RESPONSE TO THE SENIORS HEALTH ROUNDTABLE REPORT
COMMUNITY SERVICES DIRECTORATE
2017
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Contents
Minister’s message 4
Introduction 5
Structure of the government response to the report 6
Emergent themes 7
Theme 1: Health, Literacy and Empowerment 7
What we are already doing 8
What we will do 9
Theme 2: System Navigation and Advocacy 9
What we are already doing 10
What we will do 10
Theme 3: Practice Changes 11
Conclusion 11
Attachment A:
ACT Government Response to the Seniors Health Roundtable Report 2016 12
Minister’s message
I am pleased to present this ACT Government response to the Seniors Health Roundtable of 2016. I want to thank the participants of the Roundtable for their work and their innovative and robust discussions and suggestions.
I am also pleased that the recommendations presented by the Roundtable to the ACT Government align with the key areas and actions in the ACT Active Ageing Framework 2015-2018 and its associated Action Plan (the Framework). To me, this alignment speaks to the coordinated way that the ACT Government works with the community and the community sector, respects and values their expertise and translates this partnership into outcomes for the community.
Seniors are a significant asset to our community, but are often talked or written about in negative terms, about the increasing costs of care or the burdens of old age, or a lack of capacity. However, research proves that far from being a drain on our community older people are net contributors to the economy through their engagement with their communities and families. We need to ensure that we are harnessing the rich diversity and often unacknowledged wealth of experience that seniors bring and contribute to our communities.
Communities must respond or miss the opportunity of fully engaging the largest, most educated generation of social innovators in the nation’s history.
Dick Goldberg, Coming of Age Director
Many of the actions recommended by the Roundtable seek to create these opportunities, to empower seniors to make choices and to facilitate their active participation in the community. As one innovative program for seniors in the United States notes, if we can overcome our outdated, ageist views, we can “learn to leverage the intellectual capacity, talent, skills, and commitment of older residents to help solve issues for all ages in our community”.
It is my hope that implementation of recommendations in the Roundtable report will contribute to our capacity to truly acknowledge and utilise the asset that is our senior population.
Gordon Ramsay MLA
Minister for Veterans and Seniors
Introduction
The ACT Government thanks the participants (the Delegates) for their participation in the Seniors Health Round Table (the Roundtable), on 11 May 2016. The ACT Government has a proud history of working collaboratively with community organisations and across government to achieve quality outcomes for our seniors. The ACT Government acknowledges the enormous contribution community organisations and the broader community make in achieving quality health services for seniors within the ACT community.
The ACT Government notes that age is not, in itself, a challenge. As with any other stage of life, seniors may have some specific needs and considerations that impact on their health and wellbeing and their participation in the community. However, as with people at any other stage of life, seniors play a significant part in creating the rich diversity that is the ACT community.
The Seniors Health Roundtable was organised in response to feedback received from the Health Care Consumers’ Association (HCCA) of the ACT – that senior’s health should have been included as one of the key topics of the 2014 Older Person’s Assembly (OPA).
Subsequently, the Roundtable was identified as a key action under the ACT Active Ageing Framework 2015-2018 and its associated Action Plan (the Framework), which was tabled in the Legislative Assembly in November 2015. The ACT Government has committed to monitoring the implementation of activities and efforts to progress the practical outcomes of the Framework by reporting to the ACT Legislative Assembly through an annual Ministerial Statement.
A planning working group was formed to organise the Roundtable, comprising representatives from ACT Health, Community Services Directorate, the Ministerial Advisory Council on Ageing (MACA), Health Care Consumers Association of the ACT, the ACT Lesbian, Gay, Bisexual, Transgender, Intersex and Queer Ministerial Advisory Council and the 2016 ACT Senior of the Year, Professor Greg Tegart.
The Roundtable was attended by over 70 delegates and 36 organisations, representing a range of people from the health sector and various community groups from across the ACT. The event provided the opportunity for delegates to explore key topics that are specific to seniors in the ACT.
The six key topics identified and discussed in detail were:
1. Advocacy (health decision-making);
2. Access to Health;
3. Transitions in Care (continuity of care across services);
4. End of Life Care Issues;
5. Health Technologies (eHealth); and
6. Health Promotion, Wellbeing and Healthy Living.
A report of the Roundtable was prepared that includes the delegates discussions on the six key topics and contains 42 recommendations for the Government’s consideration.
The recommendations in the report of the Seniors Health Roundtable are largely consistent with the Active Ageing Framework 2015-2018 and that many of the practical suggestion are consistent with actions in the action plan of the ACT Active Ageing Framework 2015-2018.
Structure of the government response to the report
As there are a significant number of quite diverse recommendations in the report from the Roundtable, the ACT Government response has been organised around three particular broad themes that were common across a number of discussion areas and recommendations in the report. These three themes are: health literacy and empowerment; advocacy and navigation of ‘the system’; and practice/policy changes.
A table is included at Attachment A which provides the ACT government response to each individual recommendation.
It is important to note that a number of the recommendations in the Roundtable report are not within the ACT Governments remit (4,5,8,10,11,12,13,14,15,21,23,32,34,38 and 42), being either the responsibility of the Commonwealth government or the private sector. However, the ACT Government notes the worthwhile nature of many of these recommendations and, where possible and appropriate, the ACT Government will work with the Commonwealth Government and/or the private sector to encourage consideration or implementation of these recommendations.
Emergent themes
Theme 1: Health, Literacy and Empowerment
Decision-making is at the heart of being human.
(Health Roundtable report, 2016: 10)
The strongest theme to emerge across the 6 key areas of discussion at the Roundtable, related to the provision of and access to information. It was consistently noted that good and easy to access information is the key to people being empowered to make their own choices about their health needs.
The need for information identified by delegates ranged from understanding power of attorney, care planning, decision making and transition care options to information about the full range of social and physical activities available for seniors across the ACT (recommendations 2,3,14,30,34,37 and 41).
The Delegates identified the need for organisations to make it easier for clients to access information about the services and/or programs that they provide (recommendations 13, 18, 38 and 42). As the report noted:
Older Canberrans must be aware of the availability of advocacy services and what they offer well before they need [them]. Unfortunately, many individuals do not encounter advocacy services until they are in crisis.
(Health Roundtable report, 2016:11)
Closely related and again mentioned frequently across the 6 key areas of discussion was the need for more education to care providers, government and the community on the needs of the ageing (recommendations 8,12, 27 and 39). This has the potential to increase their capacity to provide appropriate information on services and the choices available to seniors and the way in which they do so.
The fifteen recommendations relevant to this theme were focussed on increasing what was termed by delegates as ‘health literacy’. Health literacy can be defined as: ‘ the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions’.
The ACT Government is strongly committed to providing accessible health services that are respectful and affordable and to ensuring that seniors are supported to access the services they need at the time that they need them. This commitment is evident in the range of resources provided and programs already funded and/or in operation in the ACT designed to improve the health literacy and decision making capacity of the senior population.
The ACT Government accepts in principle all the recommendations in relation to health literacy while acknowledging the significant work already being done in this area.
What we are already doing
· Under the Respecting Patient Choice Program (RPC), the ACT Government provides RPC facilitators and other staff in hospital to assist people with their healthcare treatment and to provide information on their options through a range of mechanisms including Advanced care planning and Enduring Power of Attorney.
· The ACT Government supports the national eHealth record system, and in March 2013 the Canberra Hospital and Health Services began submitting standard discharge summaries to the national eHealth record system. Inpatients at the Canberra Hospital that are registered for a national eHealth record, can now access their discharge summary electronically.
· To complement the national eHealth system, ACT Health has developed a local eHealth system, known as ‘My e Health’ which provides ACT Health-specific information, such as appointment times and details of hospital stays.
· The ACT Health Consumer Portal has initially been implemented for a select group of healthcare consumers who have agreed to participate in a pilot and provide feedback to assist ACT Health to provide a better, more simple and user-friendly service for people who access ACT Health services. Over time the intention is to expand access to anyone receiving healthcare in the ACT.
· The ACT Government is committed to people being provided with an accredited interpreter. ACT Health Policy: Language Services -Interpreters, Multilingual Staff and Translated Materials articulates that all health services must use accredited interpreters for people with limited English proficiency
· Additionally, ACT Health has in place, Towards Culturally Appropriate and Inclusive Services: A Coordinating framework for ACT Health 2014-2018, which outlines the need and responsibility for health care providers to provide services and information in a culturally appropriate and sensitive manner
· Council of the Ageing (COTA) coordinates Seniors Week Expo – which provides information on the range of services and activities available for older people in the ACT. Most government and government funded services working with older people provide information for the expo.
· The ACT Government recognises that digital platforms are essential to service and information delivery and is committed to providing timely and accurate online information that is accessible. All ACT Government websites conform to the Web Content Accessibility Guidelines, version 2.0 to ensure information is provided in varying formats that meet the needs of our diverse community.
· The Public Trustee promotes patient choice through the annual End-of-Life week.
· The ACT Government is also committed to working with key stakeholders to address social isolation for ACT seniors. This includes working with key stakeholders to build social and community participation for seniors via the provision of grants and the development of partnerships with community centres, men’s sheds, seniors clubs and support for volunteering and community events and festivals.
What we will do
· Task the Ministerial Advisory Council on Ageing to explore in more detail how information about community services and programs could be more widely distributed and known to older people and consider these in development of the next action plan under the Ageing Framework.
· Ensure that distribution of information on the services provided by community based organisations is included as a requirement in the organisations service funding agreements.
· Explore whether the ACT Health Consumer Portal does and/or could include information on the broad range of community based services and programs available for senior Canberrans.
· CSD will work in partnership with ACT Health, the Justice and Community Safety Directorate (JACSD) and other key stakeholders to promote awareness and education of the options within the Respecting Patient Choice (RPC) program.
· The ACT Government will work with the Public Trustee to investigate options to raise awareness about end of life issues and further promote the ‘End-of-Life’ week.
· The ACT Government will work with organisations such as the Australian Association of Gerontology to identify and address the gaps in knowledge of gerontology in the ACT. However, improving gerontology training in Australian medical schools is outside the responsibility of the ACT Government.
Theme 2: System Navigation and Advocacy
Older people often feel isolated when involved in the health care system. They feel that they are not fully informed about their condition of their treatment options...and not consulted in a meaningful way.
(Health Roundtable report, 2016: 13).
The next most mentioned theme across the roundtable discussions and reflected in the recommendations was the need for enhanced advocacy to assist clients to both understand the complexity that is the aged care system and to navigate the often ‘fragmented and siloed’ service system (recommendations 1,5,6,11,19,25 and 28).
Related to this were some practice suggestions aimed at reducing ‘red tape’, inconsistency and confusion across and within the health system, (recommendations 15, 16, 17,20, 21, 24, 29 and 31).
The ACT Government is committed to the provision of appropriate advocacy for seniors in the ACT and this commitment is reflected in the current range of resources provided for this purpose. The ACT Government also continues to work with the Commonwealth government to advocate for improvements to the broader aged care and health system and is committed to exploring all options to better streamline systems and services.
What we are already doing
· The ACT Government is an active member of the national Aged Care Officials (ACO) Forum. This group is comprised of representatives from all state, territory and Commonwealth governments to work together to consider and address issues related to the provision of services for older people and the aged care system.