Introduction of 3 new staffing quality indicators – Webinar

[Opening visual of slide with text saying ‘Australian Government with Crest (logo)’, ‘Department of Health and Aged Care’, ‘3 new staffing quality indicators’, ‘This webinar provides providers and workers with information about how to collect and report data for 3 new staffing quality indicators. Data collection will start from 1 April 2025.’, ‘agedcareengagement.health.gov.au’, ‘3 December 2024’]

[The visuals during this webinar are of each speaker connecting via videoconference and visible on the right-hand side of the screen, speaking with reference to the content of a PowerPoint presentation being played on screen]

Ingrid Leonard:

Thank you all for attending today’s webinar. My name is Ingrid Leonard. I’m the Assistant Secretary of the Choice and Transparency Branch within the Department of Health and Aged Care and I’ll be chairing today’s webinar.

I’ll begin by acknowledging the Traditional Custodians of the lands on which we are virtually meeting today. I’m based in Canberra on the lands of the Ngunnawal people and I acknowledge and pay respect to their continuing culture and contribution they make to the life of this city and region. I also extend that acknowledgement and respect to other families with a connection to this region and any other Aboriginal or Torres Strait Islander people who are here with us today.

So the slides from today’s webinar are available on our website and a recording will be accessible on our website in the coming days. We’ve also published quick reference guides on the new staffing quality indicators. And if you haven’t already had an opportunity to look at these resources I encourage you to download them from our website.

Please feel free to scan the QR code on the screen now to view them. And we’ll also include a link to the quick reference guides in the chat.

So I’ll kick off by introducing today’s speakers. So I’m joined by my colleague, Victoria Angel, who is the Director of the Quality Indicators Section within the Department of Health and Aged Care. Victoria will provide information about the three new quality indicators and the collection and reporting of the data.

Tim O’Mahony is a Senior Director, Intelligence and Analysis with the Aged Care Quality and Safety Commission. Tim will focus on regulating compliance with reporting and how the Commission uses quality indicator data.

And finally I’m also joined by Associate Professor Dr Micah Peters who is Director of the National Policy Research Unit within the Australian Nursing and Midwifery Federation who will talk about how the quality indicators will contribute to workforce recognition.

The topics we’ll cover in today’s webinar are the three new staffing quality indicators, why they’re being introduced, data and collection reporting requirements, how the department will help you to prepare, why quality indicators matter, how the new indicators recognise the workforce’s contribution and how they also support quality improvement.

Now we’ll have a Q-and-A session at the end of this webinar. And I encourage you to submit questions in the Slido box to the right-hand side of your screen and we’ll certainly try to get through as many questions as we can. All questions and answers, including those that we may not get to today, will be published in a frequently-asked questions document on our website.

Now we have received a few questions already through the registration process and they will also be considered in our Q-and-A session this afternoon. And just a reminder there’s no option for attendees to turn on their video or microphone.

So now I’ll hand to my colleague, Victoria Angel.

Victoria Angel:

Thank you Ingrid. And thank you all for joining us today. So as you would all know, under the current National Aged Care Mandatory Quality Indicator Program information is collected from residential aged-care services on 11 indicators across critical areas of care that can impact a resident’s health and wellbeing. From the 1st of April next year we’re increasing the number of quality indicators to 14 with the addition of three new quality indicators specifically related to staffing. 

Reporting on the quality of care through the QI Program helps approved providers measure, monitor, compare and improve the quality of their services. It helps older people find information about the quality of aged-care services when making choices about their care. And lastly it helps government monitor the quality of aged care provided to residents and to assist in making evidence-based policy decisions. 

The three new staffing quality indicators are enrolled nursing, allied health and lifestyle officers. These have been chosen after extensive consultation and a pilot to make sure they are fit for purpose. 

We all know how important enrolled nurses are to aged care. Many enrolled nurses have significant clinical expertise and contribute to safe, person-centred care under the guidance of registered nurses. 

Allied health services are vital for enhancing functional health and quality of life for residents. Allied health professions for the purposes of the QI Program are consistent with those defined by the Quarterly Financial Report or the QFR. This includes physiotherapy, occupational therapy, speech pathology, podiatry, dietetics, allied health assistants and other allied health therapies. Professions included in these other allied health therapies are inclusive of social workers, psychologists, osteopaths, music therapists, exercise physiologists, diabetes educators, counsellors, chiropractors, audiologists and art therapists. 

And lastly lifestyle officers support activities to enrich a resident’s wellbeing beyond the medical. Things that will enhance the psychological, spiritual, social and physical wellbeing of aged-care residents. We know what a crucial impact these activities have on the wellbeing of residents.

Expanding the QI Program to measure the impact of these key roles will allow us to recognise the crucial role of the staffing in providing high-quality care. By implementing new staffing quality indicators we will be able to measure and monitor these important roles. 

To undertake this work the department engaged a consortium consisting of HealthConsult, the South Australian Health and Medical Research Institute and the University of Queensland. This involved a literature and evidence review, consultation and a pilot. Our consultation gathered diverse views from a broad representation of people and organisations across the sector. The consortium then developed and tested the three new staffing indicators for residential aged care. The national six-week pilot engaged 69 residential aged-care services of varying size and type and from different states and territories. They tested eight potential data points across the three indicators.

The consultation and pilot found overall support for the introduction of enrolled nursing, allied health and lifestyle services as quality indicators. The change we’ve seen is a step toward recognizing the value of these professions. The consultation and pilot also confirms that care minutes data from the QFR will provide a useful snapshot to measure the impact of the professions, be well understood by providers and provide a useful overview of current practices. The consultation also confirmed that the allied health indicator should factor in residents’ diverse and changing care needs. Finally we know there is limited international evidence regarding lifestyle quality indicators. This therefore means that Australia has the opportunity to lead the world in this area.

These webinars are an opportunity to check in with you so we can make sure our resources are informed by your needs and fit for purpose. So we thought we’d do an audience poll on what resources you currently use to help you collect and report quality indicator data. Please let us know which resources you use most. I’ll give you a moment to complete the poll which should be showing up on the right-hand side of your screen.

You will start to see the results show up on your screen soon.

We’d also now be keen to hear from you about what other resources might be useful.

You’ll see an option has just popped up on your screen to tell us your views. Please let us know what resources you’d like to see in the future and you’ll see the response displayed shortly.

As a result of the Royal Commission’s Recommendation 109 the Australian Government has invested in a business-to-government initiative to streamline reporting, improve data quality and enhance data exchange between aged-care providers and government. Developers can access the B2G developer portal to build software products that enable aged-care providers’ software to communicate with government systems, streamline reporting and data exchange to reduce administration burden for aged-care providers. Developers are building solutions but do not have software products available at the moment. Currently there are four APIs available for developers to build software solutions. The number of APIs will expand over time, with additional details shared on the department’s website.

The B2G quality indicator API is currently being updated to include the three new staffing indicators. And if you’re interested in finding out more please scan the QR code on your screen now. Also software vendors and IT teams can register on the B2G developer portal to start developing software. We will share a link to the B2G developer portal in the chat now.

If you haven’t yet read the quick reference guides I’m sure you’re wondering how these new indicators will be measured. For enrolled nursing the quality indicator will be measured against two data points, the first being the proportion of enrolled nursing care minutes. This is enrolled nursing care minutes as a percentage of total care minutes. And the second data point being the proportion of nursing care minutes. This is registered and enrolled nursing care minutes as a percentage of total care minutes.

For allied health the quality indicator will also be measured against two data points, with the first one being allied health care minutes and then the second one being the percentage of recommended allied health services received. 

For lifestyle officers the quality indicator will be reported against one data point which will be lifestyle officer care minutes. 

Throughout the consultation and pilot we have listened to the sector about the need to minimise additional reporting introduced by the new quality indicators, while also ensuring robust data that will measure and monitor what is important. We have built upon existing reporting wherever possible, with four out of our five new data points for the new indicators coming directly from Quarterly Financial Report data. 

So there will be no additional reporting for these four data points. The information you report through the QFR will feed automatically into your quality indicator reporting within the Government Provider Management System. The only new data that you will need to collect and report is for the percentage of recommended allied health services received. 

To that end you can see on the screen what you will need to do for that additional reporting. First you will complete a single review of care records for each resident each quarter. Then you will collect and report the number of allied health services recommended in care plans and how many of those recommended allied health services were received. This will include reporting on how many residents were assessed for allied health, how many residents were excluded, how many allied health services were recommended in care plans against each discipline and how many recommended allied health services were received against each discipline.

Note that each recommended discipline is recorded only once regardless of how many sessions or appointments occur in that quarter. For example if a resident is recommended physiotherapy in their care plan and receives three physiotherapy appointments this is counted as one recommendation and one recommended service received. This will enable us to understand how many allied health services have been recommended for aged-care residents are actually received and what types of allied health services are being received most often.

In terms of timing you will need to start collecting staffing data in Quarter 4 of 2024-25. That means staffing quality indicators apply from 1 April 2025. You will report the percentage of recommended allied health services received for Quarter 4 by the 21st of July 2025 through the Government Provider Management System. You will also need to submit your QFR data as per the usual reporting dates, which for Quarter 4 of 2024-25 is by the 4th of August 2025. If you do not submit the QFR data on time or you don’t submit it at all this will be considered an automatic non-submission of the relevant quality indicators.

We will extract the relevant quality indicator data you submit through the QFR and undertake calculations to reach the data points for the indicators. This will then be displayed in the QI Program app within the Government Provider Management System. This will allow providers to see all their QI Program data in one place.

We’re here to help. As I said earlier we have put the links to the four quick reference guides in the chat. And next year we will be publishing updates to many resources including FAQs and the Quality Indicator Manual, both part A and B, which I can see from the earlier poll that so many of you use to support you to report. You can see on screen the link to the landing page that brings up all of the resources together for the QI Program and we’re putting these two links in the chat now.

And for our last poll please tell us if you think you now have the information you need to prepare, to collect and report data for the new staffing indicators. You’ll see again the poll is on the screen. If you can take a moment to respond.

Thank you for your time today. And thank you Ingrid. Back to you.

Ingrid Leonard:

Thanks very much Tori. And I’d like to thank everyone who submitted a question so far and responded to our polls.

I’d now like to welcome Tim O’Mahony, the Senior Director of Intelligence and Analysis at the Aged Care Quality and Safety Commission to speak. As a brief introduction Tim leads the group responsible for the use of aged-care data and intelligence within the Commission, and reporting of data and analysis to the sector, including through the Commission’s sector performance reports. Tim’s section also helps the Commission understand risk in aged care through the analysis that they undertake. Thanks Tim.

Tim O’Mahony:

Thanks Ingrid. Hello everyone, nice to be with you today. I’m going to outline the Aged Care Quality and Safety Commission’s role in the Quality Indicator Program, including our roles in regulating reporting and also how we use quality indicator data in our regulatory practice.

As with other reporting responsibilities under the Aged Care Act such as Quarterly Financial Reporting, we monitor and regulate compliance of reporting for quality indicators. Importantly like all our regulatory practice, we take a proportionate response to any non-compliance. What this means is we engage with providers where there has been non-compliance of reporting obligations to understand why there may have been delays. We also consider the length of those delays and whether they are repeated. If needed we do take regulatory action with providers. 

We also use quality indicators as a dataset to understand risk about providers alongside other datasets that we have access to. This helps us to engage with providers early and to prevent harm to older Australians where possible.

You can visit our website, which is agedcarequality.gov.au, to find out more about our compliance approach and our full reporting requirements through our compliance and enforcement policy. 

I’m now going to talk about how we use quality indicator data in understanding risk, which is outlined in our regulatory strategy also available on our website.

Many of you may have seen this before. This is the aged-care regulatory diamond. The top-half of this diamond demonstrates that our expectations at the Commission of providers don’t just stop with compliance of meeting obligations. Our expectations are that providers strive for better practice and excellence and our activities engagement with providers support this.

Our use of quality indicator data is mostly related to the yellow band in this diagram which is risk-based monitoring. This is where we identify providers that are higher risk than their peers and providers with a holistic view of risk about those providers or risk around a specific issue. We engage with providers in risk-based monitoring through onsite visits and discussions or requests for information. 

I’ll now outline how quality indicator data informs this work.

This is our risk surveillance model which is also in our regulatory strategy. And it outlines how we use data and information to understand risk about providers and workers. You’ll see on the left-hand side of this diagram that quality indicators are one of the datasets we consider.

On this slide the list of datasets we use include complaints and reportable incidents we receive, our findings from audit, but also Quarterly Financial Reports. As Victoria mentioned much of the data of the three new quality indicators will be presented through the Quarterly Financial Reports.

We don’t use these datasets in isolation though. We consider multiple datasets together to understand risk. We bring together these data as risk profiles either about the provider as a whole or in relation to a specific issue.

To finish my part of today’s webinar I’ll now outline a case study on how we use quality indicators in practice.

The Commission and the Department of Health and Aged Care have been running a campaign on food, nutrition and dining in aged care. This includes a range of activities that both support providers to improve and also identify where there may be issues with food, nutrition and dining.

In the middle of the diagram on the left-hand side of this slide is targeted monitoring and compliance which includes the Commission visiting a subset of residential services to observe their food, nutrition and dining practices onsite.

Providers and their services were prioritised for these visits based on their risk profiles, with higher-risk providers targeted. To do this we used a wide range of data which I showed on the previous slide. This included complaints we received about food, nutrition and dining issues, non-compliance of the relevant requirement of the Quality Standards, food expenditure as recorded in the Quarterly Financial Report, responses to the resident experience survey question ‘Do you like the food here?’ And relevant to this webinar, quality indicator data on unplanned weight loss was used as a proxy for nutrition information about that provider.

I’ll now hand back to Ingrid.

Ingrid Leonard:

Thank you Tim. It’s great to have the Aged Care Quality and Safety Commission’s perspective on the new staffing quality indicators and what that really means for the sector.

So our final speaker today is Micah Peters, the Director of the Australian Nursing and Midwifery Foundation’s National Policy Research Unit. So Micah was appointed as the ANMF federal office’s National Policy Research Advisor in 2018. He is an Associate Professor and researcher based at the Rosemary Bryant AO Research Centre at the University of South Australia.

 In his role he aims to support and empower nurses, midwives and carers to use the best available evidence to improve the health and wellbeing of all community members. Over to you Micah.

Micah Peters:

Thanks Ingrid. And thank you everyone. 

So yeah the ANMF use aged-care context as healthcare context. And that’s why healthcare professionals and staff are employed there to provide care. That’s also most often why people enter residential aged care. Older people are individuals and have a diverse range of care needs and preferences. These also change and evolve over time. Older people in aged care are often older, frailer and have more complex care needs than in the past. This is particularly because many people remain in their own homes for longer because they’re living healthier, longer lives. It’s therefore important to have diverse multi-disciplinary care teams to deliver care to meet those needs effectively, appropriately and in a coordinated and timely manner. 

Members of care teams have diverse roles and responsibilities and support and collaborate with each other. This team-based care enhances worker satisfaction and confidence in their ability to provide better care and improves interfaces with the broader healthcare system and professions, for example in hospitals, general practices and specialist clinics. Enrolled nurses, lifestyle officers and allied healthcare professionals are important members of these teams and must be valued for their contributions, clinical skills and specialised expertise.

The Royal Commission’s recommendations and initial government response didn’t include specified direct care time to be provided by enrolled nurses. Instead registered nurse care time was distinguished from care provided by the wider direct care team. Our members told us that this meant that some providers reduced enrolled nurse shifts and roles, converted EN roles to personal care worker roles or reclassified ENs to care workers. This is in the context of widespread nursing workforce shortages.

Our members in the ANMF have been concerned about the risks of this deskilling of the workforce increasing negative impacts on residents in terms of worse clinical outcomes and care experiences. Members have reported in some nursing homes personal care workers have been required to administer medications. And while care workers provide an essential role in assisting with medication administration, this role should be undertaken by nurses. 

Fewer ENs working in aged care means fewer regulated nursing staff to identify, assess and respond to changes in residents’ health status. It also means fewer nursing staff for care workers to escalate concerns to and less support for registered nurses leading to role intensification. A significant body of evidence shows quite clearly that more nurses at the bedside enhances care outcomes. So this is a real concern for us and our members.

Including staff-related quality indicators helps to embed sufficient staffing levels and skills mixes in nursing homes. It helps with transparency and accountability so that consumers and workers can make decisions based on clear information reported by providers that underpins how care is delivered and by whom. 

Our members and published evidence report that having enough of the right kind of staff supports more timely and efficient care. Sufficient staffing improves interfaces with the wider healthcare system and in-reach health professionals. It reduces reliance on emergency services and emergency departments which benefits the whole community. This means that older people can receive safer, higher-quality care in place. And where indicated reduces the risk of unnecessary and distressing transfers for care that can be provided by a skilled, well-supported healthcare team. 

More nurses onsite also provides enhanced engagement with residents, family members and visitors. Valuing enrolled nurses as part of aged-care teams also enhances staff wellbeing and factors regarding workforce attraction and retention which will support nursing homes to provide better continuity of care from familiar staff and improve turnover and workforce stability.

While not directly related to the quality indicators, some of my recent research has focused on barriers and enablers for nurse practitioners working in Australia’s aged-care sector. NPs are registered nurses with additional advanced Master’s qualifications and provide advanced nursing care. They can be employed in aged care or work in primary health or hospitals providing in-reach care. They’re effective in preventative and primary healthcare provision and can also have specialised expertise in palliative and end-of-life care, care for older adults and other clinical focuses. Again having enough nursing staff onsite providing continuity of care helps create an environment where wider care teams like NPs can provide effective and timely care in place.

These new quality indicators are a positive move that helps providers track care delivered by members of their direct care workforce and transparently report that data to workers and consumers. It will enable more informed decision-making for all stakeholders such as consumers, workers and industry bodies and also support better outcomes and experiences such as better working conditions for staff which in turn supports better health outcomes for residents. 

These quality indicators will provide important data to help stakeholders make informed decisions regarding workforce structures, rostering and the health and wellbeing outcomes of residents. They will also help inform and provide greater transparency regarding budgets and staffing models. With better oversight and reporting, providers will be able to make more informed decisions regarding staffing, benchmarking and efforts to engage in continuous quality improvement. They’ll provide greater assurances for consumers and workers and help to create an aged-care system with enough of the right kind of multi-disciplinary healthcare staff to deliver better outcomes and experiences.

Thanks everyone.

Ingrid Leonard:

Thank you Micah.

Now you may have heard that the latest sector poll survey is open now until the 13th of December. I absolutely encourage you to complete the survey and give your feedback. You can access it by using the URL or the QR code on this slide and it takes about 20 minutes to complete.

So that brings us to the end of our formal presentations today and we’ll now begin the question and answer session. So I’ll start with some of the pre-submitted questions and then move into the questions that have been asked during today’s webinar.

So our first question is:

Q:          Why are we introducing these new staffing quality indicators?

So I’ll hand to Tori. 

Victoria Angel:

Thanks Ingrid. So by implementing the new staffing quality indicators for enrolled nursing, allied health and lifestyle officers we will be able to measure and monitor these important roles. We’ve also listened to the feedback from providers and feedback from residents and their representatives that the 24/7 nursing requirement could lead to a decrease in these important professions, being enrolled nurses, allied health services and lifestyle officers. However we also know that the sector has moved a long way since the introduction of the 24/7 nursing requirement and has made good progress to implement this measure.

Ingrid Leonard:

Thanks Tori. Thank you.

Another one from the pre-submitted questions. 

Q:          Is this webinar relevant to Support at Home? And if so where can we find out more information? 

Now look hopefully we’ve answered that throughout the webinar. But Tori did you want to directly respond to that one?

Victoria Angel:

Yeah. Thank you Ingrid. So I think hopefully we have as well. But this webinar won’t be including any information on the Support at Home Quality Indicator Program as this is just around expanding the current residential aged-care National Aged Care Mandatory Quality Indicator Program. 

Work is currently underway though to expand the QI Program into home care. The indicators to be introduced into home care are yet to be determined. And if people are looking for further information please have a look on our website for the work that’s been undertaken to date and is continuing to happen at this time.

Ingrid Leonard:

Thanks Tori.

Next question. 

Q:        So we are collecting workforce QI data for enrolled nurses already. So how is this different from the new staffing quality indicator on enrolled nursing? 

Micah I might hand to you for that one.

Micah Peters:

Thanks Ingrid. Well I think the value of reporting care minutes for ENs alone could be diminished if it’s reported in isolation. So by reporting it as a proportion, as well as RNs and other care staff minutes, it provides a better picture of the service workforce and the skills mix. And EN minutes were already reported and publicly available on My Aged Care website and they are now reported separately to assistants in nursing and personal care workers. So there’d be limited value in including them as part of the QI Program itself.

Ingrid Leonard:

Thanks Micah. Thank you.

All right, next question. 

Q:          Do the new quality indicators stipulate, recommend or enforce any minimum requirements for care minutes pertaining to allied health? 

So look in short the answer to that is no. But I’ll hand to my colleague, Victoria Angel.

Victoria Angel:

Thanks Ingrid. So Ingrid is correct. The answer is no, the short answer. The primary intent of the staffing indicators is to captures services and care delivered. So the new allied health quality indicator data points in combination are intended to help providers address potential gaps in allied health service provision and care. Providers will also be able to see this data alongside their other QI Program data and use it for benchmarking and quality improvement. Whilst the allied health care minutes data point captures care minutes derived from QFR labour hours, it is not intended to be used to develop broader care minute targets for allied health. Introduction of any such future measures would be a matter for government.

Ingrid Leonard:

Thanks Tori.

Now one of the popular questions.

Q:          The QFR reporting and submission period is different to the QI submission date. How will the department compare this data and how do we see the results in a timely manner?

Tori back to you.

Victoria Angel:

Thank you. So they are different reporting dates. And that has been an intentional decision that’s been made previously so that it sort of lessens the reporting requirement on providers to not have the same due date. 

So what it will mean for the staffing indicators, because the information for four out of the five data points is coming directly from the QFR, once you do report your QFR information in the QFR app on GPMS that will then be visible in the QI Program app. So you’ll continue to report your QI Program data by the 21st day of the month after the end of the quarter. And that information will be available to you straight away, as it is now. And then once you do report in QFR you will then see that in your QI Program app as well.

So as quickly as you do it, you’ll have that visible in GPMS.

Ingrid Leonard:

Fantastic. Thank you.

Another one of the popular questions.

Q:          Why is there no qualification requirement for lifestyle staff? Why is the department continuing to use the old-fashioned term of ‘lifestyle’ instead of ‘recreational therapy’ or ‘leisure and health’?

Tori did you want to respond to that?

Victoria Angel:

Yeah. Sure. So we did test as part of the development stage of these indicators and whether or not it should be a qualification requirement for lifestyle staff. The feedback that we did receive as part of the consultation was that that would be quite difficult for a lot of people to capture. And if that was something we were capturing, it would start to stifle innovation on the lifestyle support that is provided to residents. 

In that we heard examples from some providers that if it’s at nighttime and somebody has dementia but that’s when they would like to go and pray or if that’s when they would like to do a specific activity, if they are relying on a specifically-qualified lifestyle staff member and they’re not on roster at that time, that person may miss out on doing that activity that is really beneficial to them and something that they would enjoy and would like to do. So if they have other lifestyle officer staff on, that is something that could be done at any point in time. 

As to the second part of the question which goes to the old-fashioned term of ‘lifestyle’ instead of ‘recreational therapy’ or ‘leisure and health’, this is something that we can take up with our Quarterly Financial Report policy owners. We have matched the language that’s used in the QFR for consistency with the QI Program so as not to confuse providers when it comes to reporting that. It is the same information that’s being collected. But happy to take that away and have a conversation with them about the language that’s used.

Ingrid Leonard:

Thanks Tori.

There’s a question here.

Q:          Will there be additional funding available for allied health?

So the new quality indicators which we’re discussing this afternoon really don’t go to the funding issues. The introduction of these quality indicators is certainly reflecting the importance of ENs, allied health and lifestyle services in a residential-care environment. And it’s about collecting relevant data to support continuous improvement in a residential aged-care service. So there is no additional funding or funding isn’t actually contemplated as part of this QI work.

Another question.

Tori coming off the back of probably the previous one. 

Q:          Do visiting ministers of religion or visits from those people count towards lifestyle hours as they contribute towards spiritual wellbeing?

Victoria Angel:

I would need to check that one, I’m sorry, with the policy area. I’m happy to come back with our published FAQs. My understanding is that I think that they are captured but I need to just confirm that. I’m sorry Ingrid.

Ingrid Leonard:

No problems. We will publish the outcomes of the FAQs on our website after the webinar. And so that will be able to be responded to there.

Another question.

Q:          Where do nurse practitioner hours sit? E.g. we have a wound consultant that is on a referral basis. Also do our exercise physiologists essentially count towards I assume within the allied health QI? 

Now in broad terms the definition of allied health, as Tori explained before, is actually taken from the definition for the purposes of the Quarterly Financial Report. So Tori I’ll hand to you to provide any sort of supplementary information on that question. 

Victoria Angel:

Thanks Ingrid. And I can confirm exercise physiologists are included in the other allied health therapies as one of the professions there. So you would be capturing that in your QFR and that would then carry across to the allied health care minutes indicator. And then you should also be capturing that for the allied health services received indicator as well.

Ingrid Leonard:

Great. Thank you.

Q:          Is the purpose of all of these indicators to evaluate the quality or quantity of care?

So I’ll kick off and then I’ll hand – Micah you might have some kind of reflections to share in response to this. 

So the Quality Indicator Program as the name suggests is absolutely about the provision of quality care. And the information and the data that’s collected through the various quality indicators which make up the program are intended to assist providers in a continuous improvement journey regarding the care and services that they actually provide to older Australians and residents within their care. 

Micah did you have anything you’d like to add to that?

Micah Peters:

Yeah. Thanks Ingrid. And I think it speaks to I guess the notion of having enough time, so quantity of care, and enough of the right staff to deliver that care is fundamental to the quality of that care and those care outcomes. So measuring direct care minutes provided is a good measure of what underpins quality care outcomes and experiences. So I think that they sort of go hand-in-hand in many ways.

Ingrid Leonard:

Thank you. Agree. Thank you.

There was just a question there.

Q:          How are you defining allied health? 

So just recapping that definition is consistent with the definition that applies for providers reporting on the Quarterly Financial Report. And that was actually available in our slides, so that’ll be published alongside the outcome of today’s webinar.

Q:          Do recommendations for allied health need to be justified or does it just need to be recorded who’s making the recommendation? How does this work? 

I’ll kick off and then I’ll hand to you Tori.

So where care needs are assessed it is an expectation that those needs are outlined in an individual’s care and services management plan. And that’s something that is managed by the provider but certainly in conjunction with visiting GPs and allied health professionals. So if in fact a recommendation is made for allied health assessment or assistance the provider then would work with the relevant allied health profession to organise and provide that care.

Tori did you have anything you wanted to add to that?

Victoria Angel:

No. I actually think you’ve answered that perfectly Ingrid. That’s correct. If it’s in someone’s care plan that they should see an allied health profession and then they receive that service, both of those data points would be captured under the new indicator. In the same way if it was recommended that they didn’t receive it, you would still capture that it was recommended.

Ingrid Leonard:

Thank you.

There’s a question here once again for the department.

Q:          What support will be provided in terms of templates and assistance in pulling together the data, noting that it is time consuming to collect that data?

Tori did you want to respond to that?

Victoria Angel:

Yeah. Sure. Thanks Ingrid. So for the four data points that obviously are part of the QFR there is nothing to report with the QI Program. So you would just continue reporting your data. There’s nothing additional. We will just pull information from that to do the calculations for these indicators. 

For the new allied health one that will require reporting, we do have the two resources which majority of you I’m sure would be aware of currently on the department’s website. Which is the data reporting template. So that will be updated or has been updated. There is a version available now on the website that includes that allied health data point in there that you can be using. 

And in the same way if you are a provider that manages reporting for multiples services and you do use the bulk upload function, that template has also been updated to allow for you to add in that data input. 

And then obviously if you just do single-service reporting, the GPMS system as well will be updated ahead of 1 April to allow you to then report directly in there. But the data reporting template will definitely be the one that will be most helpful for people and that is available on our website now.

Ingrid Leonard:

Thanks Tori. And this is probably just a follow-on from that. 

Q:          Timing in terms of when the QI portal document upload might be available?

Victoria Angel:

So it will not be available until 1 April. So that’s the first opportunity that someone would have to report is from the 1st of April. So the IT system will go live on the same day.

Ingrid Leonard:

Thank you. Thanks.

One of the popular questions.

Q:          What happens when the care plan states that a dietician or similar allied health professional is used as required or at least annually? How do we report against that type of scenario?

Tori.

Victoria Angel:

So in that instance you would report that when it is I guess first put into the care plan. So I imagine it would be reviewed annually. So if it is put in say for this quarter, you would report it that it is a recommendation. And then when that service is received, that’s when you capture that it was received.

Ingrid Leonard:

Great. Thank you. Thanks.

And then once again the specificity of the allied health services data.

Q:          Will the percentage of recommended allied health services received be reported in the QFR or elsewhere?

Tori.

Victoria Angel:

That’s the data point that will be reported under the QI Program app and as part of the QI Program reporting. So by the 21st day of the month, at the end of every quarter is when you’ll report that data. So not through the QFR.

Ingrid Leonard:

Thank you.

Q:          So how would these new staffing indicators align with and are complementary to the quality indicators that are clinical?

So I’ll sort of start there. 

So as you know there are 11 quality indicators that make up the residential aged-care quality indicator program currently. These new three staffing will take the indicators to 14. 

There is one in particular, current QI, which deals with workforce turnover. And as the name suggests it does look at the degree to which there has been turnover in that quarter for which it is reporting. So the new staffing quality indicators which we’re discussing this afternoon aren’t duplicative but certainly complementary to the other quality indicators. They will provide a range of information and data which isn’t currently available, particularly across the three streams, allied health, EN and lifestyle.

There’s a question Tori.

Q:          Is it likely that we will soon have to report on GP minutes per resident?

Victoria Angel:

No. That is not something that we are looking into for the QI Program. And any inclusions or expansion of the program is a matter for government to decide on, but that’s definitely not something in the near future.

Ingrid Leonard:

Thank you.

And following that there’s another question.

Q:          Will these indicators form part of the star ratings? 

So I’ll respond to that. There’s no decision by government to include the three new staffing QIs as a part of the star ratings. Certainly that would be subject to a future consideration and decision of government. 

And it is worth pointing out that in order to – before we even got to that point there would certainly be a need for a dataset which is quite mature. And generally that takes sort of some two years or so before that dataset would even be considered for possible inclusion in star ratings.

Tim there’s just a question here which you might respond to on behalf of the Commission. 

Q:          So following I guess from your presentation how do the Commission use the information from quality indicator reporting in your regulatory activities?

Tim O’Mahony:

Thanks Ingrid. So as I mentioned during the presentation I gave, we look at it in the context of risk and characteristics about a provider. There is some really useful information and I’d encourage all providers to use that themselves to understand their performance and how they’re going. But we look at those data to understand providers in comparison to each other. So from one provider to another we look at that over time. But the important thing is we use it as part of a broader range of data. Not in isolation but we look at it more holistically. We also work closely with the Department of Health and Aged Care on what’s been captured through quality indicators if there’s any trends to see if there’s areas that we need to focus on.

Ingrid Leonard:

Thanks Tim. Thank you.

Just a question here. Micah I’d be interested in your views for this one.

Q:          Just around attraction and retaining staff in regional areas and whether you have any comments in respect of the importance or the role of quality indicators in that attraction and retaining of quality staff?

Micah Peters:

Yeah. Sure. Thanks Ingrid. I think it speaks to transparency in terms of stakeholders, workers being able to look at the staffing profile, how providers are performing in terms of those quality indicators and then being able to make an informed decision regarding their willingness to work there. 

So if a provider is performing well in terms of their quality indicators particularly regarding staffing, that speaks to nurses, enrolled nurses, registered nurses, other staff being able to see that if they worked in that nursing home and that provider they would be supported by a sufficient number of other staff to be able to support them and deliver care in their work. So I think in that way it provides a supported, better working environment for other staff which then in turn addresses issues around retention and attraction. And I understand that that can be particularly challenging in regional and remote areas with lower populations and wider issues regarding attraction and retention. But I think there is a link here between quality indicators and improving attraction and retention for them as well.

Ingrid Leonard:

Thank you. Thanks.

A question here.

Q:          The data needed for the new indicators may not be available in our existing systems. We’d like to get some advice from the department on how to manage the dataflow.

Tori I’ll hand to you, noting that in your presentation you spoke to which of the data sources will be drawn from the Quarterly Financial Report. But over to you.

Victoria Angel:

Yeah. Thank you Ingrid. So I think as I have said a couple of times, so four of the five data points will come from the QFR. So I think whatever process you’re using to report that information, then this doesn’t change that. You will continue to do it that way. 

The allied health services recommended and received, that will be the new data point. Which is why we have said that if it is recommended in a care plan, that that’s the data point. So that it’s a consistent way of measuring it. Every resident should have a care plan. We would expect that in that care plan it does recommend if people are to see an allied health profession. It means that we can make some consistency across the sector when it comes to the reporting.

We do understand that for some people this will be something that will be done manually. We have heard from other providers though that they are talking to their software vendors about getting it to be performed or be able to be pulled as part of other QI Program reporting. So I think I would encourage people, if you haven’t already, to possibly talk to your software vendor to see if there’s a way that they can streamline that for you, given we do know that there are a number out there that are doing that currently.

Ingrid Leonard:

Thanks very much Tori.

There’s a question.

Q:          Will the definition of allied health be updated as new professional groups are added to the Allied Health Professions Australia? 

So in response to that, the definition of allied health for the purposes of the Quality Indicator Program will remain consistent with the definition used for Quarterly Financial Reporting. So to the extent that any changes to that definition for QFR purposes, they will be considered for flow-through in terms of the QI. But certainly the definition for the purposes of this staffing indicator remains consistent with the QFR definition.

Now we’ve sort of dealt with quite a few of those.

Now I think I’ll pop back over to the more recent ones. So there’s a question here.

Q:          Is the expectation that we review care plans for all residents and find recommendations by reading all care plans? 

Tori did you want to respond to that?

Victoria Angel:

That’s correct. So it is a once-a-quarter review of all residents’ care plans and documenting down when it was recommended that they received an allied health professional service. And then if they have then subsequently received that as well, it’s capturing that information.

Ingrid Leonard:

Thanks.

A new question that’s just come in on lifestyle minutes.

Q:          So really just trying to seek some clarity around what’s involved in lifestyle care minutes, so how they – essentially to assist their reporting?

Victoria Angel:

So that one is a requirement under the QFR. So whatever you’re reporting now for lifestyle care minutes you will continue to do so. We will do calculations on our side to get to the quality indicator which will then be usable in your QI app on GPMS.

Ingrid Leonard:

Thank you.

A template question.

Q:          The QI reporting data template on the Department of Health website is not yet updated. So just seeking clarification in terms of the timeframes for that?

Tori did you want to circle back on that previous advice?

Victoria Angel:

Yeah. It has been updated. I wonder if it’s maybe in a different spot. I’ve got a couple of people from my team on. I might see if we can add the link into the chat now on where that is. 

Ingrid Leonard:

Lovely. Thank you.

And a question here.

Q:          Will the new staffing indicators apply to multi-purpose services?

Tori.

Victoria Angel:

No. So currently it is not a requirement for multi-purpose services to report under the Quality Indicator Program. So we’re not looking to change that as part of this process.

Ingrid Leonard:

Thank you. That’s right, any application of the QI Program to I guess multi-purpose services or other programs will certainly be subject to a future decision by government.

I’ll flip back over to the popular questions.

Q:          And are there any minutes for any category provided by unpaid volunteers included? So essentially the question is do we only include paid employees and sort of other paid third-party consultants for the purposes of reporting against these QIs?

Tori.

Victoria Angel:

So for the four indicators that feed into the – that come from the QFR, it is just paid employees or paid third-party labour hire staff members. I can’t imagine and I can’t think when there would be a volunteer allied health service but I’m happy to be told otherwise. So I would imagine they will all be paid as well unless there is an unusual circumstance where someone is getting free allied health.

Ingrid Leonard:

Thank you.

Q:          And there’s a question here in terms of the definition of other allied health.

So just circling back to your presentation Tori and noting the definition for the purposes of the Quarterly Financial Report. Did you want to respond to that?

Victoria Angel:

Yeah. I can run through what ‘other’ is again. This is all available on the department’s website as well. But ‘other’ is social workers, psychologists, osteopaths, music therapists, exercise physiologists, diabetes educators, counsellors, chiropractors, audiologists and art therapists.

Ingrid Leonard:

Thank you. There’s a question here. 

Q:          Is there anything changing for the QFR reporting because of these QI changes? 

In short no.

We have worked with our colleagues to ensure consistency in definition as we’ve spoken about this afternoon. And many of the data metrics that will be captured under these new QIs are being drawn by the QFR as Tori has mentioned today. So there’s no immediate changes to any of the QFR reporting due to the introduction of these quality indicators.

And probably time maybe for one last question.

I’m just trying to find one that we haven’t necessarily been through before.

Q:          Will this data be used to develop care minutes for allied health and boost the level of allied health services?

So in response to that question the QFR, the Quarterly Financial Report, already contains reporting on the degree to which allied health services are obtained in residential aged care. And the reporting against the quality indicator will supplement that and provide some really important and useful information for both providers and also for government in terms of the use of allied health services.

So look it is now 3 o'clock. Thank you all for our speakers today and everyone who submitted questions. As I said we’ll publish responses to all of the questions received today in coming days. I hope you found today’s webinar informative and helpful as you begin to plan for the introduction of the new quality indicators. 

When the webinar finishes just a short survey will pop up in your browser. It only takes about a minute just to answer the three questions. We’d be extremely grateful if you did answer those just to help us improve in future webinars. Thank you very much everyone. 

[Closing visual of slide with text saying ‘Australian Government with Crest (logo)’, ‘Department of Health and Aged Care’, ‘Webinar survey’, ‘Thank you for attending today’s webinar. Please provide your feedback by answering 3 short questions.’, ‘agedcareengagement.health.gov.au’, ‘3 December 2024’]

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