Promise check: Require 24/7 registered nurse presence in aged care facilities by mid-2023

Promise check: Require 24/7 registered nurse presence in aged care facilities by mid-2023

At the 2022 election, Labor promised to require the 24/7 presence of a registered nurse in aged care facilities by mid-2023. Here's how that promise is tracking.

Person in wheelchair being pushed down a hallway (Image by ABC News: Nic MacBean)

Aged care was a major focus of the 2022 election campaign, held after waves of deadly COVID-19 outbreaks swept through residential care facilities and a damning royal commission exposed deep flaws in the sector.

In its final report, the Royal Commission into Aged Care Safety and Quality identified "unacceptably high levels of substandard care" across the system, with residential facilities in particular failing to deliver adequate routine care.

"Too often there are not enough staff members, particularly nurses, in home and residential aged care," the commission said.

Labor went to the election promising to improve standards by introducing a new requirement for residential facilities to have, at a minimum, one registered nurse working on site all day every day.

"Under a Labor Government, every aged care facility will be required to have a registered, qualified nurse on site, 24 hours a day, 7 days a week," it said.

"This will save thousands of stressful, expensive and ultimately unnecessary trips to hospital emergency departments, for issues a nurse could solve on the spot."

In another policy document, Labor again pledged to "lift care and quality standards and improve health outcomes by making it mandatory to have a registered nurse onsite 24 hours a day in residential aged care facilities".

"This was a key recommendation of the Aged Care Royal Commission", it added, pledging that "24/7 registered nurses will become required from July 2023".

Assessing the promise

Labor promised to require the presence of a registered nurse in "every aged care facility".

In Australia, most residential care facilities are operated by not-for-profit and private providers, and are subsidised by the federal government.

Providers that receive these subsidies under the Aged Care Act 1997 are also subject to federal government regulation and quality standards, though there are some entirely private providers that fall outside this framework.

However, the promise referred specifically to a recommendation made by the aged care royal commission, whose terms of reference made clear that "aged care services" meant government-subsidised providers.

The commission's recommendation also made clear that there should be certain circumstances under which exemptions to the 24/7 rule would be allowed, such as where a different qualified health professional may be more appropriate or where regional facilities are unable to recruit staff.

Questioned before the election on how quickly facilities would be able to find nurses to meet Labor's requirement, then shadow attorney-general Mark Dreyfus told ABC radio listeners: "We're talking about setting the standard. And if it is in fact true that there are not enough nurses in Australia to provide that level of care, we should train more."

In the days after Labor leader Anthony Albanese used his budget reply speech to reiterate the promise (and following Mr Dreyfus's comments), Labor issued a statement to clarify that aged care providers would be given the flexibility to ensure they were "not unfairly penalised where workforce supply issues limit their ability to meet [the 24/7] standard".

This promise will be delivered if federally regulated residential aged care facilities are required to have at least one registered nurse on site at all times, starting from July 2023.

19 May 2023

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19 May 2023

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