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27 Sep 2018

The Royal Commission into aged care must consider the case for a regulated registered nurse-to-resident ratio that is sufficiently flexible and adapts to the specific needs of the residents in each aged care facility, AMA President, Dr Tony Bartone, said today.

The AMA’s submission to the consultation around the terms of reference for the recently-announced Royal Commission into Aged Care Quality and Safety broadly supports Prime Minister Scott Morrison’s proposals, but argues that more attention must be paid to clinical issues.

“There have been too many cases of elder abuse and neglect in aged care to ignore, many of which involve inadequate clinical care,” Dr Bartone, a GP who regularly visits patients in aged care homes, said.

“Australia’s culture must change to ensure older people have autonomy and are respected.

“Many aged care providers commonly do not meet the Clinical Care Accreditation Standard, likely due to a shortage of trained, experienced, and appropriate staff, and a lack of resources.

“There are not enough registered nurses with aged care experience to provide the clinical governance, oversight, and leadership required in these facilities, leading to poor clinical care, inadequate communication, and a lack of knowledge about individual residents.

“One in three AMA members who currently visit patients in residential aged care facilities report that they are planning to scale back or completely end these visits within the next two years, largely due to the lack of access to nurses and the problems that stem from this.

“Registered nurses must be available in sufficient numbers, 24 hours a day, where appropriate, to ensure older people’s clinical care needs are adequately met, and the non-nursing workforce must be better trained.

“AMA members are deeply concerned and have repeatedly, and continuously, expressed their frustration that the health and aged care systems are not well coordinated or resourced to allow timely access to clinical care for older people.

“Entering a residential aged care facility is usually not a lifestyle choice, but a necessity often due to chronic medical conditions resulting in permanent disability.

“With an ageing population, and aged care reform moving to ensure older people can stay in their home for as long as is appropriate, it is likely that the clinical attention required by those in residential facilities will become more intense.

“The Government must, as a matter of urgency, ensure that the health and aged care systems, and their workforces, are prepared for this.”

The AMA submission calls for six additional terms of reference to be added to the Royal Commission’s scope:

  • the impact of the fragmentation of State and Commonwealth health and aged care systems on the standard of care of older people;
  • access gaps to clinical care in all aged care settings, including residential facilities, the older person’s home, and in the community;
  • the suitability of funding models, and the level of funding, for the care of older people in the health and aged care systems;
  • the suitability of the aged care workforce skills mix, and the case for a regulated registered nurse-to-resident ratio that is adequate and reflects the individual levels of care needed by older people living in residential facilities;
  • quality of, and access to, specialist support and allied health in aged care settings, including palliative care, mental health care, and services such as physiotherapy, audiometry, dentistry, optometry, and occupational therapy;
  • the availability of, and need for, research and data concerning the care of older people.

Dr Bartone last week wrote to Prime Minister Morrison to thank him for launching the Royal Commission, and to urge him to consult in-depth with the medical profession on the challenges facing the aged care sector.

The AMA submission is at

The AMA Aged Care Survey is at

The AMA submission to the Aged Care Workforce Strategy Taskforce is at:

The AMA Position Statement on Resourcing Aged Care is at:

27 September 2018

CONTACT:        John Flannery            02 6270 5477 / 0419 494 761
                            Maria Hawthorne       02 6270 5478 / 0427 209 753

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Published: 27 Sep 2018