Government and NSW Health agree on joint protocol to manage COVID-19 outbreaks in aged care –providers must raise alarm bell within one hour but no guidance on transferring residents to hospital.

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NSW aged care providers finally have clear guidelines on what will be expected of them during a coronavirus outbreak – but the issue of transferring COVID positive residents to hospitals remains unresolved.

The Department of Health and the NSW Ministry of Health have agreed on a joint protocol to formalise the coordination of Government support to NSW aged care providers in their management of a COVID-19 outbreak based on consultation with aged care peak bodies and providers.

You can download the protocol here.

The 11-page document details the roles and responsibilities of the Department of Health, Aged Care Quality and Safety Commission, aged care providers, NSW Local Public Health Unit and Local Health District and NSW Health.

A single confirmed coronavirus case is considered enough to trigger the protocol, it states, with outbreaks to be escalated to the Senior Intergovernmental Oversight Group (SIOG) – which includes representatives from the Department of Health, NSW Health and the Aged Care Quality and Safety Commissioner, Janet Anderson – if:

  • There is rapid deterioration of the situation
  • The provider does not demonstrate capability to effectively lead and manage the outbreak response
  • The RACF premises are unsuitable to manage the outbreak effectively
  • The Local Health District does not have capacity to provide a clinical outreach response
  • Any other issue impacting on the effective management of the outbreak

Providers must alert this group within one hour of a positive case being identified as well as their own outbreak management team, with the provider and local Public Health Unit to set up this team within 12 hours.

The SIOG will meet to discuss the outbreak within 48 hours.

However, there is no clear answer for providers on transferring sick residents to hospital.

Some guidance appears to come in the underlying principles of the protocol which state:

“All Australians should be able to access healthcare and live with dignity, regardless of their age and where they live,” reads the first line.

“Decisions on the most appropriate clinical care, including location of the care and whether transfer to hospital is required, are made in consultation with clinical care staff and residents (and their representatives),” it adds.

“RACF residents continue, as do other people in the community, to have a right to access public health services (including hospital) based on their clinically assessed need.”

The principles suggest residents should be given access to hospital treatment should they and their families request it – but there is no flat out ‘yes’ or ‘no’.

As we reported here two weeks ago, there are no national guidelines on transferring COVID residents to hospital, reportedly because South Australia and NSW refuse to back away from their respective policies which in NSW revolves around setting up a ‘Hospital in the Home’ program in a home.

The new protocol suggests that this stand-off is still ongoing.

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