A new national strategy to address Australia’s social infrastructure gap for a growing ageing population

Closing the gap in health and ageing

On 12 February 2018, PricewaterhouseCoopers and Australian Unity launched a national report for Australia entitled ‘Closing the social infrastructure gap in health and ageing.’ The report begins by highlighting the scale of future demand for health and ageing and the billions of investment that will be needed for hard and soft social infrastructure in the future. Examples for hard social infrastructure, include a shortage of aged care facilities and hospital beds to soft social infrastructure with workforce needs across the allied health professions and caregiver roles. The report stresses the importance to act now on a national stage as the current trajectory is not sustainable, and is no longer fit for purpose.

A national interdisciplinary Advisory Group comprised of academics, policy makers, and health care experts assembled to develop a more thorough understanding of the current infrastructure status for health and ageing across Australia, along with the challenges and potential pathways for improvement. Over several intensive workshops from 2016-2017, the Advisory Group reviewed national and international examples, and proposed the way forward is to invest in a population health and wellbeing approach, primarily by focussing on prevention and early intervention strategies.

This report identifies and recommends a practical approach which aims to:

• Transform the system towards a more holistic and outcomes focussed approach
• Improve integration and patient centricity in how care and support are delivered
• Establish an Innovation Accelerator as an independent function that funds and supports innovative partnerships and collaborations to trial new or improved models of care that are person, place and population oriented, rather than provider based
• Leverage an existing institution in order to act quickly

As a member of the Advisory Group, I am excited about these recommendations. One example for the last recommendation builds on Australia’s popular Maternal, Child and Family Health Nurses Model to identify and support the growing population of people suffering from dementia (see page 75 of the report). The Maternal, Child and Family Health Nurses Model provides support and care for mothers and infants, particularly those who are vulnerable, through key ages and stages checks via clinic and at-home visits. The Advisory Group proposes a similarly structured Dementia Community Health Model where community nurses help families identify dementia symptoms, understand the disease, and navigate the system in order to provide dementia care. This approach may be particularly appropriate in the early stages of the disease, where modifiable risk factors for dementia, such as low physical activity, depression, poor sleep, and low cognitive activity could be addressed. These modifiable risk factors contribute to 30-50% of dementia risk. If detected early and managed, then this health model could help reduce potential elder abuse associated with dementia, and the harm dementia causes to individuals, their loved ones, and the larger community.

The report concludes with the overall vision for Australia: to have a new national strategy for health and ageing focussed on wellbeing (rather than illness), that has a more integrated, preventive and outcomes-focussed approach by 2025.

For access to the full report: https://www.pwc.com.au/practicalinnovation

[Source: Tara Sklar, Fellow in the Law and Public Health Group, University of Melbourne, Professor of Health Law and Director of Graduate Health Sciences Programs, James E. Rogers College of Law, University of Arizona]