SARRAH Weekly Newsletter "Connected" 9 December 2022

From the CEO's desk

Allied health and aged care – are people missing out enough yet for things to change?

Early this week our colleagues at Allied Health Professions Australia (AHPA) released the findings of a survey their Aged Care Working Group conducted with allied health professionals working in residential aged care to identify changes experienced in the six weeks since 1 October 2022 and the commencement of the new AN-ACC funding model. As readers will know there is no mandated allied health provision in the AN ACC. While the design of the new system variously enables, encourages, is subject to quality measures etc it does not require aged care service providers to deliver allied health care.

AHPA’s survey results show that in the six weeks since AN-ACCs introduction more than one in eight allied health professionals losing their jobs and another 30% planning to leave the sector.
The results confirm what AHPA, SARRAH, and others, such as Alwyn Blayze, CEO of Allied Aged Care, have been actively raising as a serious risk for well over a year: access to allied health services among aged care recipients is in serious decline and the post-Aged Care Royal Commission (ACRC) reforms developed to date have done nothing to address the decline.
You can read more about the AHPA survey here and an article covering the story in Australian Ageing Agenda here.

Possibly the most concerning issue with these findings is that it indicates a sharp deterioration in what has been long-term decline in allied health workforce and service engagement across the sector, even since the ACRC put the spotlight on it. The ACRC heard evidence that on average aged care residents received 8 minutes of allied health care per day. The ACRC, having also heard of international best practice being around 22 minutes a day, made clear recommendations to increase access to allied health care. But what’s happened since?

The StewartBrown organisation which produces the regular Aged Care Financial Performance Service Sector report has the figure at around 5 minutes a day.
MirusAustralia, a major provider of services to the aged care sector reports has industry data showing the figure is around 2 minutes a day.

The issue has been raised repeatedly with officials and notwithstanding any reluctance on their part to put further pressure or compliance expectations on the sector, aged care recipients are missing out on vital care, and allied health services are being impacted. In rural and remote communities, the situation is even worse because of pre-existing chronic workforce shortages, especially in allied health.

Readers may be aware the Government commissioned an Independent capability review of the Aged Care Quality and Safety Commission. Given the implications of these latest developments, perhaps the review will recommend the Commission take a more active role in identifying and promoting action to address systemic failings – such as massive under-provision of care, sector-wide shortfalls in service provision and structural undersupply of key workforce.

The Aged Care Safety and Quality Commissioner was asked specifically about the issues raised above when providing evidence on 25 August 2022 to the Senate Community Affairs Legislation Committee in the public hearing of the Committee’s Inquiry into the Aged Care Amendment (Implementing Care Reform) Bill 2022 (from pages 34 and 35 of the transcript):

Senator RICE: Ms Anderson, are you watching very closely to see what the behaviour of the facilities is already, because there is certainly ample evidence of physio contracts being cancelled?
Ms Anderson: We watch closely, full stop. We have a monitoring brief across the entire sector and for particular services, and in particular we monitor those services which have a high-risk profile. Where we find shortcomings in care and poorer outcomes for consumers, we track that back and reach an understanding of how that is the case. Sometimes it is a shortage of allied health input, sometimes it is to do with other profiling issues in relation to staffing and sometimes it is to do with numbers and capability in terms of their training requirements. The short answer is back where I started. We are watching closely, and we will certainly be looking at a system level and also in relation to individual providers and services.

Even accepting that the Commission has probably not been resourced adequately or necessarily had the political imprimatur to take a proactive, system compliance and risk management approach, the evidence certainly suggests more than a ‘watching brief’ is required. Perhaps it is also time to identify services that are delivering high quality access and showcasing what that means for the people in their care. Another article in Australian Ageing Agenda might point to one example.

Travel Safe,

Cath

As part of a multifaceted workforce recruitment and retention strategy, Gippsland Lakes Complete Health (Victoria) in partnership with Federation University has developed a cadetship program offering undergraduate allied health students paid employment and other supports while they complete their degree, in exchange for a two-year return service. Ainsleigh Whelan (Executive Manager, Support, Therapy, Education and Prevention Unit) and Rebecca Woodland (Executive Manager, Corporate Services) explain further in this informative episode of Talking for Purpose.

Do you have any themes/topics that you would like to hear us discuss? People you’d like us to interview? Please drop us an email to our mailbox at sarrah@sarrah.org.au

Listen to earlier episodes here

Congratulations to proud Murrawarri woman and optometrist Ms Lauren Hutchinson on being recognised as an inspirational role model for Aboriginal and Torres Strait Islander peoples.

Lauren was announced as the winner of Indigenous Allied Health Australia’s (IAHA) Allied Health Inspiration Award at the 2022 National Indigenous Allied Health Awards in Canberra in November.

The Allied Health Inspiration Award is awarded to a current IAHA member who has demonstrated an ability to inspire others through their positive approach to their personal and professional allied health journeys – overcoming challenges and taking a strengths-based approach to success – and demonstrated commitment to improving the health and wellbeing of Aboriginal and Torres Strait Islander peoples. Here she is being presented her award by our own SARRAH CEO, Cath Maloney.

Congratulations to Nanthini Kanthan, speech pathologist from Central Australia, one of this year's recipients of the prestigious Churchill Fellowships. Read more about Nanthini and her work here. (Pictured with the Administrator of the NT. Photo credit: The Administrator of the Northern Territory)

The Strengthening Medicare Taskforce is due to report to government on 13 December.
As frequently occurs ahead of Budgets and the release of major policy reviews etc, stakeholders reinforce the positions have or have not had the opportunity to voice in developing the work. With the imminent report of the Strengthening Medicare Taskforce, the Grattan Institute (for one) has released A new Medicare: strengthening general practice. They note “The way GPs work and get paid should be overhauled so Australia can turn the tide of chronic disease, keep more people out of hospital, and ensure poorer Australians get the care they need when they need it. …. Australia’s universal healthcare system has failed to keep up with changes to Australians’ health needs since it started four decades ago.GPs’ work has become much more complex, as the population has grown older and rates of mental ill-health and chronic disease have climbed. But the way we structure and fund general practice hasn’t kept up. Despite patient care becoming more complex, appointments have been stuck at an average length of 15 minutes for the past two decades. GPs are struggling to meet their patients’ needs, and they lack the support of a broader team of health professionals to do so. Other countries have reformed general practice, and their rates of avoidable hospital visits for chronic disease are falling. But Australia is spending more on hospitals while neglecting general practice: the best place to tackle chronic disease. Patients suffer the consequences.”

Like the Primary Health Care Ten Year Plan, the broad thrust of the proposed reforms deserve strong support, but there are aspects that ignore fundamental issues with our health system as it is: for instance, the role of allied health practitioners as independent practitioners, with their own expertise and remit, not only as an adjunct of medical general practice. A better health system will deal with that reality and enable coordinated, person-centred care that delivers better for our communities.
We’ll see what the Taskforce delivers.

Value-based health care: more from the AHHA.
The Australian Healthcare and Hospitals Association’s (AHHA) Deeble Institute for Health Policy Research, has released the Issues Brief ‘A roadmap towards scalable value-based payments in Australian health care’
It examines challenges and advantages of moving ahead with a health funding model that includes value-based payments. It suggests Australian healthcare funding policy needs a rethink, and value-based payments will be a necessary step towards securing Australia’s healthcare system sustainability:
‘To promote and maintain high-quality, high-value healthcare, we need to adopt alternative funding models, such as value-based payments to provide for the growing number of Australians with complex health conditions where typical activity-based or fee-for-service funding isn’t incentivising the best care. …‘Value-based payments are designed to incentivise providers and clinicians to change their services to improve value by improving on outcomes that matter to patients, reducing costs associated with delivering those outcomes, or both. ‘This type of payment model also shifts the burden of financial risk from the payer, or patient, to the provider. This means that for providers and clinicians to adopt this model successfully, they need clear, accurate and timely health data on the populations they are caring for to assess their care needs and expected health expenditure going forward.'

The Murray PHN has released a November 2022 workforce report. The report reflects a growing focus on allied health and mentions SARRAHs work with the Allied Health Rural Generalist pathway. Hopefully the PHNs will be among the advocates calling for an expansion of the program to meet unmet demand

The Australian Parliament’s House of Representatives Inquiry into Long Covid has released an Issues Paper.
Also available is the transcript of the Committee’s public hearings on 12 October. The transcript includes evidence provided by representatives of Nepean and Blue Mountains Local Health District. The evidence worth reading, with a lot of acknowledgement of the critical role allied health practitioners have had in the LHDs multidisciplinary approach to dealing with long COVID.
Some members of the Committee – which has a high representation of members with medical qualifications – appear to have difficulty accepting allied health is an important contribution, despite medical practitioners working intensively and extensively in the areas testifying to that effect. Evidence is one thing, entrenched attitudes another. Perhaps the Committee members could read this timely opinion piece from the University of Western Sydney on how physios and occupational therapists are helping long covid sufferers.

Indigenous Affairs Ministers met on 6 December and issued a communique, essentially recommitting to their joint efforts to Close the Gap and to work toward a referendum on an Indigenous Voice to Parliament. The communique can be found here. If you’re interested in reading the background to what is being to be proposed you can read this report.

We understand the NSW Government will be progressing work on the Allied Health Rural Generalist pathway in that jurisdiction and supporting an expansion of the AHA workforce. This is a welcome and exciting development, which we look forward to being able to contribute to, beyond the media release issued to accompany the developments.

Tasmania – the Government launched Advancing Tasmania’s Health
The report is the culmination of an extensive process to date. Health workforce is, of course, an identified priority (see pages 32 and 3 for detail) and while this document doesn’t go into detail on developing and supporting specific professions, action areas include:

Tasmania’s health workforce is better aligned with the needs of the community, with an appropriate mix of generalist and specialist services; and
There will be professional development opportunities and specialist capability for health professionals working in rural and remote areas of Tasmania.

The Australian Government Department of Health and Aged Care, in collaboration with the Australian Commission on Safety and Quality in Health Care, has released the national guiding principles and resources to shape future medication management practices.
The updated guiding principles align with the National Medicines Policy and are focused on person-centred care in aged care facilities, the community and at transitions of care. They provide guidance to healthcare professionals and the individual, their carer and/or family in the quality use of medicines. You can access the guiding principles document here.

AHACPA Release - The Independent Health and Aged Care Pricing Authority (IHACPA) has released the Pricing Framework for Australian Public Hospital Services 2023–24 (the Pricing Framework).
The Pricing Framework outlines the policy decisions which will underpin the national efficient price and national efficient cost for the 2023–24 financial year. You may view submissions to the Consultation Paper on the Pricing Framework for Australian Public Hospital Services 2023–24, except where submissions have been identified as confidential for commercial or other reasons.

Seeking your input:
SARRAH advocates strongly for the interests of rural and remote allied health and for these to be a fundamental consideration in national health and related service strategy design, oversight and development of integrated policy, program and service design. The value of allied health in addressing service gaps, demographic and population health trends needs to be better understood by decision-makers and funders.
To this end, SARRAH puts considerable effort into providing submissions to government and other inquiries and consultation processes. Those submissions are always better, and potentially more influential, when they are informed by the expertise and knowledge of our members. We encourage you contribute. A short email or a quick phone conversation on a subject of direct concern to you can be extremely valuable in these processes. If you’d like to contribute, please contact allan@sarrah.org.au.

The list of submissions we contributed to during 2021-22 can be found on page 20 of the SARRAH 2021-22 Annual Report.

CONSULTATIONS

The Federal Government has opened the 2023-24 Pre-Budget Submissions process. This is the opportunity for individuals, businesses and community groups on their views regarding priorities for the 2023-24 Budget. Submissions are due by Friday 27 January 2023.

SARRAH will be advocating for investment in much needed allied health workforce and service support in rural and remote Australia to address chronic systemic shortfalls. We’ll also push for our service systems to better reflect the realities and needs of rural and remote communities.
SARRAH strongly urges members and friends to contribute to the process, either directly and/or through SARRAH.

Independent Review of Health Practitioner Regulatory settings - Minister for Finance Katy Gallagher and Minister for Health and Aged Care Mark Butler announced the review of regulatory settings relating to health practitioner registration and qualification recognition for overseas trained health professionals and international students who have studied in Australia. The Review, announced by National Cabinet on 30 September 2022, will deliver recommendations designed to ease skills shortages in key health professions - including nursing and midwifery, medicine, psychology, pharmacy, para-medicine and occupational therapy.

SARRAH anticipates the review, which will be led by Robyn Kruk AO (former-Director General of NSW Health), will involve a consultation process. We’ll keep you updated.

The Australian Commission on Safety and Quality in Healthcare (ACSQHC) has developed a draft Sustainable Healthcare Module to add to the National Safety and Quality Health Service (NSQHS) standards - recognising the importance of sustainable, adaptable and resilient healthcare services. ACSQHC are inviting you to help shape the future of Australia's sustainable healthcare. The draft Module was developed by healthcare and environmental experts and contains five actions, including sustainability measures and targets. You can access the Module for consultation here. The consultation will close on 31 January 2023.

The Australian Parliament’s House Standing Committee on Employment, Education and Training is commencing an inquiry into the perceptions and status of vocational education and training.
More information about the inquiry is available here, including the terms of reference. Submissions are due by Wednesday 1 March 2023

CONSULTATION REMINDERS

Closing the Gap Review: Review paper 2: Proposed approach and invitation to engage with the review: Review paper 2 outlines how you can contact the Productivity Commission to share your views on their planned approach to assessing progress of the National Agreement on Closing the Gap and how it is implemented. Submissions are due by 12 December 2022. To make a submission or comment visit www.pc.gov.au/inquiries/current/closing-the-gap-review. You can email the Commission at CTG.Review@pc.gov.au.

The Joint Standing Committee (JSC) on the National Disability Insurance Scheme (NDIS)
Inquiry into the Capability and Culture of the National Disability Insurance Agency (NDIA) - Submissions closing 16 December 2022.
Inquiry into and report on general issues around the implementation, performance, governance, administration and expenditure of the NDIS - Submissions close on 30 June 2023

Cancer Australia is inviting your feedback on the public consultation for the Australian Cancer Plan (ACP), which sets a 10-year plan to improve outcomes. Cancer Australia is calling for coordinated system-wide engagement and inviting comment on a on the strategy, priority areas, objectives and actions in cancer control. To view the draft Australian Cancer Plan and provide feedback, visit engage.australiancancerplan.gov.au. Public consultation will close on 16 December 2022.

The Commonwealth Government review of the Disability Services Act. The Act governs how the Government provides services for people with disability to improve their independence and participate in community and economic life. The new Act will also provide a basis for continued supports and services outside the NDIS for people living with disability, and support priorities in Australia’s Disability Strategy 2021-31, the national disability policy framework. (See the separate submission process on the Strategy, below).
Consultation on the Disability Services Act is open until 20 December 2022. More details are available at DSS Engage.

Review of the NDIS. You are invited to “Have your say” online by 5 pm Saturday 31 December 2022. A supporting paper is available at Our Approach. There is also a summary version and an Easy Read version (PDF 1 MB). The Review team also indicate you can “contact us” if you need more time.

The ACSQHC is updating the National Consensus Statement: Essential elements for safe and high-quality end-of-life care. The Consensus Statement sets out suggested practices when providing end-of-life care in all relevant healthcare settings. You can view the revised version here. Importantly, the updated Consensus Statement broadens the scope beyond hospitals, to include Primary and Community Health Care and residential aged care settings. The Commission would like your feedback on the draft Statement through a short online survey which is open until 14 January 2023.

The National Dementia Action Plan is a joint initiative of the Australian Government and state and territory governments. It is a 10 year plan to put people living with dementia, their families, and carers at the centre of all action on dementia.
The consultation paper is available in several formats - summary of the consultation paper (15 pages); consultation paper on a page; and consultation paper (70 pages). You can provide feedback by completing an online survey (approx 15 mins) or by emailing dementiaplan@health.gov.au. The consultation closes on 23 January 2023. This information is also on the Department of Health and Aged Care’s consultation hub.

The National Mental Health Commission is developing a National Stigma and Discrimination Reduction Strategy to address mental health-related stigma and discrimination. The Draft Strategy is available for input and feedback, with input due by 1 February 2023. The Commissioner invites you to provide your feedback via an online survey on proposed actions and/or by uploading a submission.
If you have questions, please reach out via email to StigmaStrategy@mentalhealthcommission.gov.au.

The Senate Community Affairs References Committee is inquiring into the extent and nature of poverty in Australia, with a report due by 31 October 2023. The Terms of Reference include – to quote: (c) the impact of poverty on individuals in relation to: (i) employment outcomes, (ii) housing security, (iii) health outcomes, and (iv) education outcomes. Further detail about the scope of the inquiry is provided in the terms of reference. Submissions are sought by 3 February 2023.

The Australian Bureau of Statistics has commenced a comprehensive review of ANZSCO to reflect the contemporary Australian labour market and better meet stakeholders’ needs. SARRAH has flagged this previously. Further information on how to participate in the upcoming consultations is now available. Resources for the ANZSCO are available at Updating ANZSCO. Contact anzsco.maintenance@abs.gov.au if you would like to subscribe to receive communication on the ANZSCO update.

The Joint Standing Committee (JSC) on the National Disability Insurance Scheme (NDIS)
Submissions close on 30 June 2023 Inquiry into and report on general issues around the implementation, performance, governance, administration and expenditure of the NDIS

SUBMISSIONS
SARRAH has recently provided submissions to the following consultation processes:

The Independent capability review of the Aged Care Quality and Safety Commission and
National Health and Climate Strategy: Draft Discussion Paper – provided through the Climate and Health Alliance (CAHA). Note – a further public consultation process is expected early in the new year.

Indigenous Psychological Services: 2023 workshops with Dr Tracy Westerman AM are now available: spots are limited.

The Department of Health and Aged Care is working with the Wicking Dementia Research and Education Centre at the University of Tasmania to develop introductory and refresher learning packages for aged care workers. These are also available for anyone with an interest in caring for older people. The first 6 modules are now available for free online. All modules are expected to be available by March 2023.
The modules are approximately 10 minutes long and cover a range of topics including:

dementia and palliative care
trauma-informed care
wound management
cross-cultural awareness
oral health
mental health and wellbeing
falls management.

Each module is accompanied by interactive learning materials and links to further learning opportunities to enable ongoing group or individual on-demand learning.
Register and enrol for these modules at Equip Aged Care Learning (utas.edu.au).
For further enquiries, email equip.learning@utas.edu.au

Natural Disaster Recovery Support
On Rural Health Pro, you can find an overview of key recovery grants and assistance available to support the rural health workforce and relieve some of the costs of rebuilding practices.
To access 24/7 mental health and wellbeing support, please call:

Lifeline – 13 11 14
Beyond Blue – 1300 224 636
NSW Mental Health Line – 1800 011 511.

External Grant Opportunities
AUS: National NAIDOC Awards Nominations
AUS: Improving respite care for people with dementia and their carers
AUS: Ferris Family Fellowships
AUS: MRFF - Million Minds Mental Health Research Mission - 2022 Mental Health Research Grant Opportunity
WA: Healthy Research Program - Exploratory Research Grants
QLD: Queensland Reconciliation Awards

June 7 - 9, 2023, Gold Coast, Qld, Australia

Change to DVA’s Nutritional Supplementation request form for veterans residing in a residential aged care facility

Rural health professionals and students can register now to attend the RWAV Conference at the Rydges in Geelong on Thursday, 16th February 2023.

RACGP HAS just launched the new Infection prevention and control guidelines for general practices and other office-based and community-based practices (the IPC Guidelines) on our website.
The IPC Guidelines provide you with updated guidance on planning and implementing high standards of infection prevention and control in your workplace by addressing:

the basics of infection prevention and control (including principles, hand hygiene, personal protective equipment, aseptic technique, levels of precaution)
managing risks to staff (including staff screening immunisation and infection management, sharps, exposure to blood and other body substances)
managing the practice environment (including cleaning, laundry and waste management)
managing equipment (including reprocessing reusable medical devices)
managing outbreaks (including disease surveillance and outbreak response)
practice setup (including practice design, fit-out, equipment and consumables).

Complete Advertising Listing Form and submit it to sarrah@sarrah.org.au .

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Services for Australian Rural and Remote Allied Health
Level 2, 53 Blackall Street, Barton, ACT, 2600

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Phone: 1800 338 061
Email: sarrah@sarrah.org.au

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