The Dawning of a New Era in Ageing - Strategic Directions in Australian Aged Care

Veronica Jamison

It’s All About People!

Megatrends

• By 2020 the number of people aged over 60 years will outnumber children younger than 5 years (Global Megatrends Institute - 2018)

• Other industries have reinvented their delivery models, technological base and value chain –healthcare has remained fundamentally unchanged. Meanwhile demand for services is being driven by the burden of disease, ageing population and rising consumer expectations. Overview of Megatrends in Health (BCA 2015)

The era of ageing is upon us…

Net growth in population aged 65+ over 100 years in Australia

Source: Based on Australian Bureau of Statistics data; KPMG Demographics

-

20,000

40,000

60,000

80,000

100,000

120,000

140,000

160,000

1950

1954

1958

1962

1966

1970

1974

1978

1982

1986

1990

1994

1998

2002

2006

2010

2014

2018

2022

2026

2030

2034

2038

2042

2046

2050

1950 20001975 2025 2050

1950: 0.7m

2016: 3.7m

2050: 7.9m

• 2011 – Productivity Commission Report

• 2012 - Living Longer Living Better Reform ( LLLB)

• 2012/13 – Supporting Framework to LLLB Established & My Aged Care Website introduced

• 2014 – New Accommodation Payment Structure

• 2017 - Consumer Directed Care in Home Care Commences

• 2018 - Unannounced Accreditation

• 2019 – Aged Care Quality & Safety Commission

• 2019 - New Single Aged Care Quality Framework

• 2020 and Beyond?

Background - A Journey of Reforms

Aged Care Reform in Australia

Living Longer Living Better Reform Package (2012)

• 10 year reform plan that:

“will build a responsive, integrated, consumer-centred and sustainable

aged care system, designed to meet the challenges of population ageing and ensure ongoing innovation and

improvement”

• Key Principles

1. Ageing in Place

2. Consumer Choice

3. Market Based Competition

4. Consumer Contributions

Aged Care in Crisis

Reports, Reviews, Inquiry’s & The Royal Commission

Number of reviews waiting for Government response or yet to go before Government

The Royal Commission into

Aged Care

Quality & Safety

Legislated Review of Aged Care (Tune Review)

Bond Guarantee Scheme (ACFA)

Prudential legislation (Ernst & Young)

Report on access to care for supported residents

ACFI & Resource Utilisation Classification Study

Future of Australia’s aged care Workforce Inquiry

Review of the National Aged Care Quality Regulatory Processes (Carnell/Patterson)

Zimmerman Inquiry

Royal Commission into Aged Care Quality & Safety

Carnell-Paterson Review Response

Independent Aged Care Quality & Safety Commission from 1stJanuary 2019

Chief Clinical Advisor

Performance rating against quality standards

Serious Incident Response Scheme

Provider Comparison function on My Aged Care

• While the Royal Commission is underway we must press on with addressing key industry issues, and not lose sight of making Australia’s aged care system better right now:

Access: addressing the unacceptable level of older Australians waiting in the national queue for care in the homes

Quality: moving forward with implementing the new Q&S commission and the new quality standards, whilst addressing ongoing issues with the current quality regulatory system

Funding: addressing the urgent need to provide relief to the growing numbers residential care facilities experiencing significant financial pressure, and the growing financial pressures on many home care providers, and

Workforce: translating the intent of the recently released aged care workforce strategy into action and outcomes.

Aged Care Focus moving forward

Current Status of Service Offerings

Services, Funding & Providers

2016-17 Funding

CHSP $2.4b

Home Care $1.6b

Flexible & Other Care $1.3b

Residential Care $11.9b

Total $17.2b

Residential Care

Home Care

CHSP812

91

673

100

171

45

130

There has been a move towards Consumer Directed Care (CDC) for some years now.

This has been the focus of Home Care for some years with the introduction of CDC and now Increasing Choice in Home Care. There are further reforms planned for 2020 which could include more self-management by consumers and their families.

CDC is also a big focus now in Residential Care.

The Government is continuing to take a consumer rights-based (person-centred) approach. They are doing this through:

Consumer Experience Reports (CER) – with home care to happen

The new draft Single Charter of Aged Care Rights and

The new Aged Care Quality Standards.

It’s all about the Consumer

Quality and Safety

The NEW Aged Care Quality Standards will FOCUS on QUALTY outcomes for CONSUMERS rather than provider focus…..

Single AC Quality Standards

Workforce

• 2011 Productivity Commission Report “Caring for Older Australians”

•

• 2015 Senate Inquiry into the Future of Australia’s Aged Care Sector Workforce

• 2017 Aged Care Workforce Taskforce Announced

The Aged Care Workforce Taskforce

What are some of the key changes in workforce?

• Moving from a task-based to relationship based model.

• Care planning, encouraging and supporting goal setting.

• Negotiating with consumers and their families – CDC model, extra services

• Assisting support workers with problem solving.

Not anymore

• Industry Consolidation

• Providers Diversifying

• Health Care, Social Assistance, Disability and Aged Care Colliding

• Big Providers are Targeting Regional and Rural Communities

• Quality and Safety

• Shift in Who Pays for Care

• New Business Models are Emerging

• Workforce

• Disruption is all around us!

Current Trends

1.Consumer Choice and Control

• Consumer Directed Care

• Changing Consumer Expectations

• Baby Boomers

2.Quality and Safety

• Clinical to a bio psychosocial, spiritual model

• Consumer and Governance Model

3.Access to Care & Services

• Flexible and mobile

4. Funding, Viability & Sustainability

• Welfare to a market driven model

• Maintaining Occupancy/Clients in a Market Driven Model

5.Workforce

• Effective design in the context of tightening labor market

Key Drivers of Change

• We are at the beginning of a new aged services system, of which the final outcome depends on the how the current suggested reforms are taken up and enacted.

• The barriers between Residential Care, Home Care and Retirement Living will continue to breakdown regardless of the reforms

• The consumer will have more power and will be truly at the centre of the service system

• Home care will grow and play a much bigger role in the system

• The big will get bigger and niche/specialist providers will thrive

• The Baby Boomers are the game changers

• Quality, Safety & Workforce will be defining factors for success

• Funding, Viability and Sustainability will continue to be key to every organisation

• The innovators will prosper

• We need to ensure that our system keeps people connected, safe and living well

In Closing

The future is also about Social Connectedness

Leading Age Services Australia (LASA)

is the national peak body representing all providers of age services

across residential care, home care and retirement living.

Questions & Thankyou