Aged care

 

As hearings resume in Melbourne from July and the Royal Commission into Aged Care Quality and Safety enters its final months of deliberations, an AICD webinar has revealed calls for clinical governance standards to be raised on boards and for directors to improve their levels of clinical literacy.

Greg Adey GAICD, Chair of the Minda Board Clinical & Services Governance Committee, Chair of Clayton Church Homes, and member of the Yorke Northern Local Health Network Aged Care Board, told the webinar that, “The Royal Commission was for many boards their first exposure to clinical governance responsibilities.”

Clinical governance is a core responsibility for boards and they need to commit to this at the same level as they do with financial oversight, says Adey. “Making sure we have that (clinical) oversight is critical, because at the end of the day, we need to hold ourselves accountable for making sure that we're promoting that culture of safety inclusivity and that quality of care.”

The Clinical Governance Essentials for Aged Care Boards webinar was hosted by Adey and Rosina Hislop FAICD, a former partner at Ernst & Young, who is current deputy chair at South Australian provider ECH.

The COVID-19 crisis has been a valuable learning experience in terms of what integrated governance can mean, Adey said. “We all had to quickly escalate the governance risk around infection control to the board level….we had to learn a new level of clinical literacy…”

As we move into the recovery phase, it is important now for boards to maintain that integration of clinical governance with other core parts of business responsibility.

Adey said the main question coming out of the aged care royal commission had been the issue of care and clinical oversight: “What did the boards know about this, and if they didn’t know, why not?” One year on, he has called for aged care boards to formally revisit their self-declarations in their submissions to the royal commission.

Royal Commission resumes hearings

The Royal Commission into Aged Care Quality and Safety will resume hearings in July this year, after they were suspended in March due to the COVID-19 pandemic. A hearing on mental health, oral health and allied health care in aged care provision will now take place in Melbourne from 15 to 17 July 2020.

This hearing will be closed to the public due to COVID-19 restrictions but can be accessed via a live webcast.

The royal commission has also released a new consultation paper, Financing Aged Care and is seeking submissions in response until Tuesday, 4 August 2020. The paper suggests a series of funding options including that working Australians could pay into a social insurance scheme to fund their future age care needs.

The paper examines how aged care is funded in Australia and overseas, and considers a range of options that have the potential to transform the way aged care is funded and delivered in Australia.

The Royal Commission is also now calling for submissions from the general public and organisations relating to the impact of the coronavirus (COVID-19) on the aged care sector. The deadline for submissions is 31 July 2020. Visit the submissions page to learn more.

The inquiry is also inviting submissions by 13 July 2020 on the topics of system governance, market management and the allocation and clarification of roles and responsibilities for these functions. Questions are provided on the commission website. Current submissions can also be viewed.

The inquiry’s final report due in November will set a framework for a complete overhaul of the aged care system – from system philosophy and design, to interactions with health and disability services, to workforce, funding and regulation. Governance is to be a focus of the final report.

As at 23 June 2020, more than 8620 submissions have been received. Ahead of the final report’s release, there are calls for reforms in the sector to fund and develop new facilities and models of care and to improve clinical governance.

The royal commission flagged the experience and makeup of boards as an issue during its hearings on governance last year. In her evidence given to the royal commission last year, Professor Kathy Eagar, Director, Australian Health Services Research Institute, University of Wollongong, proposed a focus on clinical care in residential aged care. In her submission to the inquiry, she proposes four funding streams administered through 60 or so regional authorities. Eagar also recently warned that more medical experts are needed on aged care boards and in management ranks to prevent future COVID-19 outbreaks.

Possible new funding arrangements under new business models are also the focus of a new report produced by business advisory firm Grant Thornton. The report: A model for transformation and governance proposes a phased approach to transformation that provides for industry rationalisation and different funding arrangements at different times to drive sectoral behaviour change and stimulate reform, investment and sustainable outcomes.

The report recommends substantially updating the Aged Care Roadmap developed in 2016 by the Aged Care Sector Committee, chaired by David Tune AO PSM. “The governance over the transformation will need to have authority over the changes required and the components of the aged care system they represent, to remove barriers, and to cement structural reforms in their own areas of influence,” the report says.