Поставщик услуг домашнего ухода Life Without Barriers отказался от штатных клиницистов в пользу внешней аутсорсинговой модели

Home care provider outsources clinical services Life Without Barriers no longer has on-the-ground clinicians and instead uses associated providers to meet demand while upskilling care partners to build confidence in decision-making. Home care provider Life Without Barriers has no on-the-ground clinicians and instead has a centralised model with two registered nurses on the clinical governance team. Other clinical services are delivered through associated providers. Speaking to Australian Ageing Agenda on the sidelines of the LPA Support at Home in Practice workshop on Tuesday, Life Without Barriers director of practice assurance and policy Sue Jones said the two registered nurses provide clinical advice and support to non-clinical care partners. If a care partner has a concern about a client, they organise a case conference with the two nurses, where they will discuss strategies to put in place. “And then those clinical advisors may recommend, ‘I think you need a nurse to come in,’ so then we broker associated providers to provide that direct clinical support to the clients in each of the regions,” Ms Jones said. While addressing the workshop, LPA managing director Lorraine Poulos said that of course there needs to be someone to provide clinical care when someone is sick or when someone needs a falls assessment or something similar. But the idea that you need huge clinical care teams assumes everyone is going to get sicker after 1 November, which they haven’t, and now providers may be stuck with clinicians who are not being utilised effectively because the demand is not there. While abandoning clinical teams is not a workforce model all providers would think to adopt, Ms Jones said it has worked well for Life Without Barriers. Life Without Barriers provides home care across every state and territory, bar Western Australia and Tasmania, servicing around 25 regions. “That means we would need 25 clinical teams to manage that – and if you don’t have a model where your clinical teams are prepared to [work outside] of their designated clinical remit, then you’re employing them for 30 hours a week and they might be doing 10 hours a week – and we’ve tried and tested that previously as well,” Ms Jones told AAA. She said having clinical teams “just wasn’t viable” because the clinical demand can fluctuate so much. “You might have heaps of times where you do need an occupational therapy assessment and then you might not need an OT assessment for any of your clients,” Ms Jones told AAA. “Because once you’ve got a client base too, you’re not getting OT assessments every week for every client. That’s generally a one-off thing, or if something’s occurred, then you’re getting another OT assessment. “Once people have aids in their houses, they generally last their lifetime.” Model requires upskilling other frontline workers Ms Jones said their approach “seems to work really well” but emphasised the need to ensure non-clinical care partners receive strong advice. Life Without Barriers director of aged care operations NSW/ACT Rach March said she views it as upskilling – helping the non-clinical care team feel confident in making the right decisions at the right time. “And the whole intention of Support at Home is not to do for, it’s to do with – so how do we partner the right way with different people in the community, but internally?” Ms March said. “And then how do we seek that advice?” “We talk about our care partners needing to wear a number of different hats. That’s also one of them; they have to have an understanding of what clinical care is and what best practice is and you have to be able to have a team centrally to provide that support, because they’re two different things.” Ms Jones said they also focus on uplifting home care assistants, who she described as “the eyes and ears” when it comes to first noticing decline and understanding client needs on a deeper level. “The critical thing is our HCAs noticing a decline or something happening, escalating that through to the care team, then the care team going, ‘Does that need a referral?’” Often they’ll refer to an OT or whoever is required, she said. Read other workforce stories here Follow Australian Ageing Agenda on LinkedIn and Facebook, sign up to our newsletter and subscribe to AAA magazine