A new report from the Australian Medical Associaton (AMA) has shown that the situation is only going to get worse for older Australians living in residential aged care, as the number of doctors who conduct residential aged care visits continues to decline.
The report comes off the back of a recent 2012 Aged Care Survey, conducted by the professional body, which shows that the older medical workforce is providing the majority of medical services to older Australians in residential aged care.
The survey, carried out in July this year, highlights that only about a quarter of those who attend residential aged care facilities are female, and nine in 10 practitioners who attend are over 40.
It also found that more than 15 per cent of survey participants working within the medical workforce, intend to reduce their visits over the next two years.
The statistics sharply contrast with the demographics of Australia’s overall medical workforce, two-fifths of which are female and a third are under 45.
The average number of patients seen by medical practitioners per visit to residential aged care facilities is also 5.8 – up from 4.77 patients in 2008 – indicating higher demand for medical care.
The average time spent with each patient is 16.2 minutes – up from 13.12 minutes in 2008 and the average time spent for each patient managing the care of the patient with the facility and/or family is 13.9 minutes – up from 13.2 minutes in 2008.
The AMA say the survey acts as further evidence that the government and aged care sector are struggling to produce incentives and conditions to attract female and younger doctors to provide medical services in residential aged care into the future.
AMA President, Dr Steve Hambleton, said the aged care sector is in urgent need of support and long-term vision.
It is therefore calling on the major political parties to spell out comprehensive aged care policies ahead of next year’s election.
“This year’s Living Longer Living Better aged care reform package provided no focus at all on the medical needs of older Australians once they enter residential aged care,” Dr Hambleton said.
“For many years, the AMA has highlighted that access to medical care for older Australians has been a policy free zone for successive governments.
“The aged care sector must be able to provide a level and quality of medical, nursing and allied health services that meets the needs of the ageing population.
“It is time for the government to take a serious look at measures to ensure older Australians continue to have access to medical care.”
Around 731 general practitioners, consultant physicians, geriatricians, emergency physicians, psychiatrists, and palliative medicine specialists responded to the survey.
“The AMA calls on the Minister for Ageing to convene a specific forum for clinical providers to consider and advise the government on the best options to incorporate medical and nursing care in the aged care sector.
“Medicare rebates for medical services provided in residential aged care facilities must be increased to reflect the complexity of care and the significant amount of additional, but clinically relevant, non face-to-face time with the patient that goes into overseeing their care.
“Medicare rebates for GP video consultations would mean residents of aged care facilities could receive timely quality health care without medical practitioners sacrificing time in their busy practices.
“And improving IT facilities – considered a priority by 81.6 per cent of respondents – would overcome the technological barriers to the entry of younger medical practitioners into the aged care sector.”
Almost 100 per cent of survey respondents identified the need to improve the availability of suitably trained and experienced nurses and other health professionals in residential aged care.
The survey found the average age of medical practitioners providing medical care to older Australians in residential aged care facilities is 52.5; 25.4 per cent of medical practitioners providing medical care to older Australians in residential aged care facilities are female; the average number of visits by medical practitioners per month to residential aged care facilities is 6.3 visits– down from 8.36 visits per month in the 2008 AMA Survey.
General Practitioner and immediate past president of Palliative Care Australia, Dr Scott Blackwell, agrees that the AMAs survey has revealed the current and potential worsening crisis is clinical care in aged care, especially in residential aged care facilities.
“There are quite a lot of younger doctors interested in a career in primary care in aged care but indeed aged care does need to be made more attractive,” said Dr Blackwell, who has worked with Silver Chain Hospice Service for over 15 years.
“The current business model for GPs working in aged care simply does not fit the need.
“Firstly applying the practice based item numbers to RAC is like asking a square peg to fit in a round hole.
“Item numbers for this work need a complete rethink to be appropriate. For instance much of the work needed in RAC is not face to face with the resident and this needs to be recognised.
“Clinical governance in RAC should be re-modelled into a collaborative approach where a variety of clinicians can achieve a better outcome for residents. This will require a much more person centered approach rather than the current document centered approach.
“Other clinicians like Nurse Practitioners must be better funded to be a fair part of any future collaborative model.”
More than 700 survey respondents gave a high priority to measures to increase the availability of suitably trained and experienced nurses and other health professions to support the care of older Australians living in residential aged care facilities.
The AMA 2012 Aged Care Survey Report is at https://ama.com.au/ama-aged-care-survey-2012