Industry responds to aged care report proposals

After Prime Minister Scott Morrison announced additional funding in response to the Royal Commission into Aged Care Quality and Safety final report, a few industry bodies from the sector have come forward in response to the Government’s key recommendations.

The Pharmacy Guild of Australia, said the final report of the Royal Commission into Aged Care Quality and Safety reinforces the Guild’s commitment to helping ensure the growing ageing population receives the best possible healthcare, regardless of whether they live at home or in aged care facilities.

Welcoming the findings and recommendations of the report, the National President of the Pharmacy Guild, George Tambassis, says the report sets the basis for major change and reform in the sector and the Guild looks forward to working closely with the Government to help refine and implement appropriate recommendations.

“We note that the Guild’s `Clinically safe and better value’ Community Pharmacy Aged Care model of care as presented to government in the Seventh Community Pharmacy Agreement negotiations presents a solution in keeping with the report’s recommendations.

“This package of care is underpinned by community pharmacist-led clinical governance and allows for autonomous prescribing by community pharmacists, including the ability to deprescribe.

“In addition, it provides for medicine education and oversight of medicine management policies and procedures. Medication adherence for people ageing at home is a critical need to be addressed to achieve safety and quality care, and community pharmacy is ideally placed to support those in their local communities in their safe use of medicines.

“Importantly, the model of care is based on quality assurance through accreditation against the AS85000 Quality Care Pharmacy Standard.

“It is a model of care that aligns with the Royal Commission’s intents and findings,” says Mr Tambassis.

The report recommended “employing or otherwise retaining” a pharmacist in residential aged care facilities, “so it is appropriate that the services of a local community pharmacy be retained”.

“Other areas where we look forward to working to help the report’s recommendations bear fruit include seeing community pharmacy play an active role as care finders, and providing elements of care at home.”

PSA: Safety and quality use of medicines in aged care

The Pharmaceutical Society of Australia (PSA) says it also backs a number of proposed recommendations and, if adopted, will improve medicine safety for older Australians.

In particular, PSA endorses the proposed recommendation that pharmacists be embedded within all aged care facilities across Australia.

PSA National President Associate Professor Chris Freeman says pharmacists were critical to ensure the safe and quality use of medicines in aged care.

“Counsel assisting has recognised the vital role of pharmacists in tackling the problems of overuse of opioids, chemical restraints and inappropriate use of antibiotics”.

“PSA is pleased counsel assisting has adopted our recommendation for pharmacists to have a greater role in aged care and be embedded in these environments. We maintain pharmacists need to be able to spend more time on the ground in aged care, to be able to protect residents when it comes to the safe and effective use of medicines.

“The Aged Care Quality and Safety Royal Commission in its interim report has already recognised the urgent need to address the critical medicine safety failures in aged care.

“Our `Medicine Safety: Aged Care’ report found more than 95 per cent of people living in aged care facilities have at least one problem with their medicine and most have three. Many of these problems are very serious, and potentially catastrophic.

“For too long pharmacists have felt powerless that the system has not supported them in addressing these problems.

“If adopted, these recommendations would provide real hope that our older and vulnerable Australians will receive safer care.

PSA endorses the establishment of benchmarking and public reporting of quality indicators which must include data on medicine safety.

Associate Professor Freeman said comprehensive indicators on the safe and quality use of medicines currently do not exist.

“The public reporting and measurement of this data is necessary to improve medicine safety,” he said.

“We know that when pharmacists spend more time on the ground in aged care they can make a meaningful difference to how medicines are prescribed and administered to improve safety for all residents over time.”

Associate Professor Freeman urged the Commission to adopt the recommendation to establish an aged care workforce planning division and an aged care workforce fund.

“PSA supports a staffing ratio of at least 0.5 FTE pharmacists per 100 residents,” he said.

“This will ensure that pharmacists have the time to properly address medication management issues within the aged care environment.”

PSA also welcomes the proposed establishment of a dedicated research council to conduct research into effective programs to improve the use of medicines in aged care.

“Up until now research into aged care has been ad-hoc and small-scale. This will provide a better opportunity to develop the evidence base for best practice models of care that will improve medicine safety for older Australians”.

ACN: Nurses need time to provide holistic care

While the Australian College of Nursing (ACN) welcomed the delivery of the final report, the ACN’s Chief Executive Officer Adjunct Professor Kylie Ward FACN, says “we must not use this historic split as an excuse to do nothing about a sector so badly in need of reform.”

The Royal Commission called for additional support for nurses as part of its changes to improve aged care, including minimum time with a nurse for residents, Medicare Benefits Scheme changes to support nurse practitioners in assessing the health of residents and greater transparency around staffing hours in aged care facilities, moves which were welcomed by Adjunct Professor Ward.

“These changes will contribute to a nursing workforce that is capable of supporting residents in aged care facilities,” says Adjunct Professor Ward.

“However, while minimum timeframes are welcome, we must demand that this does not become care by timesheet. Rather, nurses need time to provide holistic care to meet the individual needs of each person.”

Adjunct Professor Ward also welcomed calls for registration and mandatory minimum qualifications for personal care workers who currently provide the bulk of aged care.

“Unregulated workers have been able to go untracked and unchecked for far too long in aged care,” Adjunct Professor Ward said.

“These changes will protect care workers who provide exceptional care, while embedding accountability for those who perform badly and should be removed from the sector.”

Adjunct Professor Ward welcomed the Government’s initial response to the Royal Commission but said more needs to be done to ensure that the changes that are necessary for the system can occur.

“While we welcome the immediate funding rollout, we have real concerns about the lack of workforce data to understand how to deliver safe, appropriate care for those who choose to be supported in their homes,” she says.

“We call on the Government to support our call, outlined in our budget submission to Treasury, for a research program into understanding the long-term nursing workforce requirements for home care.”

The Royal Commission also called for a number of critical changes to the aged care system, including significant reform to the Aged Care Act, funding levels and the assessment system.

Adjunct Professor Ward said that these recommendations would be assessed in detail by an ACN-led Expert Advisory Group of nurses in the coming weeks.

“This is an extraordinary report which requires the appropriate attention to ensure that every aspect can be dealt with in its importance,” she says.

“It is crucial that the voices of nurses are heard in the response to this report to identify the best way to enact the Royal Commission’s recommendations.”

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