The Australian Nurses and Midwifery Federation has hit back at claims its fixed staff ratio model is flawed.

Aged care consulting firm Ansell Consulting issued a submission to the royal commission last month, in which it said the ANMF’s proposed fixed staff ratio model of care is “not appropriate” and “simplistic”.

The report features a 1917 quote from American journalist HL Mencken: “For every complex problem, there is a solution that is neat, simple and wrong”, and goes on to explain why the ANMF’s proposal isn’t realistic.

What is the ANMF’s proposed fixed staff ratio model?

The ANMF’s fixed staff ratio model aims to provide residents with 4.3 hours of care a day by 2025 with a staff skill mix of 30 percent registered nurses, 20 percent employed nurses, and 50 per cent personal care workers.

The proposal recommends a 240 per cent increase in full time equivalent nurses, and for nursing hours to increase from 25 per cent to 50 per cent of the workforce.

Model is not realistic: Ansell Consulting

Ansell’s submission, which relies on international research and interviews with aged care operators and clinical leaders (mainly nurses) from more than 160 private and not-for-profit nursing homes, claims the ANMF’s proposal would require an extra 57,000 FTE nurses, compared with the 24,000 FTE nurses that are currently employed.

Ansell says there are six main reasons fixed staff ratios are not appropriate in aged care:

  • there is a variability in resident needs and staff skills,
  • it would lead to overinvestment in clinical resources,
  • models of care are evolving,
  • there are a scarcity of registered and enrolled nurses,
  • they would create an economic and administrative burden, and
  • they would negatively affect consumer choice.

Ansell report disputes stated economic benefits of staff ratio model

The ANMF commissioned Flinders University to assess its proposal, and while Flinders found the plan would cost $5.7 billion, it said those costs would be offset by indirect and social benefits.

Flinders argued that financial savings, additional tax revenue, and improved quality of life outcomes support the ANMFs proposal on economic grounds.

But Ansell’s report has rebuffed those claims, saying that ‘improved quality of life’ can’t be measured in financial terms.

Ansell also says Flinders University’s claim that increased tax revenue will come from “new” wages is wrong, because those employed will be skilled workers most likely already work in another sector.

Thirdly, Ansell argues there is little evidence to support Flinders’ claim that staff ratios will cut aged care resident hospitalisations by 50 per cent.

“The assertion that additional clinical resources would significantly reduce hospital transfers is to adopt a simplistic view to a complex issue,” the report states.

Ansell Consulting believes the solutions to problems in aged care include:

  • Improved resourcing of home care to reduce pressure on residential aged care,
  • Improved the training, education and recognition of the aged care workforce;
  • And creating partnerships between key aged care stakeholders.

The ANMF has today hit back

The ANMF has today hit back at those trying to “discredit” its proposal, and is attempting to correct which is believes is “misinformation” being circulated in the industry.

The ANMF says, “Those making the claims about ratios and minimum staffing levels have not read or understood the ANMF’s research and reports, that they have also not read or understood the evidence provided by the ANMF to the Royal Commission, and they have not listened to the heartbreaking stories of unnecessary pain and suffering being experienced by some residents in aged care.

“It’s time for each and every provider, accountant, consultant and aged care lobbyist to start listening to the stories of those who live in aged care and the families, who have experienced the system directly, as well as the staff who work with the residents and families directly.”

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