Response to redesigning aged care in Australia

HammondCare has responded to the Aged Care Royal Commission's inquiries into redesigning Australian aged care, by providing a range of proposals and recommendations. In the meantime, the Aged Care Royal Commission (ACRC) has recently suspended hearings due to Covid-19 but extended public submission to June 30, 2020.

Before this pause, the ACRC had called for submissions in response to its paper, Aged Care Services Redesign: Programs for the Future, which was followed by a workshop and hearings on redesigning aged care. Submissions have been published on the ACRC website and while broadly supporting the main redesign features outlined by the ACRC, HammondCare focused on a number of areas of differentiation. These include:

  • Aged care should have compassion in care as a focus alongside choice because putting a premium on choice alone sidelines important relationships, commodifies care and can lead to a burden of choice that overwhelms more vulnerable people.
  • A face to face option for accessing the aged care system must be added to the online and phone options already available.
    • This face to face access should be provided by helpful and empathetic system navigators - distinct from case managers - who are a mobile workforce and co-located with existing government service branches, medical centres, social clubs, community centres and similar familiar environments.
  • GPs, geriatricians and rehabilitation physicians should be able to assess older people to receive entry level aged care services, speeding up access to services and freeing up comprehensive assessment services for access higher level care.
  • HammondCare agrees broadly with the proposal from the ACRC of three service streams but proposes different names and definitions to avoid confusion:
    • Support stream (‘Entry level stream’) – block funded, non-means tested services focused on overcoming isolation and building community through social clubs, transport, and activities such as arts program.
    • Preventative stream (‘Investment stream’) – time limited, intensive support services to help maintain independence, restore function and delay higher level admissions, available to any older person regardless of circumstances. This stream includes respite and reablement - HammondCare advocates for increased provision of cottage respite, as well as increased provision of restorative care and reablement programs.
    • Care stream (‘Care stream’) – HammondCare cautions against suggesting all levels of care can be provided in any setting. As much as people may want to live at home, some levels of care can only be provided in a specialist residential setting, and these settings should themselves be differentiated, specialised services, not ‘one size fits all’.
  • While a review of funding methods is welcome, HammondCare believes a fixation on costing individualised care services reduces the relationship-focus of care delivery and risks increasing commodification of care.
  • HammondCare supports an appointment model for GPs where they are formally appointed to one of more residential aged care homes ensuring regular support for residents.
  • In a similar model to the roll out of Specialist Dementia Care Units, HammondCare proposes the roll out of hospice style units in both sub-acute hospitals and residential aged care alongside provision of a palliative care inreach model providing training and consultancy.
  • Financing of aged care should include the ability for providers to charge higher daily fees for those who can afford it and also acknowledge in charging that some providers maintain a superior level of care hours (in some cases double).

The full HammondCare submission is published on the ACRC website here.

The Aged Care Royal Commission delivered an Interim Report on October 31, 2019 and will provide a final report by November 12, 2020. Up until March 25 2020, 8191 public submissions had been received and these close on June 30, 2020.