Community nurse teams needed for aged care reform
The population is growing while GP numbers are dropping, and health care is becoming harder to access. Frontline health workers say they have a solution.
Key points
Nurses call for innovative models of care to support older people in their neighbourhoods.
Those models are already operating in other countries.
The Intergenerational Report 2023 predicts that in 40 years’ time, Australians will remain healthier to an older age.
The number of people 85-plus is expected to triple by 2063, while the number of people 65-plus is expected to double.
The report warned this “will exert considerable pressure on aged care spending”. While the growth in spending on residential aged care will be the main contributor to the increase, the authors say spending on community care is also projected “to rise significantly”.
Additionally, Australians are expected to live longer with life expectancies forecast to rise to 87 years for men and 89.5 years for women by 2062-63.
To reduce our reliance on government-funded services for longer, a coalition of peak nursing organisations, representing 400,000 nurses across the nation says the report is a call to Australia to become more innovative in adopting new models of care to support a healthier ageing population.
The nurses’ coalition says these models must minimise the impact on acute health services by enabling people to age in place by:
Being more literate in aged care and health.
Providing the support and skills for self-care to maintain wellness and health.
Nurses already form the single largest group of health professionals working in primary health care in Australia, but currently are under-utilised and under-funded to work to full scope of practice.
This could be achieved by nurses working in partnership with consumers to maximise their independence and to enable them to live healthy and productive lives in the community.
Models such as the Buurtzorg model of care, developed by a social enterprise in The Netherlands in 2006, involve small teams of nursing staff providing a range of personal, social, and clinical care to people in their own homes in a particular neighbourhood.
Care staff work with each individual and their informal carers to access all the resources available in their social networks and neighbourhood to support them to be more independent.
The nurses work in teams and make all the clinical and operational decisions themselves.
The coalition says these models are cost- and health-effective in a number of European countries, in the United Kingdom, and in Canada. To work effectively in Australia would require a restructuring of funding models for primary health care.
The coalition points to nurses being sacked in the outback Queensland town of Doomadgee, with the promise of replacing them with GPs.
“Those doctors never arrived, leaving the predominantly First Nations community exposed with no primary health care services,” the coalition said in a statement.
Karen Booth, President of Australian Primary Health Care Nurses Association (APNA), said there are already successful models of care using nurses and nurse practitioners to run preventive health clinics and clinics for people with chronic health issues.
Medication prescribed by Registered Nurses could provide patients with immediate access to their regular medications, most importantly when they can’t access the doctor.
“Many people will seek health care, but they don’t always need medical care, so we need to look at how we meet their health needs and conserve doctor care for those more acute problems,” Ms Booth said.
“We need to think big picture and better utilise the skills of allied health professionals, pharmacists and community-based paramedics to meet immediate non-life-threatening health needs and keep people out of hospital.”
Related reading: APNA, Community Care Review
