Better resources needed for aged care

Your Family Doctor and You: Partnering for Health

A lack of resources and funding is hampering family doctors who want to continue providing care to older patients who move into residential aged care, AMA President, Dr Tony Bartone, said today.

Dr Bartone – a Melbourne GP who has worked for more than 30 years with patients as they move through the stages of life – said that GPs provide cradle-to-grave care for patients.

“In Family Doctor Week, it is important to pay tribute to GPs who have cared for patients throughout all stages of their lives, but now face hurdles when wanting to care for these same patients when they enter aged care facilities,” Dr Bartone said.

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

“Doctors who visit aged care facilities usually have a long-standing association with their patients, and want to continue their clinical care.

“However, AMA members tell us that they are continually meeting barriers to facilitating that care, despite the improved health outcomes from a long-standing doctor-patient relationship.

“The Royal Commission into Aged Care Quality and Safety is highlighting the evident lack of support from both the health and aged care systems for doctors caring for patients in aged care.

“The increasing reliance on lesser-trained personal care assistants instead of registered nursing staff creates barriers to patient care.

“If there is no registered nurse present for a clinical handover by the doctor, crucial medical information may be missed, increasing the risk of patients not receiving their prescribed medication.

“Residential aged care homes often lack basic equipment and facilities to support doctors to carry out their work. Often there are no frameworks around clinical care delivery or communication with doctors about the provision of medical care for older patients.

“Medicare rebates for visiting patients in residential aged care go nowhere near meeting the real cost of providing care.

“You have to take into account the amount of non-contact time needed compared to a patient consultation in the doctor’s surgery, including travel time, increased paperwork, difficulties in locating patients if they are not in their designated rooms at the time of the visit, and follow-up telephone calls with the facility and the patient’s family.

“As a consequence, doctors are increasingly looking at cutting back on their visits, or stopping visits altogether.

“The AMA is calling for an appropriate and mandated staff-resident ratio that aligns with the level of care needed in each facility, and ensures 24-hour on-site registered nurse availability.

“The AMA is also calling for Medicare rebates to increase by at least 50 per cent to adequately compensate family doctors for the additional time and complexity involved in a visit, compared to a consultation in the GP’s practice.

“The injection of almost $100 million in the last term of government was a welcome start, but more will be needed.”

AMA Family Doctor Week 2019 runs from 21 to 27 July. Follow all the action on Twitter: #amafdw19 and the Family Doctor Week website.

Background

• Australians are living longer. Life expectancy in 2018 was 84.6 years for males and 87.3 years for females, and the number of Australians aged 65+ is projected to be 8.7 million by 2056 – 22 per cent of the population.
• In 2009-10, more than half of RACF residents (53 per cent) had dementia. This proportion is estimated to grow , with projections reaching up to 1.1 million people with dementia by 2056.
• The most recent AMA Aged Care Survey found that more than one in three doctors plan to cut back on or completely end their visits to patients in residential aged care facilities (RACFs) over the next two years.
• The survey also found that almost half (47.11 per cent) of all monthly visits to RACFs are from doctors aged 61 years and older, with less than 4 per cent of monthly visits from doctors aged under 40.

The AMA Aged Care Survey Report is at https://ama.com.au/article/2017-ama-aged-care-survey

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27 July 2019

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