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Doctors say lack of nurses most urgent aged care issue


Australia’s peak doctors’ group is calling on the Commonwealth to fund a quality aged care workforce following the release of a member survey that raises concerns over doctors cutting back on facility visits, a lack of trained nurses and inadequate financial compensation.

The fourth Australian Medical Association Aged Care Survey, which was carried out in November 2017, involved 608 general practitioners, consultant physicians, and palliative care and geriatrician specialists.

The most urgent aged care issues reported by all respondents are improved availability of suitably trained and experienced nurses and other health professionals (67 per cent) followed by increasing funding for medical practitioners (58 per cent), according to the survey.

Almost two-thirds of the medical practitioners surveyed visit residential aged care facilities (64 per cent), which is a 14 per cent decrease since the 2015 survey.

In response to a question on clinical handover, around 63 per cent of aged care doctors said facility processes ensured a reliable clinical handover always (23 per cent) or often (40 per cent) while the remaining reported a reliable handover only occasionally or sometimes (26 per cent), rarely (9 per cent) or never (2 per cent).

Most doctors said a nurse’s level of expertise was required to conduct a professionally responsible handover (85 per cent).

Compared to two years ago, doctors are making more visits to facilities (from 7.4 to 8.6 visits per month) and spending more time with patients (from 6.5 to 6.6 patients per visit), the survey found.

However, among the 129 aged care doctors who responded to a question about intentions to visit facilities over the next two years, more than a third said they intend to decrease their visits (20 per cent), not take on any new patients (7 per cent) or stop visiting facilities altogether (9 per cent).

Just over half of this group said they intend to maintain the number of facility visits (53 per cent) while almost 12 per cent said they planned to increase the number of visits.

Doctors were asked about access to treatment rooms in facilities, which an area that has been highlighted previously as lacking and therefore a deterrent to doctors visiting facilities.

More than half of aged care doctors said facilities never (36 per cent) or rarely (22 per cent) have treatment or visiting rooms with the remaining reporting rooms available sometimes (24 per cent), often (10 per cent) and never (8 per cent).

Aged care GP and AMA President Dr Tony Bartone said the survey raised concerns over providing medical care to aged care residents and action was needed now.

“The current aged care workforce does not have the capability, capacity and connectedness to adequately meet the needs of older people,” he said.

“There must be adequate funding to ensure that Australia’s ageing population has access to quality medical care through a quality aged care workforce. This must be an urgent priority,” Dr Bartone said.

Pat Sparrow

Aged and Community Services Australia CEO Pat Sparrow said doctors had a responsibility to ensure positive health outcomes for aged care residents just as for any other patient they treat.

“With consumers’ expectations of aged care increasing, and funding pressures continuing to bite, it is time for doctor’s to recognise aged care facilities do their best to provide quality care with limited resources,” Ms Sparrow said.

“Australia can only develop the services frail older Australian want and need now and into the future by ensuring we have a well-funded and sustainable residential aged care sector,” she said.

Speaking after his appearance at an aged care conference in Sydney today, Federal Treasurer Scott Morrison said the AMA survey was conducted before this year’s federal budget and therefore doesn’t take new measures into account.

“There’s been a lot of work that’s been done in this year’s budget to address those issues that are identified in that survey so I’d say those issues are a bit out of date…,” Mr Morrison said.

Leading Age Services Australia CEO Sen Rooney called on all aged care and health stakeholders to work together to ensure the system provided accessible, affordable and quality aged care and services to all seniors.

He said providing appropriate care for aged care residents was not as simple as the number of staff on duty or arbitrary staffing ratios.

“The basis for deciding on staffing levels and their skills mix needs to be driven by the actual care needs of individual residents.”

Mr Rooney said the AMA survey findings about doctors intending to cut back or stop visiting their patients in aged care was a cause for concern.

“A priority for older Australians living in the community or an aged care home is having access to quality and responsive GP care, as many have complex and chronic conditions.”

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4 Responses to Doctors say lack of nurses most urgent aged care issue

  1. Dr Drew Dwyer July 25, 2018 at 3:11 pm #

    From the perspective of working with the GP and Nurse medical team….simply the item numbers and incentives to treat and care for the elderly are the lowest in the MBS and as such do not attract the quality of time and focus on the complex care that is required for older patients.

    Elderly need time with the HP and the HP needs time to conduct formal and proper assessment….proper health care team management of the multiservices needed to provide the long term care.

    None of this is met in the medicare system

  2. Karyn Dijkstra July 26, 2018 at 2:09 pm #

    When my mum went into aged care I was given a list of Drs who visited the facility. I had no idea of the quality of these Drs, their bed side manner etc. My mother wanted her own Dr. He initially agreed to continue her care, however I found him to be very unresponsive when an issue arose. This exacerbated my mum’s anxiety which was already a difficult issue. It also put more pressure on the family. In the end I sought out a sympathetic and experienced RN at the facility who suggested 2 Drs to me. I had a very long conversation with one of these, as my mum’s medical history (chiefly involving depression and anxiety associated with macular degeneration) was extensive. Fortunately he agreed to take her on. This Dr always visited the facility once a week and was responsive if issues arose in between visits. The relief at finally being able to obtain descent and ongoing care for my mum was immense. My experience is that many Drs do not want to visit aged care facilities and that aged persons in facilities are basically second class citizens when it comes to accessing GP and medical specialists. A very sad state of affairs.

  3. Grant Lucas July 26, 2018 at 5:17 pm #

    I agree the problem is a lack of financial incentive to GPs.
    Perhaps the MBS could decrease all the other scheduled fees rather than increasing the ones associated with Aged care? This sounds radical, but if they lifted the current rate freeze (I think it is to be changed in 2020) at the same time it may equal the playing field. Our elderly would get the care they require and GPs total revenue would not be diminished.

  4. Ross, RN8 CNC December 28, 2018 at 3:52 pm #

    Regarding Registered Nurses, there is a huge pay difference. The same Registered Nurse RN8 would earn $300.92 more a week, while an RN1 would earn $195.55 a week more, on morning shifts, working in the NSW Public Health System than working in aged care under the National Nurses Award. The Fair Work Commission’s awards need to address this difference. NSW Public Health System is the largest employer of nurses and has the greatest demand for Registered Nurses – the aged care system can not compete under the current award framework.

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