RACGP aged care standards out for second review

Morgan Liotta

25/06/2020 3:25:16 PM

Following initial consultation last year, the college is seeking further feedback to its standards for aged care. newsGP details key updates.

Aged care residents
GP feedback on the Standards will enable the RACGP to address any barriers encountered when providing care to RACF residents.

The RACGP’s Standards for general practice residential aged care (Standards for GPRAC) have been developed to help address the gaps between the Aged Care Quality Standards and the Standards for general practices (5th edition).
Member and stakeholder feedback collated from the first round of consultation was used to develop the second draft of the Standards for GPRAC.

Dr Louise Acland, Chair of the RACGP Expert Committee – Standards for General Practices (REC–SGP) talks to newsGP about the key updates.
Update of the Best practice guide to collaborative care between GPs and RACFs
‘We are revising this resource that was created in 2013 ­to address feedback about the GP and RACF [residential aged care facility] responsibilities during an RACF visit,’ Dr Acland said.
‘The guide was supported with a collaborative care information form which outlines agreed responsibilities in order to provide collaborative care to residents in RACFs.
‘The [updated] toolkit will be developed with reference to the Silver Book [RACGP aged care clinical guide] and Standards for GPRAC, with key stakeholders engaged to consult on the development.’
Confirmed requirements of consultation and treatment rooms in the explanatory notes
‘Concerns were raised regarding consultation spaces and treatment room availability,’ Dr Acland said.

‘The explanatory notes have [thus] been expanded in Indicator 2.1 regarding the importance of having a consultation and treatment room; however, [they] acknowledge the difficulties in implementing them in facilities.’

The Standards for GPRAC state that ‘A dedicated, safe and private environment such as a consultation room protects residents and supports the delivery of quality care. Having a dedicated treatment room available in your RACF could improve resident access to care’.

Terms relating to chemical restraints aligned with the Silver Book
‘We aligned these terms with the Silver Book, which is the pharmacotherapy review,’ Dr Acland said.
‘The RACGP believes the widespread use of the term “chemical restraints” does not adequately or appropriately reflect the potential role of short-term pharmacotherapy management of severe BPSD [behavioural and psychological symptoms of dementia].’
Criterion 5.1: Qualifications of the RACF care team unflagged
‘This criterion was unflagged after feedback had been received from participants that they felt the skills and qualifications of RACF staff are sufficiently captured with Aged Care Quality Standard 7: Human resources,’ Dr Acland said.

‘This was not the intended purpose of this Standard as it is out of scope to dictate the types of qualifications or mix of workforce an RACF should have.

‘This Standard focuses on ensuring that all RACF care teams are suitably qualified to provide residents with safe, high-quality care. The team is defined as the RACF residents’ multidisciplinary care that is provided by a range of health professionals external to the RACF.’

Dr Acland also underlined the importance of GPs providing feedback on the Standards for GPRAC, given their role and the barriers they face in providing care to people in RACFs.

‘GPs face significant barriers in providing care to residents in RACFs, including a lack of recognition of their role as a patient’s nominated GP; inadequate clinical, administrative and financial support; clinical complexity; time pressures; workforce issues; and lack of infrastructure and support structures,’ she said.

Some of these barriers have been used to shape the Standards for GPRAC, as well as implementing suitably qualified and appropriately trained staff in RACFs as an essential aspect of the quality of care provided.

‘The RACGP advocates for a model of medical care for RACF residents that integrates with general practice and enables GPs to continue to oversee their patients’ medical care,’ Dr Acland said.

‘GPs should be able to work in collaboration with the patient’s broader multidisciplinary healthcare team, including RACF staff, other specialist medical practitioners, and allied health professionals, in a way that focuses on residents’ and carers’ needs.

‘Hearing from more GPs about the current Standards consultation enables the RACGP to tailor them to any further barriers that GPs have encountered, especially during COVID-19.

Piloting of RACFs for the Standards is currently on hold due to COVID-19 restrictions, but the RACGP will be sending out additional expressions of interest for RACFs to be part of the pilot once restrictions are eased.
Dr Acland said it is important that RACFs are involved in piloting the draft Standards to help identify any practical issues with implementation and provide ‘real-life feedback’ on the feasibility, acceptability, achievability and applicability.
‘[The pilots can also give] advance warning about areas inappropriate or too complicated for RACFs and allow the RACGP to address any areas that cause issues to RACFs or surveyors before the Standards are finalised,’ she said.
Dr Acland will be presenting at a live Health2Ageducate webinar on 30 July to outline the objectives of the Standards for GPRAC and the clinical interface between RACFs and GPs.
Second round consultation on the current draft Standards for GPRAC can be provided via the RACGP website.
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