New models of nursing care will provide solutions to the ageing population

Media Release 25 August 2023 

The Intergenerational Report, released yesterday, predicts that Australia’s population is expected to climb to 39.8 million by 2060-61, a million more than the previous projections for 38.8 million released in 2021, and pass 40 million by 2063. Additionally, Australians are expected to live longer with life expectancies forecast to rise to 87 years for men and 89.5 years for women by 2062-63.

The number of people over 65 is set to double, and the number of Australians over 85 will triple, according to the report. It is expected Australians will remain healthier to an older age, and have fewer children, which is expected to bring long-term economic challenges as more people rely on government-funded services for longer.

This coalition of peak nursing organisations, representing over 400,000 nurses states that these predictions call for innovative models of care, to support this healthier ageing population. These new models will increase health literacy and enable people to age in place, and support and teach people skills to self-care to keep well and healthy, thus minimising the impact on acute health services.

Nurses already form the single largest group of health professionals working in primary health care in Australia, but currently are under-utilised and under-funded to work to full scope of practice. However, there is strong evidence significantly internationally and also in Australia to demonstrate the efficacy of nurses working in partnership with consumers to maximise their independence and to enable them to live healthy and productive lives in the community.

Models such as the Buurtzorg model of care, developed by a social enterprise in the Netherlands in 2006, involve small teams of nursing staff providing a range of personal, social and clinical care to people in their own homes in a particular neighbourhood.

The emphasis is on one or two staff working with each individual and their informal carers to access all the resources available in their social networks and neighbourhood to support them to be more independent. The nursing teams have a flat management structure, working in ‘non-hierarchical self-managed' teams. This means they make all the clinical and operational decisions themselves.

Such models are proven to be both cost and health effective in a number of European countries, in the UK and in Canada, but to succeed in Australia would require a restructuring of funding models for primary health care. The peak nursing organisations are keen to continue their preliminary work with the Labor Government to progress innovative models of primary health care and funding.

Representatives from the Nursing Peaks have just attended the Northern Territory First Nations Primary Care Health Workforce Summit in Alice Springs this week, where the workforce is in dire straits. Nationally in rural and remote areas there seem little relief in sight to improve workforce numbers. Sadly, we have recently seen five nurse practitioners sacked in Doomadgee in favour of employing doctors. The situation there had moved beyond serious. Those doctors never arrived, leaving the predominantly First Nations community exposed with no primary health care services. The Nursing Peaks are questioning whether our Government will allow this to continue.

Karen Booth, President of Australian Primary Health Care Nurses Association (APNA) says…’The population is growing whilst GP numbers are dropping, and health care is becoming harder to access. We need to forward focus and think smart about how we can maintain health services in primary care and keep people health and well. We need innovation in the types and models of care that use all the skills of our highly trained health care teams. There are already very successful models of care using nurses and nurse practitioners to run preventive health clinics and clinics for people with chronic health issues keeping them on track with their health and out of hospital. Registered Nurse prescribing would augment team care by giving patients immediate access to their regular medications, most importantly when they can’t access the doctor. Many people will seek health care, but they don’t always need medical care, so we need to look at how we meet their health needs and conserve doctor care for those more acute problems. We welcome to new Scope of Practice Review

We need to think big picture and better utilise the skills of allied health professionals, pharmacists and community based paramedics to meet immediate non life-threatening health needs and keep people out of hospital’

Leanne Boase, CEO of Australian College of Nurse Practitioners (ACNP) says…’The ACNP is ready to work on the upcoming scope of practice review, ensuring a forward focus on access to quality health care. Nurses represent the majority of the health workforce, are underutilised in Australia, and need to be highly valued and supported as skilled health care professionals now and into the future. As part of that health workforce, Nurse Practitioners and registered nurses working in advanced practice roles must be fully enabled to work, utilising all of their knowledge, expertise and skills to improve health outcomes. Existing barriers to practice must be removed in the interests of better health, and as highlighted in the Intergenerational report, our demand for health care will only increase. It makes no sense to continue to underutilise our greatest resources in health care.’

Annie Butler, National Secretary Australian Nursing and Midwifery Federation (ANMF) says… ‘The ANMF welcomes the Federal Government’s scope of practice review, Unleashing the Potential of our Health Workforce, a recommendation of the Strengthening Medicare Taskforce, which must achieve its aim – to ensure all health professionals are full utilised. The Review will determine how health practitioners can be supported to work to the full extent of their skills and training, which will lead to greater satisfaction for those practitioners and, most importantly, better health outcomes for our communities.

Nurses and midwives, who comprise the majority of the healthcare workforce, have the capacity, expertise, and education to vastly improve health equity and access for people living in all areas of Australia. The review needs to recognise this and that nurse and midwife-led models of care are effective, feasible, appropriate, and cost-efficient.

The Review also needs to address the barriers that currently prevent nurses and midwives from working to their full scope and identify the policy and funding measures needed to ensure nurses and midwives, and all health practitioners, are utilised most effectively. Government must then implement these measures to guarantee a future healthy Australia. ‘