New GP aged care model will further fragment care

2 Dec 2020

AMA Submission to Aged Care Royal Commission
While supporting many of the recommendations made by Counsel Assisting the Aged Care Royal Commission, the AMA today warned that a proposed new model of primary care for nursing home residents risks cutting out older people’s usual GPs and creating a two-tiered plan.

Elderly couple holding hands

AMA President Dr Omar Khorshid said the proposal to allow aged care residents to enrol with niche accredited general practices may discourage many GPs from providing care to aged care residents and lead to further fragmentation of care for our older people.

“With our population living longer and entering residential aged care at older ages and in more frail states of health, we should be aiming to bring aged care and health care closer together, not further fragment them,” Dr Khorshid said.

“Older Australians are among our most vulnerable people, and they deserve the best care possible.”

In its submission to the Aged Care Royal Commission, the AMA was broadly supportive of many of the recommendations, but argued strongly against the Counsel Assisting’s recommended new primary care model.

“Although the AMA is pleased with many of the recommendations by the Counsel Assisting, they’ve missed the mark when it comes to better access to health care and improving the model of GP care,” Dr Khorshid said.

“We need to end this rudimentary separation between aged care and health care.

“For older people, continuity of care is important, as patients benefit the most from a long-term relationship with a GP.

“Though the Counsel Assisting recommends that older people’s general practitioners should be put at the centre of planning of ageing and aged care, the recommended new model of primary care will fail to achieve this.”

The key feature of the proposed model is that a GP practice would have to be accredited to work in aged care. An older person entering a nursing home may therefore be expected to abandon the GP they have had for many years in order to find a GP has aged care accreditation.

“The AMA is very concerned that the proposed new model will be a two-tiered system where continuity of care would be discarded to the detriment of our elderly for the convenience of aged care providers,” Dr Khorshid said.

“Devising new models of care should not be a substitute for improving inadequate MBS rebates that do not recognise the complexity of care being provided to aged care residents.

“The AMA supports mandating minimum staffing ratios in aged care and has called for registered nurse availability in aged care 24/7. However, we were disappointed with the staffing ratios proposed by the Counsel Assisting.

“We call on the Royal Commission to review Counsel Assisting’s recommendation and bring the staffing ratios closer to a 5-star model.

“We remain committed to working with the Royal Commission and the Department of Health on developing a model of care for our older people that recognises the importance of GPs in aged care and in improving overall health outcomes for older Australians.”

The Counsel Assisting recommendations include a new Aged Care Act based on human rights principles for older people, mandated staffing ratios in nursing homes, demand driven access to aged care, and a new and independent process for setting aged care quality standards.

The latest AMA submission to the Royal Commission can be viewed here.