Aged and primary care can collaborate more on big issues: new LASA chief
There are remarkable parallels between aged care and primary healthcare in terms of the issues being faced and the sectors could collaborate more on key areas such as workforce and technology, says Sean Rooney.
There are remarkable parallels between aged care and primary healthcare in terms of the issues being faced and the sectors could collaborate more on key areas such as workforce and technology, says Sean Rooney, who recently commenced as CEO at Leading Age Services Australia.
Both sectors were facing ongoing issues around access, affordability, quality, the fragmentation of services, challenging provision in regional areas and the dynamics between state and federal governments, Mr Rooney said.
A core component in both aged care and primary care was the provision of care to keep people well and out of hospitals, while the sectors were also simultaneously undergoing significant reform, he said.
But while there were local examples of collaborations between primary care and aged care organisations, this was often happening in spite of the system, not because of it, Mr Rooney told Australian Ageing Agenda.
Mr Rooney, a former CEO of the Australian Medicare Local Alliance (AMLA), took up the CEO position at LASA in June. He came to the peak body from the ACT Government where he was executive director of sustainability and climate change. He has previously held executive roles at the CSIRO and in public, private, and not-for-profit organisations.
“There are some good examples of meaningful collaboration happening at grassroots level in many places and often it’s a combination of a pressing need and a bunch of motivated, passionate people who are willing to just nut it out to respond to that need,” said Mr Rooney.
But beyond collaborations at the local level, the sectors could work closer together on key areas that were ripe for a more collaborative and strategic approach, he said. These included workforce, funding, assistive technology and e-health, and population health planning to inform future services.
Engaging government: cooperation versus confrontation
Given the ongoing dispute over recent cuts to aged care funding, and the need for stakeholders to lobby the Commonwealth to get commitment on the proposals for further reform contained in the Aged Care Roadmap, many will be considering how best to engage government on the issues.
Based on his experience across government, business and not-for-profit groups, Mr Rooney said he believed constructive relationships were the key to successfully lobbying government.
“The thing that makes the difference is relationships that are built up over time and based on mutual respect. Credibility, being authoritative and having integrity – these are really important when you’re looking to deal with big public policy issues.
“It is the cooperation versus the confrontation model,” he said.
Changes underway at the peak
Mr Rooney arrived at LASA at a time of significant change in the peak body, as it moved from a federated to a national model.
He said that transition agreements had been executed with the state peaks in Western Australia, Queensland, and Victoria/Tasmania and all were now operating as a single unified organisations since 1 July.
“South Australia is a work in progress,” he said. “They had some concerns, probably due to a lack of clarity around the unified model. I have been spending some time with management and the board in SA to work through those things. I’m still confident that we’ll get to a yes,” said Mr Rooney.
He said the peak had just commenced a strategic planning process that will articulate the strategy for the unified organisation and the suite of services for members, which will be presented at the LASA congress in October for members and the sector to review.
“Our plan will be then to put in place the building blocks to have that executed over the remainder of the financial year,” he said.
“It’s time to deliver stronger advocacy in a time of unprecedented change in the sector, and to deliver support services to all our members irrespective of where they reside in the country.”
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Aged and primary care MUST collaborate (or better still, tightly integrate) if we are to move from our existing acute focus and fragmented model to a ‘continuum of care’ for the second half of the lifespan. This is needed to drastically improve quality of life outcomes at a population level.
Unfortunately CDC will probably force this change for most before proactive collaboration.
Having said that I am working with some early adopters, who understand the strong market differentiation this creates for them.
Workforce remains a major issue for building capacity and quality in aged care. NSW trains more graduate registered nurses than it can accommodate in graduate nursing programs hence any left out [of the programs] wind up working in aged care. These less experienced registered nurses have not consolidated their training, ability to solve clinical problems and make sound decisions and they are faced with the chronic & complex health needs of their residents. There is no graduate nursing program for novice RNs in the aged care sector – a gap that desperately needs to be filled.
Superimposed on this, corporate aged care consistently treat registered nurses as an operating expense and try to reduce costs by employing less of them, in favor of less qualified care workers impacting on safety & quality and the capacity of the aged care sector to cope with changes in acuity, chronic and complex care needs. There are superb examples of supportive team interventions that further the rapid clinical assessment of deteriorating residents in metro Sydney.
Hospital in the home is tightly integrated with aged care in northern sydney, studies demonstrate that elderly persons are less likely to experience delirium, hospital acquired infections, medication errors, falls and functional decline. When a resident retuurns from hospital after a 7-28 day admission, care workers often report significant changes to premorbid functioning making the resident more dependent that they were previously.
An RN ‘exchange program’ where aged care RNs have an opportunity to experience working in an Emergency Department, Medical and Aged Care rehabilitation wards in a tertiary hospital might achieve some of the objectives in terms of tighter integration and collaboration between the two sectors. It’s much bigger than individuals, and requires a system wide response to a cross-sector problem.