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In recent times, we have heard discourse in the media around unconscious bias – appearing (allegedly) in the banking sector, customer service, academia, or even amongst royalty - and unconscious bias in healthcare has also been reported on the basis of specific research findings.
It has been reported that complaints relating to registered health practitioners increased over the 2021/2022 financial year. Further (and separately), in aged care, there was a total of 2,767 complaints made in the first quarter of 2022 and 2,642 complaints in the second quarter. Both these figures had also trended upwards compared with the corresponding numbers in 2021 (with 2,313 in the first quarter of 2021 and 2,261 in the second quarter).
"It has been 14 years since all governments in Australia signed the National Agreement on Closing the Gap, yet Aboriginal and Torres Strait Islander Communities are still facing barriers to achieving equitable outcomes in health and wellbeing. Despite an abundance of good intentions, healthcare settings are still places where deficits in cultural safety often drive poorer outcomes for Aboriginal and Torres Strait Islander people."
Pain is a complex and multifactorial phenomenon, and chronic pain can rarely be eliminated. While pain can be nociceptive or neuropathic in nature – relatable to an identifiable organic cause – a third category of pain, described as ‘nociplastic’, is less well defined, and treatment particularly challenging.
Authentic ‘person-centred’ care involves truly understanding a person’s preferences, wishes and values. But what if that person is no longer able to decide what they want, or communicate this? In Australia, most states and territories (with the exception of NSW and Tasmania) have enacted legislation to support the creation of, and reliance on, advance care directives (also known by other names, such as advance care plans).
‘Successful integration is the planning, commissioning and delivery of co-ordinated, joined up and seamless services to support people to live healthy, independent and dignified lives and which improves outcomes for the population as a whole. Everyone should receive the right care, in the right place, at the right time.’
The term clinical governance was first coined in the context of the United Kingdom’s National Health Service - specifically, in a white paper endorsed by then Prime Minister Tony Blair entitled ‘The new NHS: modern, dependable.’ Now, 25 years later – where are we at?
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Professional boundaries in healthcare delineate the therapeutic relationship. They have been defined as ‘parameters that describe the limits of a relationship in which one person entrusts their welfare to another and to whom a fee is paid for the provision of a service’ - or, more broadly, as the ‘edge of appropriate clinical care’.
The Royal Commission into Aged Care Quality and Safety noted in its Final Report, presented on 26 February 2021, that aged care ‘should be able to deliver compassionate and kind care built on respectful relationships’. Person-centred care (or ‘consumer-centred’ care) was already central to the way aged care was expected to be delivered, under the Aged Care Quality Standards which have been in effect since 1 July 2019.
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The term ‘clinical governance’ was first coined in the context of the National Health Service (NHS) in the United Kingdom, being ‘a system through which NHS organisations are accountable for continuously improving the quality of their services and safeguarding high standards of care by creating an environment in which excellence in clinical care will flourish.'
