I am about to board a plane for Singapore where this week I will be speaking at the GCIC 2018 conference on integrated care.
My topic will look at where the industry may go next in its clinical governance responsibilities. I thought this was interesting to look at twenty years on from the introduction of the Aged Care Act in 1997.
I will share my full paper next week and explore some further ideas following the conference. In the Essay, I have strived to briefly describe the history of residential aged care in Australia and show how economic drivers that largely determine the funding of care may also be diminishing the clinical appropriateness of care. This can place care recipients, providers, and program funders alike potentially at risk of failure of service in financially constrained times.
The move towards more effective management of financial resources by adopting an integrated health care approach to service provision can only be achieved if within that range of integrated services there is recognition of a clinical governance system that supports service providers. Such clinical governance systems need to be understood by, and easily translated across, the range of providers so that all stakeholders can be clear about the scope of practice able to be provided in each service program.
With respect to residential aged care in Australia, the aged care quality and accreditation system that underpins the service regime, in my view, is lacking that transferability and clarity. Some fifty per cent of facilities struggle to meet the financial stability required to ensure long term viability of services, and the ability, or willingness, of providers to ensure that the most appropriately qualified providers of clinical services required in those residential aged care facilities are consistently on staff, is compromised.
Therefore, in my view, the clinical governance systems in residential aged care in Australia are lacking.
Whilst the subject of a broader discussion, this is also the likely outcome in many community aged care services. These deficits are not irreparable, but it will take a willing Commonwealth government to effect appropriate changes to ensure such clinical staffing mix is regulated, therefore providing some immediate improvement in clinical governance capability.
If you’re attending the conference please do come over, say hi and share your thoughts with me. I’d be very interested to hear the range of perspectives on this important topic. In the meantime, I think our friend Jason Chatfield has captured the thoughts of many perfectly in the latest instalment.