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

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

7. 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. 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. 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. 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. 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. 12 Increase in Activity - discharges from 2006-2009

13. 13 Discharge Destinations 2006-2009

14. 14 Functioning – Improved & Maintained 2006-2009

15. 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. 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. 17 Reform and transition care National Health and Hospitals Reform Commission Ongoing role of transition care Increased focus on primary care

18. 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