Hits and misses: Where the Department of Health and Aged Care fell short

The Department of Health and Aged Care’s 2023-24 Annual Report has been released with the Department falling short in two of its seven Ageing and Aged Care measurements.

Key program objectives linked to aged care services deemed as ‘not achieved’ include the development of a ‘Quality of Life’ indicator, achieving care minute targets and elevating access to aged care services for First Nations people and older Australians in rural and remote areas. 

Key points

• The Department’s 2023–24 Annual Report provides a transparent account to the public and Parliament of the activities undertaken throughout the financial year
• The report compares outcomes against planned performance expectations outlined in the 2023–24 Health and Aged Care Portfolio Budget Statements and 2023–24 Corporate Plan
• In the Ageing and Aged Care space, three programs ‘achieved’ their performance expectations, two ‘substantially achieved’ and two were listed as ‘not achieved’
• Successful outcomes included establishing a baseline for staff turnover and worker satisfaction and meeting aged care assessment targets 
• While listed as ‘substantially achieved’ results do indicate work is required on elements such as My Aged Care and home care delivery capacity

Secretary of the Department of Health and Aged Care Blair Comley PSM – who will also become the System Governor under the new Aged Care Act – said the Department has implemented initiatives to help achieve their vision of better health and well-being. 

While listing several examples such as a stronger Medicare system and nursing and midwifery workforce developments, he also touched on aged care advancements from the last financial year.  

“The Aged Care Taskforce chaired by the Minister for Aged Care, the Hon Anika Wells, delivered its final report in December 2023. It was released by the Government on 12 March 2024,” he explained.

“The Department advanced the development of a new Aged Care Act in 2023–24, a key reform following the Royal Commission into Aged Care Quality and Safety. Public consultations on the new Act took place in two stages, with the new Act expected to commence on 1 July 2025, pending parliamentary approval.”

Ageing and Aged Care: What went right?

The Department’s goal during the 2023-24 financial year was to improve well-being for older Australians through targeted support, access to appropriate, high-quality care, and related information services. 

Overall, they achieved this by their standards with just two of seven outcomes listed as ‘not achieved’.

Performance Measure 3.1A: Older Australians and their representatives have access to reliable and trusted information through My Aged Care, as measured through consumer satisfaction. 

The Department aimed for a My Aged Care user satisfaction rate of > (greater than) 65% and a contact centre satisfaction rate of >95%. It achieved the latter, although just 56.3% of users said they were satisfied with the service provided by My Aged Care. 

Result: Substantially achieved 

Performance Measure 3.1B: Older Australians are assessed for service need as measured through assessment timeliness

Three targets were set for this measure, with the Department aiming to have >90% high-priority assessments completed within 5-10 of referral acceptance. This included assessments in both hospital and community settings.

The Department said it plans to expand reporting to all assessment priority levels from this financial year.

Result: Achieved 

Performance Measure 3.2A: Older Australians are treated with respect and dignity in receiving aged care services, as measured through resident experience.

The planned performance was for the average Resident Experience Survey (RES) Score to remain at 82% or higher and it did increase to 84.4% in residential aged care. The Department said the increase indicates an improved care experience has occurred. 

Result: Achieved

Performance Measure 3.2D: Older Australians receive care and support at home that contributes to quality of life as measured through access to services. 

The goal was to provide access to over 285,100 Home Care Packages and 287,404 were made available. As for Commonwealth Home Support Programme services, the 834,981 provided fell short of the 840,000 target. 

Result: Substantially achieved 

Performance Measure 3.3A: Aged care workforce is available and appropriately skilled to deliver safe and high-quality care to older Australians, as measured through workforce attraction and retention, workforce skills/qualifications and workforce satisfaction

Three baselines were set based on newly assessed data:

• 27% of all directly employed nursing, personal care and clinical care manager staff left their employment in the 12 months since March 2022
• 48.0% of all directly employed Personal Care Workers hold a Certificate III or higher in a field of study related to their aged care work
• 64.7% of survey respondents of the Worker Survey are satisfied with their overall employment in their main job in aged care

Result: Achieved (Baseline established) 

Ageing and Aged Care: What went wrong?

Performance Measure 3.2B: Older Australians receive residential care services that contributes to their quality of life as measured through provider metrics, care minutes and registered nursing

Two key metrics were not achieved here, although data shows providers are very close to meeting Government requirements.

For care minutes, the goal was to maintain an average of 200 care minutes per resident per day including a minimum of 40 registered nurse minutes. The weighted sector average of 200.76 minutes was a tick in one box, however, 39.02 registered nurse minutes was not enough for the Department.

Meanwhile, the goal for 100% 24/7 registered nurse coverage fell just short as non-exempt facilities had 98.58% coverage.

The plan to establish a measurement baseline for a ‘Quality of Life’ quality indicator also stalled as the Department determined that eight quarters of data will be required. 

Result: Not achieved

Performance Measure 3.2C: Older Australians with diverse backgrounds and life experiences or who live in rural and remote areas can receive culturally safe and equitable aged care services where they live measured through access by First Nations people and people in rural and remote areas

Another two targets were not achieved here as the Department wanted to increase First Nations aged care service provision to 3.5%. 

• As of 30 June 2024, 1.3% of permanent residents accessing care in mainstream residential aged care
• As of 30 June 2024, 3.4% of people accessing services under the Home Care Package (HCP) program
• Across the 2023–24 financial year, 3.0% of people using any Commonwealth Home Support Programme (CHSP) supports

As for rural and remote aged care service provision, the 11.2% coverage target was only achieved in the CHSP.

• As of 30 June 2024, 7.7% of permanent residents accessing care in mainstream residential aged care
• As of 30 June 2024, 8.9% of people accessing services under the HCP program
• Across the 2023–24 financial year, 12.4% of people using any CHSP supports

Result: Not achieved