This page provides information about important national initiatives on clinical governance influencing the work of services across the sector as of April 2023. We did not find any publicly accessible information on current research projects for this list. However, as this is a rapidly evolving area, we will continue to monitor and update this page over time to keep it current. Please contact us if you are aware of any projects and initiatives that should be considered for inclusion.
Australian clinical governance policy initiatives
Clinical governance in aged care supports the workforce and visiting practitioners to provide safe, quality clinical care for older people. In response to the Royal Commission’s Final report: Care, dignity and respect, the Australian government has introduced a raft of policy measures aimed at improving accountability and responsibility for the quality of care provided by the sector. These measures have been incorporated in the Aged Care and Other Legislation Amendment (Royal Commission Response) Act 2020.
- Established Office of the Inspector-General of Aged Care
This independent agency will oversee the Australian Government’s administration, regulation and funding of aged care. The Inspector-General (Interim Ian Yates) will drive improvement across the aged care system by reviewing aged care and identifying systemic issues, ensuring increased accountability and transparency through regular reports to Parliament.
- Strengthened Aged Care Quality Standards
The Royal Commission into Aged Care Quality and Safety recommended a revision of the Quality Standards which outline what is expected of the sector. The Department of Health and Aged Care is working to finalise and deliver the strengthened Quality Standards to ensure the improved accountability and responsibility of providers and improved quality and safety for those receiving care. The Commission has engaged Ernst and Young Partnership Australia to assist with pilot testing the strengthened Quality Standards to determine how they work in practice. The pilot will inform how assessment against the Standards will drive performance. It will also highlight the degree of support providers and older Australians may need to understand the Standards and what is required to meet them.
- 24/7 registered nurse cover and care minutes
In response to a key recommendation from the aged care Royal Commission, Australian residential aged care homes will be required to have a registered nurse on duty 24/7 as of July 2023. From October 2023, they will also be required to deliver a minimum of 200 care minutes per resident per day. This care can be provided by nurses and personal care workers but must include 40 minutes with a registered nurse.
- Code of Conduct for Aged Care
The Code of Conduct for Aged Care was introduced in December 2022 and sets out the standard of behaviour expected of providers, governing persons, and all workers (paid or voluntary) within approved residential, home, and flexible care services. It was introduced to improve the safety, health, wellbeing, and quality of life of people receiving aged care and to improve their trust in those providing their care. It does not apply to providers or workers with the Commonwealth Home Support Programme or the National Aboriginal and Torres Strait Islander Flexible Aged Care Program.
- Extension of the Serious Incident Response Scheme (SIRS)
The SIRS is an initiative to help prevent and reduce the risk of incidence of abuse and neglect of older Australians receiving Commonwealth subsidised aged care services. The scheme was extended in December 2022 to include home care and flexible care provided in a home or community setting. This now covers providers of Home Care Packages, Short-Term Restorative Care, the Commonwealth Home Support Programme, National Aboriginal and Torres Strait Islander Flexible Aged Care, Multi-Purpose Services Program and Transition Care Program services. The Aged Care Legislation Amendment (Incident Management and Reporting) Instrument 2022 details how the SIRS will apply to home care services. The Aged Care Quality and Safety Commission has also produced Guidelines for providers of home services.
- Star ratings for residential aged care
A star ratings system for residential facilities was introduced in December 2022 to provide the public with a transparent means to compare their quality and safety performance. Facilities are rated across several domains based on available data and measures of quality. These ratings are publicly accessible via the My Aged Care website as part of its ‘Find a provider’ service.
- Strengthened regulations to minimise restrictive practices
Strengthened regulations have been introduced to eliminate or minimise the inappropriate use of restrictive practices in aged care settings. Providers need to reflect these changes in their clinical governance framework. They include having to satisfy several conditions before and during the use of a restrictive practice and justify their use of a particular practice against other available alternatives. New consent arrangements around restrictive practices are also planned which will set out who can give consent when restrictive practices are needed for someone who cannot make an informed consent decision.
- National Aged Care Mandatory Quality Indicator Program
This program is mandatory for Commonwealth-subsidised residential aged care services and works to measure the quality of care that may affect the health and wellbeing of older people. Providers have been reporting every three months on pressure injuries, physical restraint, unplanned weight loss, falls and major injuries, and medication management. As of April 2023, providers are additionally required to report their performance in the areas of activities of daily living, incontinence care, hospitalisation, workforce, consumer experience, and quality of life.
- General Practice in Aged Care Incentive
As part of its significant reforms to Medicare, the Australian Government is introducing incentive payments to general practitioners to provide care to residents in residential aged care homes. The incentive is aimed at improving the accessibility, continuity, and quality of primary care services in this setting and reducing hospitalisations. Residents without a regular general practitioner and practice will be matched to one by Primary Health Networks. This incentive replaces the extended GP Aged Care Access Incentive (ACAI) as of 1 August 2024. Residents can register with a regular provider or practice before this time through My Medicare.
- Primary Health Networks (PHNs) telehealth implementation initiative
Primary Health Networks across Australia have received Australian Government funding to improve telehealth infrastructure in residential aged care facilities (RACFs) so that residents have increased access to primary care services where they choose to have a virtual consultation and it’s safe and reasonable to do so. Timely access to primary healthcare professionals, whether through face-to-face consultation or telehealth, is recognised as an issue for many RACFs, that in some cases can lead to potentially preventable hospitalisations. The purpose of this grant program is to support RACFs improve telehealth facilities to support access to virtual consultations for their residents.
See the websites of individual PHNs for more details on how each PHN is approaching this project.