RDAA President Dr John Hall

The Rural Doctors Association of Australia (RDAA) has urged the federal government to require all aged care facilities to have a registered nurse (RN) on every shift, to ensure better health and safety for residents and the highest level of infection control.

RDAA made the call in a submission to the Royal Commission into Aged Care Quality and Safety.

The organisation is also calling for better integration and collaboration of aged care with general practice.

‘Having a registered nurse onsite at an aged care facility, around the clock, is essential,’ said RDAA President Dr John Hall.

‘COVID-19 has shone a light on the need for aged care facilities to have increased “in house” nursing and infection control capacity – but this is just as critical in non-COVID times too,’ he said.

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RNs bring multiple benefits

Dr Hall says that registered nurses bring to aged care facilities a high level of medical knowledge and training.

‘They know when an aged care resident can be treated on-site, when to call in help, and when a resident needs hospitalisation,’ he said.

‘With RNs present at an aged care facility, doctors can also prescribe drugs that an RN is able to administer. These drugs could otherwise only be administered by the doctor or at a hospital, and hence may not be prescribed if an RN is not available on-site at an aged care facility.’

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Dr Hall said RNs are also highly skilled at infection control – a critical requirement for aged care settings.

He went on to say that, ‘RNs should be compulsory for aged care facilities, and the federal government should provide aged care providers (particularly not for profit providers) with financial support to enable this to occur.’

City-country divide?

Dr Hall urged general practice training providers to increase the exposure of all GP registrars to aged care settings during their training years. ‘At present, there is a significant discrepancy between rural and city-based GP training when it comes to aged care,’ he said.

Dr Hall suggests that due to the nature of their placement, most rurally-based GP registrars will provide some services in local aged care facilities during their training years, but many city-based GP registrars are not exposed to these experiences.

‘Research has shown that GP registrars who undertake aged care placements are more likely to provide aged care outreach once they are fully fledged GPs,’ he said.

‘This can only be a good thing. All GP registrars need to experience the rewarding nature of providing medical care in aged care settings, including geriatric medicine and palliative care.’

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Rebates too low

Dr Hall urged the federal government to increase the Medicare rebates covering GP visits to aged care facilities, in order to support and encourage aged care outreach by GPs – especially in rural communities.

‘At the very least, these rebates should cover the doctor’s time and practice costs in providing outreach care to aged care facilities and home-based elderly patients,’ he said.

‘At the moment the rebates are woefully low. They do not entice doctors to take time out of already busy practices to provide consultations at aged care facilities or at aged patients’ homes.

‘The level of Government support needs to be much higher in order to facilitate this,’ said Dr Hall.