From everyone at HealthX we extend our best wishes to you and your family for a joyous Christmas and a prosperous New Year!

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The Directors Cut – a look towards 2015 in aged care

HealthX is excited to look to the future of aged care for the year 2015.

As providers, care staff and stakeholders we play a crucial role in the lives of individuals, families, communities and governments in supporting people in the aged care sector.

As economic, demographic, social and technological changes are redefining the aged care sector in Australia I would like to take a look at what these industry-wide changes mean for Australian aged care in 2015.

Derek Irwin, Director of HealthX looks into workforce planning, investment and technology for 2015:

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 Australia requires a co-ordinated approach to workforce planning

A recent article by Nursing Professor Di Twigg has stated that Australia will need a co-ordinated approach to adequate staffing, and Derek Irwin, Director of HealthX concurs. Derek believes in the importance of looking past the short term on costs, and developing a national strategy.

As we look into 2015, and back at 2014 we know staffing has always been in the forefront of aged care. Derek believes it’s now time to call for a national consistent approach to current workforce issues to avoid predicted shortages in 2015 and retain the current workforce.

Professor Twigg stated that “without a nationwide approach to address both the supply and retention of nurses to meet the demand, as well as the employment of new graduates, we will be facing significant shortages in the not-so-distant future.”

Reports on the national database have been presented on what our workforce is and what it is likely to be. As we are aware, most nurses work in hospitals – and most hospitals are funded by the states – there doesn’t seem to be a lot of commonwealth traction in wanting to look at the broader nursing workforce issue. But we do need to have a national strategy to meet the challenges ahead.

Derek believes the most critical element is a co-ordinated and agreed-upon national strategy. He feels we need a better understanding of what level and type of nurse is required for what roles.

Staff nursing in any sector across Australia at the moment, is not consistent. Professor Twigg points out that in Victoria hours are mandated through ratios, and in WA and NSW its nurse hours per patient day, so there are industrial agreements that set those staffing levels. In other states however it is not as well developed. There has been some work looking at ways of managing nurses’ workload but not with an accepted or formalised approach to staffing.

There is a lot of variation across the states. And it is obviously in times like now – where we are in economic difficulties that health budgets usually get affected. This causes some policy issues and budget issues, however we all know that better staffing gives you better patient outcomes.

Derek believes that the biggest issue looking forward is the projected nursing shortages in Australia and most Western developed countries where numbers are predicted to get up to about half a million by 2025.

The best thing we can do to improve is to retain our nurses more effectively and one of the big drivers for nurses not to stay in nursing is their workload – which is again associated with staffing levels.

These are hard arguments to get any traction with in a time where everyone is more worried about expenditure, without seeing that overall (better staffing) does improve the cost-effectiveness and the productivity of our health services.

The other problem that needs addressing is that although we know in two years’ time we are going to be short of nurses- we have new graduates coming in to the workforce, not getting jobs.

Derek believes that we need to look at a broader approach for the future of aged care. We need to fix the nurses workload. We need to focus less on the dollar over the next few years as we move towards future shortages. We need to make sure it doesn’t become a real cyclical problem of boom and bust in terms of the supply of nurses and the demand for them.

A successful system in the future would be Australia continuing to enjoy positive key indicators of health because we have an adequate nursing workforce. Supply and demand would be in balance, turnover would be low, and workload would be managed effectively.

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Investment activity builds in aged care

Change is underway – no longer is aged care the sole domain of not for profit organisations.

In the lead up to 2015 we have seen the re-entry of private equity firms, foreign investors and the continued expansion of existing operations. A report in the finance sector states that these factors will be the continued driving factor making the biggest waves in aged care sector history.

Recent analysis by an independent consultant shows private providers were allocated 15% of the ACAR (Aged Care Approvals Round) home support packages in the 2014 funding, and account for about 10% of that overall market.

The reforms underway and the move to consumer directed care (CDC) mean increasing private providers will become the norm in aged care – similar to child care.

Derek believes this is a positive step forward for aged care, increasing competition, and the inclusion of more private providers will result in more choice for clients and should be welcomed by the community. They should not be fearful of private providers in the industry as ultimately the end result will mean greater competition and better care for older people.

Demographic projections by the Institute of Health and Welfare suggest the aged care sector requires an additional 75,000 places over the next 10 years. And this proves that the fundamentals are solid; an ageing population and demand for beds are outstripping supply.

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 Is technology THE way of the future?

As technology advances should health professionals look at it as a ‘helper’ to their skills and a way of enhancing and amplifying the scope of their care?

Dr George Margelis, associate professor with UWS’s Telehealth Research Innovation Laboratory (THRIL) believes so. He stated in a recent article “we need to all be looking for opportunities to do things better in caring, and technology is one of the best enablers we have available to us now.

Derek also believes that the industry is adopting new technology such as telehealth and we have to look at ways (and challenges) of the role nurses have to play in increasing the role of technology in healthcare.

Technology is evolving, and telehealth is evolving alongside it. In the short term of telehealth it is hoped that there will be more video consultations, essentially emulating the classical medical interaction of a doctor-patient consultation by using technology to remove barriers of distance and time.

Over the long term, it will be hoped that we will start integrating  more technology  into the interaction including gathering information, new smart phones, artificial intelligence.

Professor Margelis believes that the first step is the education of clinicians about the world outside their normal world, in particular the advances in IT and knowledge management, automation, robotics, nano-technology and many other new areas. Empowered with this education, clinicians then need to take on the active role of developing this.

One of the main pushes to make eHealth work is having a strategy about what needs to be achieved. We need to know what the aims of the healthcare system are, what role technology plays in achieving those aims and then how we ensure these new technologies don’t end up at a dead end.

Derek believes that mistakes will be made and that’s ok, but we need to develop methods of sharing the learning, developing research around implementations of systems and services, and developing a culture of continuous improvement and innovation in our healthcare system.

Professor Margelis states that we need to empower clinicians to understand the new technologies available and let them research and experiment with ways to use them.

Nurses provide the bulk of healthcare delivery in Australian facilities so they play a critical role in advancing not only the adoption of new technologies but also the design of new technologies and feedback on what they believe will work and will not work for the future.

Telehealth is something that the industry is adopting and something that will progress over time. Our health system is in need of change, not only to keep up with the increased demand, but also to take into account the changes in technology and knowledge we have seen over the last decades.