Teaching aged care services program needs to be revived, education and training panel tells Commission

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The Teaching Research Aged Care Services (TRACS) program – which ran from 2012 and 2015 and saw tertiary students placed within aged care homes – could be a valuable tool in attracting graduates to the sector if it was reinstated and expanded into home care services and the VET sector, a panel of researchers and providers has told the Commission.

For just over an hour, Senior Counsel Assisting Peter Rozen QC questioned the panel via video link – Dr Kate Barnett OAM (pictured above centre); the Managing Director of the Stand Out Report; Helen Loffler (pictured above right), the Manager of Student Participation at Helping Hand; and Megan Corlis (pictured above left), Helping Hand’s Director of Research and Development – around the TRACS program which was discontinued by the Government in 2015, despite a positive evaluation by Dr Barnett who led the assessment of the program between 2012 and 2015.

Dr Barnett – who has 30 years’ experience in the aged care sector and was a Churchill Fellow in 2014 and completed a report on the teaching nursing home model in the US and Canada – said the program – which was first raised in a 2004 report from the then Department of Health and Ageing and then again in the 2011 Productivity Commission report on aged care services – had seen $8 million allocated to 16 student placement programs pairing universities with aged care facilities around the country.

Dr Barnett – who was awarded her OAM in 2018 for her services to aged welfare – said traditionally students placed in aged care have seen themselves as ‘drawing the short straw’, but the program had provided students with dedicated supervision and mentoring that had resulted in an uptake in graduates entering the sector.

But despite its success, the program was canned by the Government in 2015.

Dr Barnett blames the inherent ageism in the education sector and the community in part for this lack of support for the program.

“If you look at the structure of health sciences courses if indeed there is an engaging component, a module, it’s never compulsory and yet we’re living with an ageing population and whether or not our health science graduates end up working in aged care, they’re going to be working with older people and they’re going to be working with older people with complex and chronic health conditions,” she said pointedly.

“Why is it perfectly acceptable to have a network of teaching hospitals but for the aged care sector it’s a bit of a luxury and a bit of an add-on? Why isn’t it a central part of an evidence-based quality system of care? So even if you don’t intend to be ageist, it’s there and I think we’re seeing it now with COVID-19 with distinctions about priority not seeing people of a certain age.” 

Many providers also don’t have the time or resources to invest in education programs, Dr Barnett added.

“This is a very time poor sector as well as a restructures poor sector,” she said. “And if you have got to choose between a provision of care and designing a course for students, it’s pretty easy to work out what your priorities will have to be even if you don’t want them to be that way.”

Dr Barnett wholeheartedly supported the reinstatement of the program, but had a few caveats including the need for partnerships with VET providers and the acute sector and its expansion into home care.

The MD said there also needed to be an element of codesign.

“It was part of our evaluation findings that when consumers have an active role where they can in student education it’s a great win for students and those consumers as a whole,” she stated.

Dr Barnett also emphasised the importance of pre-existing relationships between providers and universities and VET groups – ideally at least a year – the use of technology and more involvement of allied health professionals.

“If you are going to be a teaching centre I believe they must be part of your core workforce,” she said. Apart from anything else, you can’t supervise students unless you have got people from those faculties.”

Ideally, the MD says she would like to see a minimum of 25 teaching aged care services across Australia, similar to the ‘hub and spokes’ model in Norway where aged care teaching facilities are funded on a regional basis by population to provide ‘best practice’ in teaching.

These could later be expanded to cater to specific groups, such as Aboriginal, CALD and people living with dementia with ideas shared through regular conferences and funding to match, she added.

Helping Hand – which has 750 aged care licenses across nine aged care homes in South Australia including rural areas – had been one of the participants – was one of the original TRACS participants and both Ms Corlis and Ms Loffler backed its return.

The Not For Profit’s board – seeing the benefits of the program – had elected to keep on Ms Loffler – who coordinated the program at its homes – after the funding dried up and have continued to see results.

“What we have been able to do is turn quite a number, particularly in the allied health area of those student placements into potential employees,” she said. “So, we at different times, we have had entire disciplines allied health have been all ex students who have been through the different sorts of models, the student clinic models.”

But as always, the discussion came down to the issue of funding – or the lack thereof – for innovations.

“We have talked about it at length about how we could actually run a hub and spoke model in the future,” Ms Corlis – an RN and former facility manager – added. “But, of course, organisations just struggle to bring together the dollars to do that sort of thing.”

“We have easily got the partnerships that already exist out there to do that,” Dr Barnett added. “It wouldn’t be a problem. It would be a funding issue. And I think the 8 million for TRACS, people thought that was huge and I remember thinking as I was watching what the projects were doing that it wasn’t really enough money and it wasn’t a lot of money.”

Again, Commissioner Lynelle Briggs was concerned with how this kind of program could be used in the home care setting – suggesting the Commissioners are still set on having the majority of older Australians supported at home or in home-like settings.

“Why is it that the Home and Community Care sector seems to be divorced from this kind of what would seem to be essential training and education?” she asked.

Ms Corlis pointed out that there are difficulties on sending students out ‘on location’ because of the lack of supervision.

“It’s an uncontrolled environment and to be honest I think it’s doable but nobody has had the time or the restructures or the money to actually work through that,” she said.

Like Monday’s workshop, the Commissioner didn’t appear to accept this argument.

“That’s probably one of the greatest sources of learning how to operate for a professional in an autonomous way,” she remarked.

It is worth noting however that a few years after Norway introduced teaching aged care services in residential care, they also began rolling it out in home care.

So, could the model work here in both residential care and home care – and would the Government be able to foot the larger bill to make it happen?

Given the current situation around the coronavirus, that seems unlikely.