In this guest post, Bronwyn Morris-Donovan, CEO of Allied Health Professions Australia, discusses the importance of a universal, needs-based aged care model. She highlights the decline in allied health services and stresses the urgent need for reforms to guarantee that aged care residents receive the individualised care they require.
On 2 August, the Inspector-General of Aged Care released a progress report on the 148
recommendations of the Royal Commission into Aged Care. The Report specified that
aged care should be underpinned by a universal entitlement to all forms of care and support in line with an assessed need and have a built-in capacity to meet those needs in a timely manner.
The report also calls for a transition from the current ‘rationed aged care’ model to the needs-based, demand-driven approach envisioned by the Royal Commission.
This shift is essential to increasing allied health service provision in aged care and ensuring that older Australians receive the care they need to maintain their health, well-being, and quality of life.
The decline in allied health services
The Royal Commission reported that residents received a total of eight minutes of allied health per day. Today, that figure has plummeted to just over four minutes.
As AHPA has consistently expressed to the government, this decline is an inadvertent impact of the shift to the Australian National Aged Care Classification (AN-ACC) model and the introduction of mandatory care minutes for nursing and personal care, but no mandatory benchmark for allied health service provision.
While the AN-ACC model funds allied health services, without specific targets, providers have little incentive to allocate funds to these services, instead, as University of Technology Sydney research recently found, some providers are using funding meant for direct care to subsidise other costs.
The Inspector-General’s report urges the Department of Health and Aged Care to review the impact of AN-ACC and the care minutes on allied health provision. The Report also calls on various levels of government to clarify their and providers’ responsibilities to equitably provide health care to older consumers, as recommended by the Royal Commission.
Importance of needs-based assessments
Currently, the aged care system lacks a universally consistent needs-based assessment process for allied health services. Without a standardised needs assessment framework, it is impossible to know (and provide) the level of allied health care that each person in aged care requires.
Additionally, there is no mechanism to ensure that older people’s assessed allied health needs are actually met. Despite amendments to the Aged Care Quality Standards, there are no clear, enforced standards to ensure that people get both the right amount and the appropriate types of professional allied health services that they are assessed to need.
The Inspector-General’s report advocates for a universal entitlement to all forms of care and support based on a consistent needs assessment. This approach would ensure that every aged care resident receives the level of care they need and deserve, tailored to their specific needs, regardless of their care setting.
Allied health and reablement
As part of multidisciplinary best practice, allied health professionals play an important role in improving quality of life (for example, addressing pain, psychological and behavioural symptoms, communication, hearing loss and mobility) and preventing deterioration and serious events (for example, through dietary and swallowing interventions, psychological management and falls prevention).
The Royal Commission found that reablement is critical to older people’s physical and mental health and wellbeing and should be a central focus of aged care. Commissioners recognised allied health as fundamental to achieving reablement, and recommended that those in aged care should be provided with allied health services based on individual needs.
However, true reablement and high-quality aged care is not achievable without consistent comprehensive needs assessment, and adequate service delivery.
Without significant reform, genuine quality aged care will not be guaranteed. Aged care residents deserve aged care, including allied health care that addresses their individual needs.
