Enhancing Care Through Provider Governance Reforms

The aged care sector is undergoing transformative changes, with new provider governance responsibilities introduced to strengthen leadership, transparency, and accountability. Effective December 2023, these reforms aim to improve the quality of care for older Australians by addressing recommendations from the Royal Commission into Aged Care Quality and Safety. These reforms lay the foundation for the significant changes anticipated in 2024-2025, including the new Aged Care Act, regulatory model, and strengthened aged care quality standards.

While the reforms encompass various aspects, this piece will primarily focus on three key areas: the composition of governing bodies, the establishment of advisory bodies, and ensuring staff qualifications, skills and experience meet the level of care required by providers.

Changes to Governing Body Membership

Clinical Care Expertise

One of the significant changes is the requirement for governing bodies to have at least one member with experience in providing clinical care. This reform recognises the importance of integrating clinical expertise into the decision-making processes that shape the provision of aged care services.

By having a governing body member with hands-on experience in clinical care, organisations can benefit from a deeper understanding of the complexities and nuances involved in providing high-quality care. This expertise can inform strategic decisions, ensuring that the organisation's clinical governance framework aligns with critical priorities and mitigates risk. Additionally, it ensures that staff training and resource allocation align with best practices, prioritising the wellbeing of older people at a time when focus on this is paramount.

Advisory Bodies

This reform also mandates the establishment of two advisory bodies: a quality care advisory body and a consumer advisory body. These bodies serve as invaluable resources for governing bodies, promoting collaboration, continuous improvement, and consumer-centric care.

A governing body, typically called a board, is the decision-making authority responsible for an organisation's strategic direction and oversight. It comprises executives, senior leaders and subject matter experts who guide the organisation and make critical decisions regarding its operations, finances, and overall strategy. Advisory bodies, on the other hand, are groups established to provide guidance, expertise, and insights to support the governing body's/board's decision-making processes and strategy setting.

Quality Care Advisory Body

Providers must work to establish a quality care advisory body to support their governing body in improving aged care services. This body should comprise members with the right skills and experience, including:

• At least one key personnel with recent aged care experience
• A staff member directly involved in care provision, representing consumer interests
• A consumer representative, such as an older person, their advocate, or an established consumer advisory board member.

Providers can decide how to appoint members and structure the body's operations to meet obligations. The advisory body's diverse perspectives aim to identify challenges, mitigate risks, ensure further alignment of the organisation's clinical governance framework with operational systems and processes, train staff, and drive continuous improvement in quality care.

Consumer Advisory Body

Engaging with care recipients and their representatives is essential to fostering a person-centred culture committed to quality care. The reforms require providers to annually offer to establish or revise a consumer advisory body, ensuring that the voices of those receiving care are heard and incorporated into decision-making processes.

Consumer advisory bodies provide valuable feedback to governing bodies about the quality of care and services received. They help organisations understand care recipients' unique needs and preferences, enabling them to meet the genuine needs of their recipients and continuously improve the care experience.

Appreciating Workforce Challenges

Attracting skilled governing body members with clinical care experience can be challenging as the sector continues to experience workforce challenges, often exacerbated for rural and remote providers. To overcome this, providers should:

• Embrace technology such as virtual meetings to engage members
• Collaborate with other providers facing similar challenges to find shared solutions
• Seek expressions of interest through local organisations and professional bodies

Staff Qualifications, Skills, and Experience

At the core of this element of provider governance reform is an encouragement to invest in workforce capability. It recognises the pivotal role of suitably qualified and skilled staff in providing safe care. The reforms ensure that governing bodies ensure their employees have the qualifications, skills, and experience to perform their duties effectively.

This requirement emphasises the importance of continuing professional development (CPD) opportunities and staff training. By investing in workforce capability, organisations can enhance staff performance, mid-career competenceand retention, benefiting providers and care recipients.

Putting Workforce Capability into Practice

Guidance from Learning and Development (L&D)

Governing bodies will benefit from establishing collaborative processes with their L&D teams to assess and monitor staff competencies, identify skill gaps, and provide targeted training and development initiatives. L&D teams can give accurate data to governing bodies, helping them understand the current skill sets, compliance data, training needs, and effectiveness of critical programs such as induction training, mandatory training, and ongoing professional development, including leadership development, upskilling, and building mid-career competence to reduce turnover and increase staff retention.

Action 2.9.5 - Training System Effectiveness

Moreover, under Standard 2: The Organisation, Outcome 2.9: Human resource management, governing bodies are encouraged to actively oversee a specific action (2.9.5): "The provider regularly reviews and improves the effectiveness of the training system."

Governing bodies need to have oversight and be across this system. While they have L&D teams in place to run it at an operational level, Boards need a framework to assess the training system's performance and establish criteria that help them evaluate whether the learning management system (LMS) is effective and performing as intended.

Conclusion

​​The provider governance reforms introduced represent a significant step forward in improving the quality of aged care services. These reforms aim to create a more person-centred, responsive, and accountable aged care system by strengthening leadership, increasing transparency, and promoting collaboration.

By implementing best practices and leveraging the expertise of governing bodies, advisory bodies, and a skilled workforce, providers can contribute to a higher standard of care and better outcomes for those they serve.

References and resources

For more information, you can refer to the following resources:

• Aged Care Quality and Safety Commission - Strengthening Provider Governance
• The Strengthened Aged Care Quality Standards
• Royal Commission into Aged Care Quality and Safety (Government Response)
• Aged Care Bill 2023 Exposure Draft

Author

Zoe Youl 

Zoe Youl is a Critical Care Registered Nurse with over ten years of experience at Ausmed, currently as Head of Community. With expertise in critical care nursing, clinical governance, education and nursing professional development, she has built an in-depth understanding of the educational and regulatory needs of the Australian healthcare sector.

As the Accredited Provider Program Director (AP-PD) of the Ausmed Education Learning Centre, she maintains and applies accreditation frameworks in software and education. In 2024, Zoe lead the Ausmed Education Learning Centre to achieve Accreditation with Distinction for the fourth consecutive cycle with the American Nurses Credentialing Center’s (ANCC) Commission on Accreditation. The AELC is the only Australian provider of nursing continuing professional development to receive this prestigious recognition.

Zoe holds a Master's in Nursing Management and Leadership, and her professional interests focus on evaluating the translation of continuing professional development into practice to improve learner and healthcare consumer outcomes. From 2019-2022, Zoe provided an international perspective to the workgroup established to publish the fourth edition of Nursing Professional Development Scope & Standards of Practice. Zoe was invited to be a peer reviewer for the 6th edition of the Core Curriculum for Nursing Professional Development.