be done to ensure people retain access to appropriate specialist care on moving from the community into a residential facility.’
 
The report laid bare concerns that people in residential aged care may not have adequate access to a GP, and that current incentives do not sufficiently recognise GPs’ importance.
 
The report’s release came the day after the new MyMedicare General Practice Aged Care Incentive (GPACI) went live, aimed at bolstering care and planning within aged care.
 
The RACGP has been involved in the discussions to design the incentive, flagging concerns with the initiative which could prevent GPs from signing up.
 
The Inspector-General said greater access to care for patients living rurally, as well as adequacy of funding, should be ‘critical Government considerations’ to ensure there is enough funding to meet the actual cost of care.
 
The Royal Commission also called for greater integration across the primary health, hospital and aged care systems, but Mr Yates said there is a lack of evidence to show any significant improvements being delivered, or ‘holistic, system-wide thinking having been done within Government’.
 
‘The Inspector-General considers that there is a clear need for more policy work and substantive action on integrating the health and aged care systems around the provision of high-quality care,’ he said.
 
‘People in residential care settings should have equal access to health care to those in the community. Too often it appears that access decreases after entry to residential care.’
 
The report also said there must be the urgent introduction of a more seamless, demand-driven aged care system, as well as increased action to improve people’s understanding of aged care, and improved integration between the healthcare and aged care systems.
 
He said there must be more ‘ambitious action’ and a continued concerted effort from the Federal Government when it comes to easing access and navigability of the aged care sector.
 
‘The Inspector-General is disappointed that the government is not implementing this cornerstone reform – the new Aged Care Act and the new Support at Home Program retain a ration-based approach,’ the report said.
 
‘As a direct consequence, older Australians with assessed needs will continue to miss out or face long delays in accessing care.
 
‘Improving information, navigability and access pathways older Australians continue to struggle when starting their aged care “journey”.’
 
Ultimately, the Inspector-General suggested the Government priorities for the next six months should be to:

  • revisit recommendations to implement a new, seamless, needs-based aged care system
  • finalise the new Aged Care Act
  • provide substantial, additional funding to resolve unmet demand
  • increase stakeholder engagement about the reform agenda
  • increase complementarity and resolving conflicts
  • examine whether current funding for regional residential aged care providers is sufficient
Mr Yates said that ultimately, many people in aged care continue to wait too long for treatment and assessment, and that there is a ‘pressing need’ for Government to provide more active face-to-face support for people seeking aged care.
 
Adding that further work is needed to improve dementia support pathways, saying awareness of, and access to, more specialist dementia care services must be improved and promoted.
 
He said culturally safe and healing-informed care needs to be embedded in aged care programs to ensure First Nations Australians receive appropriate care.
 
The Office of the Inspector-General of Aged Care is an independent statutory authority, which was established upon recommendation from the Royal Commission.
 
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Dr Brent Paul Prior   15/08/2024 10:12:10 PM

I have 15 residents in a care home - with these changes I will be only able to receive the same incentive payment as in previous years by having 33 residents.
This change removes income from any Doctor with less than 33 residents in care homes.

I will also have some visits not counting towards this incentive if I visit more than twice per quarter.

If I am asked to assist other residents at the care home eg complete medication chart as their Dr is unavailable, then this will not contribute to the incentive as those residents are not registered to me under My Medicare.
Drs have already begun to refuse to help colleagues out due to this.

Thankfully I work with a registered practice but Drs who are not associated with a practice will be forced to do so by this scheme.
In doing so they are likely to lose income to pay the practice for helping with administration.

Care homes are already struggling to attract GPs to care for their residents.
This work is unpredictable, complex, challenging and time consuming - having a straightforward incentive scheme goes someway to rewarding Drs who take on this work.
The current Medicare changes does not help the situation - we are being asked to jump through more hoops for less reward and discouraged from assisting our GP colleagues in Aged Care.
I worry as a result you will find many GPs abandoning Aged Care and making the situation worse.
This needs to be corrected ASAP before residents come to harm.