Last night on the 730 Report we saw several GPs make the point that fewer GPs are providing care to elderly Australians in Nursing Homes and other Aged Care facilities.
TRACY BOWDEN: Dr Joseph is a strong believer in continuity of care.
DR PETER JOSEPH: For patients, they come in and they don’t have to explain things to you, that happened years ago, because you know it.
You learn what’s going on in the family and how that affects their health.
You can also pick subtle changes.
What are the solutions?
Dr Stephen Dick suggests the following:
The service is not viable financially and is attached with a burden of being on call 24/7, and having to deal with untrained staff triaging patients who are
quite sick with chronic diseases.
1. GPs to operate on a salaried basis to service nursing homes, including a callout fee. The FFS model is broken, utterly, utterly broken, when it comes to aged care.
2. Legislated nurse to patient ratios – both RN to patient and carer to patient ratios.
3. Nursing homes to provide an imprest of basic medications, such as antibiotics and opioids, for after hours issues.
4. Pharmacies to be contracted to provide medications for the residents from a nationally standardised medication chart on a capitated basis – NO MORE OWING SCRIPTS.
5. Get an accreditor with teeth to do spot inspections and severe fines for companies that flout the rules. First offence – $50,000 fine. Second offence – $200,000 fine, resident fees non-payable and the CEO of the responsible corporation placed under house arrest until rectified. Third offence – Home shut down, bonds repaid in full to residents within 30 days, and residents to stay bond-free when and if the facility reopens.I guarantee that if a hospital suddenly had to find 80-odd hospital beds they’d find a solution quick smart.
6. Diets to be individualised and supervised by a dietitian and speech pathologist.
7. Responsibility for the nursing home to provide access to physio, OT, speech, podiatry, optometry in addition to DT.
8. Homes to have a standardised kit out of medical equipment, such as a diagnostic set, ECG machine, local anaesthetic and suture material, biopsy sets, and a room with a printer and wireless access to a network so that we can attend without having to bring every. Little. Piece. of equipment.
I suggest some simple rules for Aged Care facilities:
What are your thoughts?
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(on Maternity Leave from August 2018)