Health collaboration crucial for the best care of older Australians

The COVID-19 pandemic has brought into sharp focus the crucial relationship between aged care, hospitals, general practice, ambulance services and the whole health system.

What we have learnt — in sometimes tragic and devastating ways — is the importance of having cooperative models and strong communications across the entire health sector, to deliver the best care and protection for older Australians.

In Victorian aged care, we have seen thousands of people infected with coronavirus and many deaths linked to the pandemic.

At the same time, health authorities confirmed that statistics showed up to one-third of residents infected with the virus would pass away.

However, in the critical first weeks of the Melbourne and Mitchell Shire outbreaks, there were repeated reports of major shortfalls in surge staffing. Aged-care homes also reported that requests to move initial resident cases of COVID-19 immediately into hospital were ignored.

Hospital transfers have the capacity to enable aged-care homes to focus on their COVID-19 response plan including contact tracing, staff and resident testing, resident and family communication and facility cleaning — critical measures that need to be enacted early if an outbreak is to be contained.

Back on 1 April, the federal government partnered with the private hospital sector to add another 30,000 beds and 105,000 skilled staff, to back up public sector hospitals in our nation’s COVID-19 response.

As the crisis unfolded in Victoria, the state government’s decision to suspend non-essential elective surgery freed up health workers to assist in aged care.

Similarly, the federal government assigned defence personnel and AUSMAT staff. This level of assistance undoubtedly saved lives. However, sadly, many lives have been lost and many hard lessons have been learnt.

Caring for our most vulnerable is not just a matter of response — it must include comprehensive preparation and planning that is well coordinated across all the moving parts.

Aged-care facilities have had — and continue to modify, according to lessons learned — their specific COVID-19 response plans. However, the midst of a crisis is not the time to discover that other associated health services are working to a different plan or have limited resources available due to competing priorities or are being overwhelmed by demand on their services.

From early times during the pandemic, we saw welcome extensions of health linkages into aged care including the greatly increased use of telehealth and onsite pathology services.

Leading Age Services Australia (LASA) has worked hard since the very beginning of the pandemic to try to ensure a cooperative approach, wanting the needs and lessons learned at the frontline of care to influence decision-making at the highest levels.

Unfortunately, when the second wave of the virus hit Victoria, holes were revealed in the collaboration and planning between aged care and many aspects of the health system.

Cooperation was inadequate and too many people suffered.

To rectify this, the Health and Aged Care Ministers announced in late July the immediate formation of the Victorian Aged Care Response Centre (VACRC), which has set a national standard for the delivery of emergency support.

Now, Aged Care Response Centres are part of the planning for every state and territory.

LASA’s view is that these centres must focus not only on outbreak response, but equally importantly on coordination of prevention and protection planning and activities, including ‘stress testing’ COVID-19 response plans at state and regional levels.

In August, the federal government decided to form an Aged Care Advisory Group, to provide policy advice to the Australian Health Protection Principal Committee (AHPPC) to support aged care against the pandemic.

LASA endorsed this outcome given our advocacy to government on the need for review and reflection on lessons learned.

LASA welcomes both the Response Centres and the National Advisory Group — but we must further extend fundamental collaboration, whether it is against coronavirus or any other future challenges.

We must weave the aged-care and health systems together — from towns, suburbs and regions, to the formation of national policies — to create a strong safety net to protect our most vulnerable and valued older Australians.

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