The Scott Morrison-led Federal Government has formally responded to the Royal Commission into Aged Care Quality and Safety’s Interim Report (Interim Report). In a media release dated 25 November 2019, the Government states that they are:
“taking strong action to respond to the three priority areas identified in the Aged Care Royal Commission’s Interim Report release on October 31, by increasing home care packages, reducing chemical restraints and getting young people out of residential aged care”.
The Government has promised a $537 million funding package which it will spend as follows:
- $496.3 million for an additional 10,000 home care packages
- $25.5 million to improve medication management programs
- $10 million for additional dementia training and support for aged care workers and providers
- $4.7 million to help meet new targets to remove younger people with disabilities from residential aged care
The Government has also declared ‘Quality Use of Medicines and Medicines Safety’ a ‘National Health Priority’, and has made new principles titled Quality of Care Amendment (Reviewing Restraints Principles) Principles 2019 (New Principles).
The New Principles amend the Quality of Care Principles 2014 to provide that the Minister must ensure that there is a review of the operation of the Quality of Care Principles relating to physical and chemical restraint. The review must consider the effectiveness of the Quality of Care Principles in minimising the use of physical restraints and chemical restraint by approved providers in relation to consumers in the period 1 July 2019 to 30 June 2020. The stated intention is that the review will also provide an opportunity to consider any recommendations from various scrutiny and review bodies about appropriate amendments to the Quality of Care Principles, as well as the Royal Commission’s findings.
The New Principles also:
- incorporate new headings in the Quality of Care Principles which clarify that the use of physical or chemical restraints is to be used only as a last resort
- adds notes after the section in the Quality of Care Principles that refers to the use of chemical restraint. One note refers to codes of appropriate professional practice that apply to medical and nurse practitioners for the practitioners to obtain informed consent before prescribing medications. The other note refers to relevant state and territory legislation which deals with who can consent to the prescribing of medication for a patient who cannot consent because of any physical or mental incapacity.
This addresses a potential gap in the existing drafting of Part 4A of the Quality of Care Principles. The Principles already reference the need for approved providers to obtain informed consent to the use of physical restraint but do not refer to informed consent for the use of chemical restraint. The inclusion of the notes makes it clear that obtaining consent to prescribing medication is the responsibility of the practitioner.
This is likely to be the start of many further changes that the aged care sector will see with regard to the use of physical and chemical restraints. The Commissioners made it clear in the Interim Report that they will continue to consider the issue of restrictive practices and will make recommendations that will be effective in reducing and eliminating reliance on restrictive practices.