Gov report praises advocacy impact despite residential aged care barriers

An independent government report has found that the National Aged Care Advocacy Program (NACAP) is providing high-quality information and services to older people, yet residential aged care access continues to be a roadblock at times.

Key points

• The NACAP is managed by the Older Persons Advocacy Network (OPAN) and delivered by its nine-member service delivery organisations (SDOs) nationwide
• In August 2023, the Department of Health and Aged Care (the department) engaged Australian Healthcare Associates (AHA) to evaluate the NACAP’s implementation, effectiveness and efficiency
• Since a funding increase in the 2021-22 Budget, information and advocacy cases almost doubled at the time of the evaluation
• The department found that the NACAP is a highly valued program providing much-needed support and delivering positive outcomes for older people
• NACAP was also found to increase older people’s knowledge of services, advocacy and aged care rights with 90% stating that advocacy made a considerable difference in their lives

OPAN welcomed the independent evaluation with its Chief Executive Officer Craig Gear stating he’s thrilled by the findings. 

“The network’s advocates provided more than 44,000 cases of information and advocacy support in the last financial year – a 20% increase on the previous year,” OPAN CEO Craig Gear said.

“Given the significant increases in the network’s case volume, I couldn’t be more thrilled by these results.

“To me, they reflect the strength of our consortium model, which enables members to take a targeted, localised approach to the challenges facing older people while being supported by a national framework.”

Residential aged care delivery ‘is an ongoing challenge’

Overall, the report found that NACAP is suitably dealing with increasingly complex issues that can be more time-consuming to resolve. Advocates remain steadfast in consistently focusing on quality and equity, even if there are out-of-scope issues that still infringe on aged care rights.

“Both OPAN and SDOs use a range of strategies to promote the NACAP to referrers and older people, including strategies tailored to reach people with diverse needs. The introduction of the Advocacy Community Network Development (ACND) expansion project, while still in its early stages, has increased the reach of the NACAP and is helping to raise awareness of the program among older people and potential referrers,” the report stated.

Meanwhile, 90% of survey participants said they were satisfied with the services they received. Roughly three-quarters said they felt more confident and empowered to self-advocate. 

Unfortunately, residential aged care continues to be a problem. The report said NACAP education is effective but delivery in residential aged care homes is an ongoing challenge.

“That is one of the longstanding barriers to the program, that it’s not mandated [for aged care providers] to have education sessions. And so what that actually means is that there’s a lot of time invested in advocates actually trying to engage with providers and set those education [sessions] up, which they can accept or refuse,” an OPAN representative stated in the report.

SDOs (OPAN’s member organisations) are primarily responsible for delivering education sessions to aged care clients and staff in residential and community care settings. OPAN focuses more on online education, which still includes residential aged care. 

SDOs representatives reported significant challenges with delivering education sessions in residential care settings. Many said success hinges on building trust and rapport with aged care staff in their region. 

Advocates said their requests to deliver education were sometimes ignored and scheduled sessions cancelled at short notice. Other times there is no attempt to educate or prepare residents before a visit.

“One of the other challenges that we often face is that we’re getting into residential facilities to do the education sessions, but they’re giving us an audience that’s got dementia and they really have no idea what’s going on,” an SDO representative explained.

“Last week I went to do a session in a 120-bed residential home. I go in through the locked doors, to a room where they said, yep, we’ve got all these people here for you. There were 12 residents sitting there, who had no idea who we were, what we were doing. They were a really, really inappropriate audience.”

Positively, the number of education sessions delivered by SDOs has grown from 490 sessions in quarter 2 2021-22 to 885 sessions in quarter 2 2023-24. This is an 80% increase since the NACAP’s funding was increased. Additionally, aged care staff who receive the training also reported positive outcomes. 

Opportunities for improvement

The department also provided 12 recommendations, or opportunities for improvement, alongside its analysis of key NACAP features.

A focal point addressed how advocates support older people with out-of-scope issues still linked to upholding their aged care rights. One suggestion was to create a prioritisation framework to help determine when it is appropriate to address certain issues. The other was to develop reporting mechanisms to understand how much time is dedicated to out-of-scope problems.

Potential changes to education in residential aged care were also floated. This included revising SDO-specific KPIs related to residential care education so they are not penalised when providers cancel a session, and creating more flexible education options.

Visit the Department of Health and Aged Care’s website for more detailed insights from their NACAP evaluation.