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Aged care royal commission a failure for wound care

Aged care royal commission a failure for wound car
Photo: Wound care in aged care
Wounds Australia, the peak body for chronic wound prevention and management, says the Royal Commission into Aged Care has been an “almost complete failure” for hundreds of thousands of older Australians suffering from chronic wounds.

Wounds Australia Chair Hayley Ryan said the Commission’s recommendations threaten to shift costs of wound care from the Federal Government to the States and leave huge holes in the training of doctors, nurses and other clinicians.

“It is inconceivable wound care was barely mentioned in the Royal Commission’s Report given the impact and cost of chronic wounds on the aged care system.

“Over 420,000 Australians suffer from chronic wounds each year. The vast majority are over 65 and likely to be in the aged care system. Chronic wounds cost the national aged and healthcare budgets around $3 billion annually.
“And yet, of 148 Recommendations from the Royal Commission into Aged Care Quality and Safety, just four barely touch on wound care,” Hayley Ryan said.

“Sadly, even those fall short of delivering the much needed help now and into the future.

“In the end, the Royal Commission’s Report shows exactly how clueless the Commissioners and governments are on chronic wounds,” Hayley Ryan said.

“Wound care was largely omitted from the recent MBS Review and it’s now barely much beyond a footnote for aged care.

“As a result, Wounds Australia will now be inserting itself far more aggressively into the policy and program decision-making processes of government.

“Wounds Australia and the thousands of doctors, nurses and allied health professionals we represent will draw on the Report’s recommendations to make governments invest in policies and programs that will change people’s lives.

“Even small investments and small reforms will save money, restore quality of life and see the incidence of chronic wounds drop.

“A government doesn’t get a better deal than that. All they have to do is work with Wounds Australia and its members with expertise in wound care,” Hayley Ryan said.

In addition to calling on Government to include Wounds Australia in its group of stakeholders to improve wound care, the peak body has outlined straightforward solutions for how the Royal Commission recommendations can be made a reality.

Recommendation 19: Urgent review of the Aged Care Quality Standards•

By 15 July 2021 the inclusion of best practice in wound management in Aged Care Quality Standards should be considered, and how they are to be achieved.

“With the deadline a little over three months away, Wounds Australia should be used as the primary resource for achieving best practice, and not just thinking about it,” Hayley Ryan said.

“Wounds Australia already has well-developed plans and policies to deliver best practice.

“When the Government established a Taskforce on the Aged Care Workforce, Wounds Australia, the country’s single best source of expertise was not appointed. We must be an immediate inclusion in future Taskforces, Working Groups or other bodies,” Hayley Ryan said.

Recommendation 58: Access to specialists and other health practitioners through Multidisciplinary Outreach Services*

By 1 January 2022 Local Hospital Network-led multidisciplinary outreach services should provide access to embedded wound specialists already salaried within the hospital.

“This recommendation is the worst example of how little the Commissioners and Governments understand wound care,” Hayley Ryan said.

“The vast majority of wound care specialists are outside the hospital system, whether they are a GP, nurse practitioner, Wound Clinical Nurse Consultant (CNC), podiatrist or another allied health care worker.

“This approach threatens to see patients care shift from the federal arena to the states, and a further clogging up of the already-strained hospital system.

“We know the generalists in the hospital system are already at capacity.

“A more effective, more efficient and affordable reform would be to have the generalists and small number of hospital-based wound specialists, to work in conjunction with the outside experts to strengthen treatment.”

Recommendation 79: Review of certificate-based courses for aged care*

By January 2022 reviews of Certificate III and IV courses in aged care should consider additional units of competency in wound care.

“While it makes your head spin that a problem the size of chronic wounds isn’t already included in aged care education, we welcome the suggestion it should be,” Hayley Ryan said.

“However, rather than simply ‘considering’ the inclusion of wound care, Wounds Australia demands that it must be part of Aged Care certificates by next year.

“The Government must also go further and include specialised wound care units in university training courses, including for doctors’ and nurses’ degrees.

“Wounds Australia has thousands of members who treat wounds and educate other healthcare specialists. Quite simply, there is no organisation better placed to work with government and the Vocational Education System to deliver courses and share expertise.

Recommendation 114: Immediate funding for education and training to improve the quality of care*

Commencing on 1 July 2021 a scheme to reimburse home support, home care and residential aged care providers of for the cost of education and training, including continuing education in pressure injuries and wound management should be established.

“The removal of this financial barrier is smart and can be implemented very quickly. It gives a financial incentive to aged care providers to raise the standard of care for patients,” Hayley Ryan said.

“Wounds Australia is ready, willing and able to partner with government to build a system that delivers the much needed training and professional development. We already do it for our members and have the know-how and content for effective course delivery.

“However, putting people through training is just a cure to a problem that can actually be prevented.

“Governments should actually support programs to train aged care workers to stop pressure injuries from developing in the first place.”

Hayley Ryan said the strong focus on improving mental health in the Royal Commission’s Report also demanded a large investment in wound care.

“Given the direct link between chronic wounds and poor mental health, improvements to wound care must be central to aged care reforms.

“Clinicians see thousands of patients each year who admit to becoming a recluse because they are embarrassed to leave home. The stigma of a visible wound is compounded by additional problems such as odour and a once- active person cuts themselves off from socialising and recreation.

“Chronic wounds can also lead to amputations and even death due to a lack of treatment and early intervention.

“Only a dramatic new approach will solve the massive problem of chronic wounds.

“Thankfully, Wounds Australia has the expertise to deliver solutions that are affordable, effective and can be implemented as quickly as the Royal Commission demands,” Hayley Ryan said.

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