Submission to the Royal Commission into Aged Care Quality and Safety’s inquiry on the Interfaces between the aged care and the health care system

Issues for consideration

The Royal Commission has identified that in its upcoming hearing to be held in Canberra 9 – 13 December it will investigate the interfaces between the aged care and health care systems. In its announcement for the hearing it has identified that it’s inquiry will include[1]:

  • The challenges faced by people living in residential aged care services attempting to access health services funded under Medicare or by the states and territories.
  • Whether there is a need to improve access to primary health care services (particularly general practitioners, Nurse Practitioners and primary care nurses) for older people in residential aged care, and if so, how this could be achieved.
  • Whether there is a need to improve access to high quality secondary and tertiary (sub-acute and acute) health care services for older people in residential aged care, and if so, how this could be achieved
  • The challenges faced by people living in aged care in accessing medical specialists, and the harms arising from inadequate access
  • Whether it is necessary or desirable to improve how older people are transferred to and from aged care and hospitals, including the appropriateness of rehabilitation and transition care services post hospital attendance
  • Whether there is a need for improved data collection, communication and planning in relation to the health needs of older people accessing aged care services, including the interoperability of care management systems
  • The sufficiency of access to state and territory funded palliative care services for people living in residential aged care

Introduction

COTA believes improvements to the interface between healthcare and aged care systems are essential. Access to a range of healthcare services inside or outside the residential aged care facility is critical to improving the quality of life of older Australians. Similarly enabling better collaboration between home based aged care services and healthcare services, in particular communication of relevant clinical observations, will help improve quality of life outcomes.

Importantly, access to health care must not be substituted for an expectation that the existing aged care system’s funding can deliver full primary care solutions. COTA supports and encourages some of the innovative in-house solutions being delivered in aged care today such as mobile dental services, in house GP clinics and allied health clinics. However, we are deeply concerned by some of the commentary about older Australians in residential aged care which by implication seeks to propose or defend a different set of rights for them compared to the general population to access mainstream healthcare services. We welcome the Royal Commission analysing not only how services may best be structured to be delivered, but also the appropriate mechanisms in which they may be funded.

This submission broadly addresses the issues outlined by the Royal Commission for their Canberra Hearings on 9 – 13 December.

[1] As outlined at https://agedcare.royalcommission.gov.au/hearings/Pages/hearings/2019/canberra-hearing.aspx accessed 20 November 2019

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