Transition Care Into The Future

1. Transition Care Into The Future Lesley Podesta First Assistant Secretary Ageing and Aged Care Division

2. History of the Transition Care Program • Established in 2004-05 • Aims to improve the interface between the health and aged care systems. • Initial commitment was 2,000 places by 2007-08

3. Transition Care – the present As at September 2009 there were: • 79 transition care services • 66% delivered in community • 34% delivered in residential setting

4. Transition Care – total places As at September 2009 there were: • 2,499 operational places • Average length of stay – 7 weeks • This means 18,500+ people can access transition care services each year

5. The Future of Transition Care • The Transition Care Program will double from 2,000 to 4,000 places by 2011-12 • The recurrent costs of these additional places are fully funded by Australian Government • Improved access for Aboriginal and Torres Strait Islander peoples and people with dementia

6. How are these places being rolled out? • 1st tranche - 228 places allocated in 2007-08, all operational in 2008-09 • 2nd tranche – 470 places allocated in 2008-09, of these 271 operational at 14 Sept 2009 • 3rd tranche – around 600 places to be allocated by 31 March 2010, to become operational in 2010-11 • 4th tranche – around 700 places to be allocated by 31 March 2011, to become operational by 2011-12

7. Where are transition care services located? In 2008-09 • 53% in major cities • 29% in inner regional • 15% in outer regional • 0.02% in remote areas

8. How much is the Australian Government spending on transition care? • 2005-06 – $3.3 million • 2006-07 – $33 million • 2007-08 – $53 million • 2008-09 – $76 million • 2009-10 – $103 million • 2010-11 – $150 million • 2011-12 – $220 million • 2012-13 – $224 million

9. Models of Transition Care • Three Transition Care models • Predominantly Community • High average MBI, allied health hours • Low nursing, medical hours • Residential • High allied health, nursing, medical hours • Low average MBI • Mixed • Low average MBI, mainly located in Victoria

10. Results from transition care Key findings from the 2008 evaluation were: • It provided additional treatment and care options that were valued by patients and their families • Functional improvements occurred. • There was variation in access to the program across Australia. • Older people who received transition care had fewer readmissions to hospital and were less likely to move into permanent residential aged care.

11. Transition care and sub-acute care • Transition care was found, in the evaluation, to work best when not used as a substitute for conventional sub-acute care or appropriate geriatric evaluation and management

12. Increase in Activity - discharges from 2006-2009

13. Discharge Destinations 2006-2009

14. Functioning – Improved & Maintained 2006-2009

15. Continuous Improvement - Transition Care Working Group • Oversees implementation of new 2,000 places and operations of TCP • Has representation from all state and territory health departments • Includes two clinicians, Professor Leon Flicker (WA) and Dr Paul Varghese (QLD) • Chaired by the Department

16. Transition Care Working Group • Review of Transition Care Program Guidelines, including • Improved access for Indigenous people • Improved access for people with dementia • Leave from transition care • Development of long-term quality framework

17. Reform and transition care • National Health and Hospitals Reform Commission • Ongoing role of transition care • Increased focus on primary care

18. Transition care into the future • The need for improving the interface between the health and aged care systems is clear • Significant expansion and quality improvement of the transition care is in the pipeline