COVID-19: Support for aged care

Clinical leadership and advice

• Formation of a COVID-19 Aged Care Expert Advisory Group, Chaired by Dr Jagdeesh Dhaliwal

Building strategic relationships and networks

• Strategic meetings with the Australian Government Department of Health and Aged Care, and the Victorian Department of Health
• Advocating for improved communication, coordination and processes with GPs and mental health services working in residential aged care facilities (RACFs)

Mapping RACF preparedness, response, and recovery plans

• Conducting a needs assessment of all 130+ facilities in our region to identify needs and issues and to connect with the GPs who provide care to their residents

Establishing a GP community of practice/peer-learning network

• Survey of GPs to identify those working in aged care and connect them to the community of practice/peer-learning network
• Providing opportunities for GP education and peer networking; planning a webinar series in conjunction with Victorian Primary Health Networks to ensure consistent messaging where it applies across the state; PHN-based learning networks to identify and address local issues

Enabling system coordination

• Facilitating joint meetings and case conferences with GPs, RACFs and local hospital in-reach services to determine clear communication pathways and support requirements

Development of resources

• This page on the NWMPHN website for information, advice, and links for GP working with RACFs
• Maintaining the COVID-19 Aged Residential Care Assessment and Management HealthPathway to support GP management of COVID-19 in RACFs
• Developing advice/tip sheets to help GPs and RACFs plan for outbreaks
• Developing a strategy to maximise communications with all GPs working in RACFs

Enabling access to mental health supports

• Commissioning mental health services for residents and staff of RACFs

Primary Health Networks are the primary contact point for residential aged care facilities (RACFs) during the COVID-19 vaccines rollout. Aged care residents and staff are eligible to be vaccinated from Phase 1A of the rollout.

Our role is facilitating communications between:

• RACFs
• the vaccination workforce provider (Aspen Medical)
• local hospitals, including in-reach services
• GPs and other local health providers
• state and federal health authorities.

It is critical that we can contact all RACFs in our region quickly to help solve any issues that may arise during the delivery and administration of vaccines.

As per the Australian Department of Health’s clinical governance requirements, each RACF must establish a Clinical Lead (for example: a registered nurse) who is responsible for managing the vaccine program at the site. This Clinical Lead is responsible for liaising with their local Primary Health Network (us) and the immunisation provider.

If your facility has not already done so, please designate a Clinical Lead and have them contact Christine Ferlazzo by email to christine.ferlazzo@nwmphn.org.au

More information for aged care providers is available on this page and our COVID-19 Support for Aged Care page.

A new Aged Care Expert Advisory Group (EAG) has been convened to inform our response to COVID-19 in aged care facilities.

The group includes GPs, pharmacists, hospital residential-in-reach representatives, residential aged care facility representatives and the Australian Department of Health. The group is Chaired by Dr Jagdeesh Singh Dhaliwal, a GP with many years’ experience working in aged care settings.

EAG members

Chair

• Dr Jagdeesh Dhaliwal, GP and Medical Director, Aged Care GP

NWMPHN Executives

• Janelle Devereux, Executive Director, Health Systems Integration
• Jagjit Dhaliwal, Executive Director, Service Development and Reform

GP representatives

• Dr Tony Bartone
• Dr Robert Hurley
• Dr Terry Ahern
• Dr Jo-Ann Silva

Pharmacy representatives

• Jarrod McMaugh, Director, Capital Chemist and Project Pharmacist, Pharmaceutical Society of Australia
• Dr Jenny Gowan, Consultant Pharmacist, Gowan & Associates Pty Ltd and Pharmaceutical Society of Australia

Residential aged care representatives

• Heather Gray, CEO of Dorothy Impey Home
• Heather Rota, McKenzie Aged Care

Residential in-reach representative, St Vincent’s Hospital Melbourne

• Dean Jones, General Manager Subacute, Aged Care, Home and Community Services, St Vincent’s Hospital

Australian Department of Health representative

• Annabel Thorpe Acting State Manager, Victoria-Tasmania, Australian Department of Health

NWMPHN project management

• Sue Merritt

The Australian Government established the Victorian Aged Care Response Centre in July 2020 to improve the coordination of the response across governments and to improve access to health care for residents. It ceased operation on 30 September 2022.

North Western Melbourne Primary Health Network (NWMPHN) worked with the response centre, the Australian and Victorian governments and other stakeholders to ensure GPs have the information they need to maintain care for their patients in aged care facilities.

A key focus for NWMPHN is to ensure the general practice voice is heard by other stakeholders.

We are sending updates to residential aged care providers in our region about new and existing services. If you would like to receive these emails, please subscribe or contact us via email: agedcaresupport@nwmphn.org.au

Archive of communications

• 23 May 2023: NWMPHN update for aged care
• 19 April 2023: NWMPHN update for aged care
• 8 March 2023: NWMPHN update for aged care
• 26 October 2022: NWMPHN update for aged care
• 19 September 2022: NWMPHN update for aged care
• 24 May 2022: NWMPHN update for aged care
• 6 April 2022: COVID-19 update for aged care
• 23 March 2022: COVID-19 update for aged care
• 10 March 2022: COVID-19 update for aged care
• 2 March 2022: COVID-19 update for aged care
• 24 February 2022: COVID-19 update for aged care
• 22 February 2022: COVID-19 update for aged care
• 18 February 2022: COVID-19 update for aged care
• 16 February 2022: COVID-19 update for aged care
• 11 February 2022: COVID-19 update for aged care
• 10 February 2022: COVID-19 update for aged care
• 7 February 2022: COVID-19 update for aged care
• 2 February 2022: COVID-19 update for aged care
• 25 January 2022: COVID-19 update for aged care
• 11 January 2022: COVID-19 update for aged care
• 21 December 2021: COVID-19 update for aged care
• 9 December 2021: COVID-19 update for aged care
• 29 October 2021: COVID-19 update for aged care
• 28 September 2021: COVID-19 update for aged care
• 21 September 2021: COVID-19 update for aged care
• 8 September 2021: COVID-19 update for aged care
• 18 August 2021: COVID-19 update for aged care
• 16 July 2021: COVID-19 update for aged care
• 2 July 2021: COVID-19 update for aged care
• 23 June 2021: COVID-19 update for aged care
• 1 June 2021: COVID-19 update for aged care
• 4 May 2021: COVID-19 vaccines update for aged care
• 16 April 2021: COVID-19 vaccination options for aged care staff
• 14 April 2021: COVID-19 vaccination options for aged care staff
• 31 March 2021: COVID-19 vaccination options for aged care staff
• 25 March 2021: Update for aged care
• 5 March 2021: COVID-19 vaccines update for aged care
• 17 February 2021: COVID-19 vaccinations beginning from Monday 22 February in selected RACFs
• 5 February 2021: New mental health support service for residential aged care workers: request for feedback
• 4 February 2021: Services update

• In the event of an outbreak, promptly isolate and inform COVID-19 positive cases.
• Immediate notifications are required within one hour:
  • Notify your Local Public Health Unit by phone: 1300 651 160 or email: operations@dhhs.vic.gov.au
  • Report outbreak to the Australian Department of Health by email: agedcareCOVIDcases@health.gov.au
• Activate your outbreak management plan:
  • Leadership to emphasise and reinforce the plan
  • Cohort residents and staff (visit agedcarequality.gov.au for cohorting FAQs)
  • Have a communication plan for residents, staff and stakeholders
  • Infection prevention and control
  • Monitor residents for signs and symptoms
  • Entry screening
• Manage workforce and enact contingencies if required.
• Ensure your facility has at least one weeks’ worth of personal protective equipment (PPE).

• Advice from the Aged Care Quality and Safety Commission in the Flow chart for managing COVID-19.
• First 24 hours – managing COVID-19 in a residential aged care facility.
• Managing a COVID-19 outbreak in residential aged care.
• The Communicable Diseases Network Australia guidelines for the prevention, control and public health management of the COVID-19 outbreaks in residential aged care facilities provides information on the supplies needed to manage an outbreak.
• Australian Department of Health information to broadly prepare for COVID-19 in residential aged care.
• National COVID-19 Residential Aged Care Emergency Communication Guide.

• You will need wrist bands for residents.
• You will need:
  • PPE for staff
  • to be able to set up places to put on and take off PPE
  • places to store additional PPE stocks.
• Check your supply of equipment and signs. You should also have a plan to manage contaminated clinical waste.
• Plan how you will organise residents in different scenarios and how staff will access those areas. Consider the layout of your facility and the implications for staff and equipment.
• Identify how you will need to adjust care delivery and services in the event of an outbreak. You will need separate equipment for each zone.
• You will receive lots of telephone calls as entry to your facility will be controlled. Make sure you can provide additional phone numbers and staff to cope with the volume of calls.
• Catering and laundry services will also be affected. Think about what disposable equipment you may need, such as disposable crockery.
• You will need line lists for your staff.

The Australian Department of Health has published a resource pack for residential aged care providers, workers, residents, carers and families relating to the COVID-19 vaccination roll-out.

COVID-19 vaccinations are now mandatory for residential aged care workers. A fact sheet for residential aged care providers on reporting COVID-19 vaccinations and exemptions is available on the Australian Department of Health website.

What to do if a worker’s COVID-19 vaccination status is not showing on the Australian Immunisation Register (AIR)

If a worker has received their COVID-19 vaccination but it is not yet showing on their Immunisation history Statement, it may be because the vaccine provider has not uploaded the person’s vaccination record to the AIR.

As a first step, providers and facilities can call the AIR on 1800 653 809 (8:00am–5:00pm, Monday to Friday AEST) and Human Services will prioritise update of the worker’s vaccination record.

If your workforce was vaccinated on site by a Commonwealth vaccine provider, and a worker’s vaccination status is not yet appearing on their Immunisation History Statement, please contact the vaccine provider directly. Contact details for vaccine providers are available in the Australian Department of Health fact sheet.

You will need to provide the individual’s full name, Medicare number and date of vaccination at your facility.

If a worker was vaccinated at an alternate site, such as a GP or state and territory run clinic, providers should assist their workers in contacting the vaccine provider and requesting the vaccination record be uploaded to their Immunisation History Statement.

 COVID-19 vaccines information for the NWMPHN region

 Australian Department of Health COVID-19 vaccines hub

NWMPHN has commissioned a $6.5 million program, funded by the Australian Department of Health, to deliver group therapy programs to eligible RACFs. This program is aimed at improving the physical function of residents at risk of deconditioning due to COVID-19 restrictions.

Learn more.

For more information, please email Juliet.Fieldew@nwmphn.org.au

Free psychological support is available to residents in aged care facilities in our region. This service is delivered by Better Place Australia and commissioned by NWMPHN.

The service is for residents at risk of or experiencing mild to moderate mental health concerns. This could include residents living with anxiety or depression, or who are experiencing social isolation, as well as new residents transitioning into residential care.

How to refer

To enquire or refer to the service please contact:

Rhonda Withers
Better Place Australia
P: (03) 9556 5333
E: Rhonda.withers@betterplace.com.au

• Referrals to the Better Place Australia psychological support service can be made by the resident’s GP or by a registered nurse of the facility, with the consent of the resident (or a resident’s next of kin).
• Once a referral is received, Better Place Australia will contact the residential aged care facility to make arrangements with the facility and to set up an appointment with the resident.

How psychological support is delivered to residents

• Experienced mental health practitioners including mental health nurses, mental health social workers, and psychologists will provide psychological support to residents.
• Services will be offered by phone, telehealth, or face-to-face (when it is possible and safe to do so).
• Services can be provided on an individual basis and/or through group sessions with other residents (if appropriate).
• The service may be suitable for some residents with dementia, but it is not an alternative to the Dementia Behaviour Management Advisory Service (DBMAS) for residents who are experiencing changes in behaviour that affect their care or carers. DBMAS can be contacted for advice or to make a referral on 1800 699 799.

Visit HealthPathways Melbourne for the latest clinical advice and referral information for:

• COVID-19 Aged Residential Care Assessment and Management (part of the COVID-19 suite)
• Older adults’ health
• Palliative care
• Advance care planning

Need a login? Request access here or contact info@healthpathwaysmelbourne.org.au

NWMPHN is developing tip sheets to support staff working in residential aged care facilities in our region.

• Tip sheet 1: Preparing for COVID-19 in an aged care facility – Infection control and PPE (.pdf)
• Tip sheet 2: Preparing for COVID-19 – For residential aged care facility managers (.pdf)
• Tip sheet 3: Preparing for COVID-19 – Practical tips for aged care facilities (.pdf)
• Tip sheet 4: Caring for yourself during COVID-19 (.pdf)
• Tip sheet 5: How to get mental health support for residents (.pdf)
• Tip sheet 6: How to get mental health support for residents’ family members (.pdf)
• Tip sheet 7: Advice for RACFs: Working with GPs during COVID-19 (.pdf)
• Tip sheet 8: COVID-19 vaccination options for aged care workers and residents (.pdf)
• Tip sheet 9: Emergency management of a COVID-19 outbreak in a RACF (.pdf)
• Tip sheet 10: Importance of vaccination against both COVID-19 and influenza in 2022 (.pdf)

The information in these tip sheets has been developed in consultation with our new Aged Care Expert Advisory Group, convened to inform NWMPHN’s response to COVID-19 in aged care facilities, and the (now closed) Victorian Aged Care Response Centre led by Professor Michael Murray.

NWMPHN is developing tip sheets to support GPs caring for patients in residential aged care facilities in our region.

• Tip sheet 1 – Advice for GPs with patients in RACFs (.pdf)
• Tip sheet 2 – Advice for RACFs: Working with GPs during COVID-19 (.pdf)
• Tip sheet 3 – Using Telehealth in residential aged care facilities (.pdf)
• Tip sheet 4 – Plan on a page: Enhancing the access of primary health care in RACFs (.pdf)

The information in these tip sheets has been developed in consultation with our new Aged Care Expert Advisory Group, convened to inform NWMPHN’s response to COVID-19 in aged care facilities, and the (now closed) Victorian Aged Care Response Centre led by Professor Michael Murray.

Our 15 September webinar for GPs, Better telephone and video consulting in aged care settings, is now available to watch on demand.

The RACGP has developed an aged care clinical guide (Silver Book) for deprescribing where appropriate. For example, reduce the number of dose times in 24 hours to reduce exposure of staff.

View the guide

The RACGP held a webinar on 27 August 2020: Preparing for your first COVID-19 case in aged care – Lessons from Melbourne. Presenters included Dr M Imran Marzook, Dr Jagdeesh Singh Dhaliwal, Dr Cathy Parsons, Dr Paul Yates and Dr Nicholas Jones.

View the webinar

The RACGP has developed this guide for GPs to support them in providing home-based care in a private residential home (including public or community housing) for adult patients who have tested positive for COVID-19 and who are asymptomatic or have mild symptoms.

View the guide

Recommendations for general practice relating to COVID-19 are available on the Advance Care Planning Australia website.

Palliative Care Victoria’s website includes:

• COVID-19 updates
• information for health professionals
• information for patients and families including Aboriginal and Torres Strait Islander patients and non-English speakers
• podcasts about palliative care in 19 languages
• latest news.

A summary of mechanisms available to pharmacists to lawfully supply Schedule 4 and Schedule 8 poisons to residential aged care services is available on the health.vic website.

FAQs about dexamethasone and COVID-19 are available on the World Health Organization website.

The role of the Aged Care Quality and Safety Commission is to protect and enhance the safety, health, well-being and quality of life of people receiving aged care.

The Commission is the national end-to-end regulator of aged care services, and the primary point of contact for consumers and providers in relation to quality and safety.

Links

• agedcarequality.gov.au

The Australian Government has COVID-19 resources for health professionals on its website, including in relation to:

• aged care services
• hygiene and cleaning
• PPE
• training
• working arrangements.

The new Older Persons COVID-19 Support Line provides information, support and connection Monday to Friday, 8.30am to 6.00pm on 1800 171 866.

DHHS has published resources and information for the aged care sector in Victoria.

Worker permit details and forms for permitted workers and employers in greater metropolitan Melbourne during stage four restrictions are available on the Victorian Government website.

The following overseas resources may help local GPs effectively communicate with RACF residents during the COVID-19 pandemic.

• The Regional Geriatric Program of Toronto website includes:
  • communication tips for clinicians caring for older adults experiencing delirium (tip sheet, .pdf)
  • How to prevent and support delirium in an older adult in hospital or a care home, when you can’t visit in person (tip sheet, .pdf)
  • The Person Behind the Mask: Communicating with clients living with dementia in long term care while protecting ourselves (tip sheet, .pdf)
• The Health Quality and Safety Commission New Zealand has produced an infographic to support better communication with older adults at risk of deterioration.

The Taskforce is supporting Australia’s health care professionals with continually updated, evidence-based clinical guidelines.

Links

• covid19evidence.net.au

An article describing initiatives to ensure ongoing access to medications during the COVID-19 pandemic has been published in the Australian Journal of General Practice.

Use this screening tool to identify typical and atypical signs of COVID-19 in aged care residents.

Links

• Screening tool