Govt clarifies responsibilities for health care delivery among aged care recipients

The Department of Health and Aged Care has released a joint statement document to increase clarity among health and aged care providers regarding roles and responsibilities for the delivery of health care for people receiving aged care services. 

Key points

• The Royal Commission into Aged Care Quality and Safety called for the clarification of roles and responsibilities for delivery of health care to people receiving aged care (recommendation 69) and improved access to State and Territory health services by people receiving aged care (recommendation 70)
• Although the roles and responsibilities of aged care providers are set out in the Aged Care Act 1997, the Document states the Act does not articulate and specify the level of clinical care governments and providers must provide
• To achieve further clarity, it has outlined the key Principles informing the roles and responsibilities of governments and providers and their practical application through delineation of clinical care
• It is not a legal or enforceable document, however, it complements existing powers in other agreements, legislation and regulations

Why has this document been released?

The Joint Statement has been released by the Department of Health and Aged Care to provide a succinct summary of responsibilities for aged care providers when aged care services are required across different systems, including health, primary care and disability. 

Residential aged care providers, the Government (Commonwealth), State and Territory governments and Community aged care providers (home care) are all included with relevant clinical care responsibilities outlined for each.

As stated in the Document, it also aims to:

• Improve the health outcomes for people receiving aged care through timely access and appropriate health care services
• Support system stewards to understand their responsibilities and coordinate their services to maximise the benefit to the community
• Ensure the respective and joint roles and responsibilities of system leaders and service providers are clearly defined, to support effective clinical health care for people receiving aged care
• Support future reform and transformation of health and aged care service provision for older people
• Recognise the increasing complexity of care delivery that is evolving through increased life expectancy
• Support other instruments (including but not limited to, standards, regulation, and reporting) to drive accountability for the delivery of healthcare for older people

Key principles identified

A total of 14 principles are identified in the Document, relating to the Commonwealth, State and Territory governments and aged care service providers. The principles build on existing agreements, legislation and regulations, including the Aged Care Act 1997 and the National Health Reform Agreement (NHRA) 2020-2025.

The NHRA is an agreement signed by all governments in 2020 to ensure Australians receive better coordinated and joined-up care in health settings. 

Approximately nine of the principles are directly related to aged care providers, covering key issues such as timely and accurate clinical handover across care transitions, the overall coordination of care, access to palliative and end of life care and the importance of providing all reasonable options before directing older people to emergency departments. 

Reinforcing responsibilities

The focal point of the Document is the list of clinical roles and responsibilities for staff within aged care settings. Many, if not all, of the responsibilities are not new to aged care workers. But it is the clarification of them that’s important. This list is something that could be incorporated into existing clinical governance frameworks or workplace responsibilities.

The responsibilities of clinical care staff are also linked to other regulations and legislation, including the Aged Care Quality Standards. 

Examples include: 

• Care plan reviews to occur regularly along with reassessment when changes in condition occur, including any post-acute episode or deterioration, (readmission from any external care settings or post-hospitalisation), and ensuring the right staff are involved to support changed care needs
• Medication management and administration and pain management consistent with quality use of medicines guidelines
• Provide access to medical consultation and intervention, including organising of transport to appointments
• Enable lifestyle enhancements and participation to ensure quality of life and psychosocial well-being is maintained.

The Document can be viewed in full on the Department of Health and Aged Care’s website.