Aged care sector should standardise hospital discharges, royal commission hears

Tasmanian Department of Health deputy secretary Ross Smith appears before Royal Commission into Aged Care

Aged Care Royal Commission
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A senior Tasmanian health official has appeared before the Royal Commission into Aged Care on its last day of hearings for 2019.

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A senior Tasmanian health official has told the Royal Commission into Aged Care Quality and Safety it should be a key priority of the aged care sector to standardise the process by which a person is discharged from hospital into an aged care facility.

Department of Health deputy secretary Ross Smith appeared before the commission in Canberra on behalf of secretary Katherine Morgan-Wicks on Friday.

The commission's Canberra hearings have focused on the intersection between the aged care sector and state or territory services.

Mr Smith told the commission all hospital discharges should be of a high standard.

"We should be aiming for the same level of standard regardless of whether someone's discharged to home, to the GP [or] to the residential aged care facility," Mr Smith said.

He said, in Tasmania, the standard time within which a discharge summary is provided is 48 hours, however, in respect of aged care facilities there was a model colloquially referred to as the "yellow envelope" model.

"The principal idea is when the patient transfers the information goes with them, rather than they're transferred and it will turn up in the next few days," Mr Smith said.

"With that low-tech model that we probably have greater adherence to making sure we have good transfer of care through that particular model because we have sort of ownership and commitment."

Mr Smith said he disagreed with a suggestion put the commission during this week's hearings that a single model of aged care should be rolled out.

"I would very very reactant to support an idea of a single model," he said.

"My feeling is [we should be] making sure that we are picking up on what's working well elsewhere and building on that."

Mr Smith agreed he would support greater clarity in regards to the obligations of aged care providers to provide health care to residents in the facility.

"Overall, making it very clear about about what the sort of residential facility's responsibilities are, vis-à--vis, the broader health system [would help]," he said.

He said he also supported the concept of creating a definition for other providers' responsibilities outside the residential aged care facility.

"In practicality, we would have to be very careful what we're doing ... to make sure we are incorporating at every step the resident's wishes [and] the resident's consent around how that process would work," Mr Smith said.

In Tasmania, Mr Smith said gaps in service delivery occur where the state has failed to attract appropriate nurse practitioners, for example in the North-West, as part of the roll out of its rapid community response model.

"The Tasmanian government is rolling that out on the basis of what we found out - this does work [and it] does ensure people get the care they need and stay out of the hospital system, not because it's inconvenient to the hospital, but it's more appropriate to their care needs," he said.

"We're all trying to address this cap between the GP and their capacity to provide episodic care and the gap between needing to actually genuinely attend a tertiary facility and receive acute care.

"It is that gap between the GP and the hospital setting that affects residential aged care residents I think more than most."

The commission will deliver its final report in November 2020.

The story Aged care sector should standardise hospital discharges, royal commission hears first appeared on The Examiner.

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