Aged care homes must have government backing to transfer residents to hospital at the first sign of Covid-19 infections, non-profit residential care providers have argued.
With aged care at the top of the agenda for the next national cabinet meeting on Friday, Aged and Community Services Australia is calling on all states and territories to embrace immediate transfers to hospital to give operators time to stop the spread to other residents.
Acsa, the peak body for non-profit aged care providers, is also stepping up its calls for government funding to deliver paid pandemic leave for aged care workers across the nation, not just in designated Covid-19 hotspots.
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Victoria on Tuesday reported 17 more deaths, with 13 of those linked to known outbreaks in aged care facilities. There are now 2,024 active cases relating to aged care facilities.
The chief executive of Acsa, Patricia Sparrow, said Queensland and South Australia had policies supporting the transfer of Covid-19-positive aged care residents to hospital, but every other state was making decisions on a case-by-case basis.
“Our concern is that the policy doesn’t enable for that immediate transfer,” she told Guardian Australia.
Sparrow said her group believed that the first cases that were diagnosed in an aged care facility should go to hospital, because they could receive treatment there and it “helps us to try and stop it from spreading any further which is really critical”.
It would also give the provider time to set up “hospital in the home” equipment in the facility.
The focus on the aged care response intensified this week when the ABC’s Four Corners program reported that some residents from Epping Gardens, in Melbourne’s northern suburbs, had been turned away from hospital, the facility had suffered from workforce shortages, and there were critical delays in receiving test results.
Sparrow said she understood concerns about the potentially disruptive impact of transferring some people with complex needs to hospital.
“But our issue is in residential aged care is we know what happens when it gets into a facility and we know that we’re in a pandemic and that we need to actually take more steps to make sure that people are as protected as they can be,” she said.
Last week the aged care royal commission heard evidence of a “stand-off” between commonwealth and state health authorities over how to best handle an outbreak at Sydney’s Newmarch House. According to evidence tendered to the commission, NSW Health had a “preference” not to transfer residents into hospitals “given the precedent it would set”.
Sparrow said it was “really not about a precedent – this is about saving people’s lives”.
She said the different responsibilities of the commonwealth and the states needed to be clarified.
“I think mostly they’re working well together, but aged care is funded and regulated by the commonwealth and the hospitals are in the state domain, and I think it’s really important that the interface between aged care and hospitals is sorted out,” she said.
Asked about people whose advanced care directives said they did not want to go to hospital, Sparrow replied that providers would always want to help individuals have the outcome they desired.
Sparrow said the transfer of residents from Dorothy Henderson Lodge in Sydney “enabled the facility to get set up properly and then some people with advanced care directives were able to be supported at the home, but if we don’t get in and act very quickly and it spreads then it’s very different for everybody”.
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“Covid has turned out to be far more devastating than some of the things that providers have had to plan for in the past,” she said.
Federal government-backed advice to providers had urged them to prepare for potential absences of 20% to 30% of their staff, but severe outbreaks have resulted in most or all of the workforce having to be replaced. The sector is highly casualised and some workers have shifts across multiple facilities.
Sparrow praised aged care workers for doing “an amazing job”. She reaffirmed the sector’s calls for the government to help aged care providers fund paid pandemic leave nationwide. That funding should be uncapped and based on demand.
“We want to make sure that they’ve got all of the support that they need to make sure that they can stay home if they need to isolate and that that’s not a worry for them,” Sparrow said.
Last month the Fair Work Commission ordered residential aged care providers to provide two weeks’ paid leave to workers required by their employer or a government medical authority to self-isolate because of Covid-19.
The federal government argues it has invested $850m in supporting aged care during the pandemic. But aged care groups say the funding is focused on coronavirus hotspots and it needs to be broadened.
Video: ‘It shouldn’t take a pandemic to address fundamental issues in aged care’ (Sky News Australia)