Aim of Assessment:
The purpose of the paper is to enable students to get insight into health and social-political issues in aged care as well as evaluate and critique health service delivery for older people. On successful completion of this assessment Students have to meet the following learning outcomes:
1. Critique representation of older people in policy laws and legislation and health social service delivery.
2. evaluate the rationales for resources allocation, service provision and co-ordination of service for older people using a social capital approach.
3. Critique models of health service delivery for older people including models of wellness, user pays, case man, agement and active ageing. (WHO)
Critical Evaluation of Primary Healthcare for Older People living in New South Wales
Assessment 2.4.1 Essay
Concerning the increased advancements in technologies and innovation, rapid growth in outcomes can be observed in global healthcare systems. Australia is not an exception to such a promising trend, as the country is witnessing a continuously rising rate of aging population. While the aged population throughout the country is estimated to grow steadily over the next decades, it is essential for healthcare policymakers and providers to address and respond accordingly to associated issues. Rising rate of aging population has become an irrefutable concern for Australia. Developing aged care services in the form of primary healthcare, thus, is gradually becoming the need of the hour. As a result, this paper aims to explore relevant peer-reviewed academic articles to collect suitable ideas of the Australian primary healthcare system dedicated to elderly persons. It assists this essay to critically evaluate one of the major healthcare services in the context of New South Wales (NSW). Critical arguments are formed to explain the condition of primary healthcare in Australia for older individuals, concerning the introduction, resource allocation and delivery of SMHSOP approach in NSW.
Primary healthcare usually encompasses a wide range of services and providers across public, private and non-government levels, where, from the clinical perspective, it involves the first layer of services encountered throughout the healthcare. As primary healthcare necessitates cooperation among health professionals to working towards providing comprehensive, consistent and person-centred care, developing such care services addressing the needs of older population throughout communities has become a challenging task for members and associates of the country’s entire healthcare system. As 15 percent Australians, i.e. 3.8 million individuals were aged 65 years and above in 2017, the concept of primary healthcare for aged population across different communities has growingly become relevant in the delivery of proper care (Lucas et al. 2018). In Australia, ranging from health promotion, screening and prevention to early intervention, management and treatment, several kinds of services are delivered as part of the primary healthcare system.
These services, on the other hand, are principally categorised to address healthcare needs of specific cohorts, such as older persons, young individuals, children, maternity and population living across rural and remote areas. Primary healthcare services also target individuals with specific lifestyle choices and conditions, such as sexual health, drug and alcohol abuse, mental health and cancer among others (Freeman et al. 2016). In case of older population in Australia, these individuals are prone to experience chronic illnesses, disabilities and physical or cognitive incapacities, leading the primary healthcare for the older individuals to develop proactive response to provide required care and support at various levels. Aged care, in this case, can be used as the specific term that defines services for older Australians requiring specific help at home or unable to live independently.
Concerning the work of Bradbury et al. (2017), various communities in Australia, including the NSW, primary healthcare services for older persons cover a wide range of health and social care services delivering with the effective engagement of public, private, not-for-profit, as well as informal carers. While non-profit agencies include the community-based or residential care units, informal carers principally include family and friends of service users. More than one million older Australians per year are currently receiving formal aged care services while the particular numbers of people are expected to cross over 3.5 million annually by 2050 (Bradbury et al. 2017). Additionally, the announcement of the Commonwealth Health Minister in April 2015 to establish 31 new Primary Health Networks is further expected to reshape the delivery of primary healthcare services to people throughout the entire nation, thereby increasing the access to right care in the right time (Doran and Hornibrook 2016). In improving the delivery of primary healthcare services at the local level, the ministers and local governments in Australia are providing major attention to aged care.
However, several estimations concerning the delivery of aged care services at the primary levels are greatly expected to face substantial challenges due to the pressure of continuously rising aging population, with their ever-increasing needs and expectations. It appears that relationship between longevity, morbidity and disability is challenged by a complex array of conflicting trends. While developing a control mechanism through healthcare can significantly prevent the progress of chronic diseases to explain the equilibrium between decline in mortality and increase in disability, Booth et al. (2016) find no clear evidence indicating a dynamic equilibrium throughout the country. Along with the increase in years lived with disability, the study rather observes that the number of years with severe limitations continues to rise. Despite the growing proportion of population is aging over 65 years, the population belonging to 85 years necessitates increased accountability of primary healthcare services for such population cohorts.
Concerning the specific approaches to deliver primary healthcare to aged persons in Australia, NSW in particular, the services need to reflect the rising expectations regarding type and flexibility of care alongside community concerns related to variability in the quality of care. The example of Specialist Mental Health Services for Older People (SMHSOP) in the context of NSW can be discussed in this case. The particular approach to serving older people in the community is on the verge of experiencing new changes in the form of innovative service initiatives, such as behavioural assessment and intervention services alongside establishment of special care units across residential care facilities in the community (O'connor et al. 2018). The primary healthcare dedicated to aged individuals benefits the entire NSW with its caregiving approach that welcomes effective cooperation of leading clinicians and allied health professionals, committed medical nurses and other staff with their specialisation is treating mental health and other disabilities.
Given the wide range of changes, which recently introduced in SMHSOP, it is clear that an adequate amount of resources is invested to promote innovation and enable integration of advanced technologies in the clinical areas. Based on the critical analysis carried out by McMinn et al. (2017), it can be argued that resource allocation is significantly determined by clinical functions, such as capacity building, specialist treatment services, clinical assessment, mental health assessment and joint care planning adopted by the particular care delivery plan in NSW. The Joint Care Planning scheme, for example, essentially leads effective collaboration between general practitioners, aged care service specialists, general hospitals and adult mental care teams to develop an effective care mechanism for older patients in line with ‘severely and persistently challenging behavioural model’ (McMinn et al. 2017). Several other prevention programs (i.e. suicide prevention activities) and mental health promotion programmes (i.e. health aging programs), on the other hand, requires the investment of substantial amount of capitals from the local government, as well as private and non-government sectors.
Existing challenges involving current services and programmes providing require care services to older people for their chronic illnesses, mental health problems and disabilities are continuously giving rise to several strategic priorities, which must be addressed by the present service system, as well as the NSW initiatives. Residential and community aged care services play a predominant role throughout the community in providing primary care services older individuals across localities. The Australian Government Department of Health and Aging (DoHA) regulates planning, monitoring, funding and operations of these facilities. However, in order to improve service provisions in line with growing requirements, DoHA needs to work more closely with NSW Health for enabling development of construction relationship between residential and community care services and longer-term hospital care facilities through engaging aged care services and public sector mental health divisions (Borotkanics et al. 2018).
From the perspective of mental health care for older Australians, NSW has achieved significant accomplishments, where the involvement of general practitioners can be essentially observed in providing maximum of primary mental healthcare. Additionally, the involvement of community health services, including the availability of speciality mental health services has assisted in achieving significant developments. Despite the availability of such promising services and facilities, significant breakthroughs are yet to achieve by the NSW communities to respond accordingly to the needs of growing number of older people, with lifelong, recurrent or emerging mental illness, often associated with aging (Stokoe et al. 2016). Specific challenges can be observed due to the absence of targeted and specially defined mental health promotion, early intervention initiatives and prevention approaches.
The overall discussion regarding the primary level of healthcare facilities for older persons in Australia, especially in NSW, suggests the active engagement from different regulatory bodies, as well as public, private and non-governmental collaboration to address ever-evolving needs and expectations associated with growing numbers of aging population. Despite the significant developments using increasing funding, rapid innovation and adoption advanced technologies, especially through community-based and residential aged care facilities, addressing the lifelong and emerging needs of older Australians regarding their illnesses and disabilities requires a greater focus on policies, programs, services and facilities. Outcomes from these particular perspectives must appropriately match older people with their specific needs and expectations. The overall essay, hence, offers a critical discussion that prioritises on mitigating existing barriers encountered by older persons across communities in accessing the right level of aged care and community support at the right places.