Aged care reform

Jocelyn Hofman, NSW aged care registered nurse. Supplied: NSWNMA

The Albanese Government implemented sweeping reforms across the sector, highlighted by pivotal legislation mandating the presence of a registered nurse 24/7 in every nursing home. Additionally, they introduced mandatory care minute targets for aged care facilities, stipulating an initial minimum of 200 minutes per resident per day, of which 40 minutes must be provided by an RN. The government also allocated $11.3 billion to fund increased wages across the sector in response to the Fair Work Commission’s Interim decision as part of the ANMF’s ongoing Aged Care Work Value case.

Fundamentally, these reforms, championed by the ANMF over many decades, signify a genuine effort to enhance the standard of care provided to elderly Australians. They also recognise the critical role and contribution of dedicated and skilled nurses and carers throughout the sector.

“We now have an opportunity to create a system that guarantees safe and high-quality care for elderly Australians living in nursing homes. Improved staffing levels and better pay will also drive the recruitment and retention of highly skilled aged care workers, ensuring the sustained success of these transformative reforms,” ANMF Federal Secretary Annie Butler said.

Although these reforms represent significant steps forward, there are still challenges to overcome in effectively implementing these changes.

One of the biggest is the absence of mandated care minutes for enrolled nurses (ENs) within the recently introduced staffing requirements, legislated in response to recommendations from the landmark Aged Care Royal Commission.

As of last October, residential aged care facilities were legally required to provide a daily average of 200 care minutes per resident, with a minimum 40 minutes provided by a registered nurse, and the remainder by enrolled nurses and care workers. However, legislation failed to outline how the remaining daily average care minutes should be distributed among ENs and care workers.

Consequently, the unique role ENs play in aged care has increasingly come under threat as some providers explore loopholes within the legislation.

Last year, the ANMF conducted a nationwide aged care survey to understand the impact on ENs following the reforms. Key findings revealed instances of ENs being incorrectly told by colleagues or employers that no funding was allocated for ENs, a noticeable reduction in EN shifts, and reports of employers attempting to reclassify them to lower positions, such as PCWs. Some ENs, as seen in the high-profile Southern Cross Care Tasmania case, even faced redundancy.

Since the formation of care minutes legislation, the ANMF has argued for the inclusion of mandated minimum EN minutes, emphasising the need for clear specifications regarding the role and its key contribution as part of the essential skill mix required to ensure safe and high-quality care.

During 2024, the ANMF will continue lobbying and working with the government to mandate specific EN direct care minutes to ensure enrolled nurses remain a valued and critical component of the aged care workforce.

Another focus for the ANMF in aged care involves expanding upon the significant win achieved in advancing wages across the sector through the Aged Care Work Value case before the Fair Work Commission. In 2022, the FWC handed down an interim 15% increase on award rates, which took effect on 30 June 2023. Building on the momentum gained, the ANMF represented aged care members during Stage 3 hearings of the case held last December, calling for additional increases on award rates.

Underpinning the extensive range of aged care reforms underway involves empowering the voices of everyday aged care workers during implementation. This is essential to ensuring transparency and accountability, particularly in instances such as providers meeting minimum direct care minute targets.

“It is imperative that nurses and care workers at the grassroots level become vocal advocates of the system,” Ms Butler said.

“They should feel empowered to speak out when something is amiss because, far too often, we have witnessed providers manipulating the system, neglecting the primary goal of ensuring quality care.”

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