Productive care and support services

Productivity is about obtaining more, or better, outputs for the same, or fewer, hours of work. In the context of workforce shortages and increasing demand for both quantity of services and higher quality of services, productivity is important to the care and support economy.

Productivity growth in care and support has been close to zero for the last two decades.⁸⁹ At face value, it seems difficult to make productivity gains in care and support sectors because they are about human relationships and cannot be automated or replaced by machines. However, there are opportunities for productivity gains which must be pursued.

Labour-saving technologies and innovation

Human connection is a core part of providing quality care and support with dignity. Workers require emotional intelligence and the ability to listen and respond to diverse and changing needs. However, the jobs are also often physical or relate to the documenting of care and support given. It is these strenuous, repetitive or administrative tasks that can be the focus of labour-saving technologies and innovation. Sharing these labour-saving technologies across sectors will improve productivity across the whole care and support economy, by preserving people’s time for tasks that require a human-to-human connection.

There are existing technologies that could be more broadly adopted in the care and support economy to improve quality of care and support and productivity; from cutting edge assistive technologies to relatively simple business management software such as those for rostering staff.

The rapidly rising demand for care and support also presents opportunities for innovators. Services will increasingly be looking for ways to have a competitive advantage in the market and, in some contexts, families will increasingly be looking for ways to support loved ones in their homes.

Government can support better use of data and digital technologies in the system, including through creating data standards. Currently there are no common data standards across the care and support economy, meaning data cannot be easily transmitted to different systems or aggregated for analysis.⁹⁰ This influences both the quality care and support experience (e.g. those using these services having to repeat their information to multiple providers) and the efficiency of reporting to governments. Implementing data standards across large and diverse sectors would require an upfront investment but could then support better uptake of digital innovation.

Innovation can also take the form of better models of care and support or business models which are more efficient or effective. The majority of service providers are innovation adopters rather than generators of innovation. What’s more, while innovation does occur in the care and support economy, it tends to be localised and small scale. This means it is difficult for other organisations or providers in different regions to find out about best practice innovative techniques and what is working well elsewhere.

There is scope for government to improve productivity of care and support systems by better diffusing innovation, for example through an authoritative source of advice on innovative or best practice care and support.⁹¹

Regulatory duplication, burden and rigidity

Adjusting regulatory settings is a key government lever for improving productivity.

Regulation is essential to ensure the people accessing care and support are safe and receive adequate quality care and support, however there is a balance to be achieved. Overly restrictive regulation can be too rigid to suit every situation and cause inefficiencies. On the other hand, not enough regulation, or regulation that is unclear or not well-targeted, can lead to unscrupulous behaviour and devastating outcomes for those using these services.

Reducing the burden of reporting

Unfortunately, the burden of regulatory reporting has a negative impact on the quality of care and support and the experience of workers. For example, NDIS and ECEC workers have reported their ability to do a good job is blocked by paperwork and that this impacts their workplace engagement and level of burnout.⁹²

Automating regulatory reporting where possible could make a real difference to the experience of work and improve productivity. The cost of complying with administrative reporting requirements can be a significant burden on businesses, thus reducing productivity. The diversion of resources towards compliance activities also detracts from providing care and support hours, leading to lower wellbeing for individuals with care and support needs.

The administrative burden of reporting requirements is exacerbated for providers who operate across the aged care, disability support and veterans’ care programs. Approximately 57 per cent of aged care providers also provide services in the NDIS, veterans’ programs or both, and for veterans’ community nursing and home care services this figure is 87 per cent.⁹³ These providers must report the same information, into different ICT platforms, more than once to meet cross-sector regulatory requirements. It is estimated that across aged care, the NDIS and veterans’ care programs, the Australian Government supports over 80 ICT systems.⁹⁴

Opportunities for regulatory harmonisation

There is strong stakeholder support for better alignment of the regulation that governs aged care, disability support and veterans’ care.⁹⁵ There are opportunities to implement coordinated or shared approaches to regulation across each of these sectors. This is especially so for worker screening, where currently there are different rules about screening in different sectors and across the states and territories. The different worker screening arrangements make it difficult for workers to work across sectors.

Regulatory alignment will take an upfront government investment and a coordinated effort to implement more streamlined regulation and better reporting systems.

Aligning the different regulations is not the only solution. The aligned regulations should be best practice for stewarding the market towards the outcomes that best support individuals with care and support needs. Rigid regulation can constrain innovation where regulation is focussed on ‘inputs’ rather than ‘outcomes’. ⁹⁶ Prescriptive regulation, such as: the type of organisations that can enter the market, staff numbers; minimum qualifications; or minimum time spent with individuals, are proxies for good outcomes. They lead to quality outcomes much of the time but also limit new and different approaches.

Increasingly sophisticated data means there are opportunities to develop indicators of quality outcomes which may warrant, in some circumstances, the relaxing of rigid ‘input’ based regulation.

89. Productivity Commission, 'Volume 1: Advancing prosperity'<, 5-year Productivity Inquiry Report, Productivity Commission, 2023, accessed April 2023.Return to footnote 89 ↩
90. R Dendere, M Hargrave, J Ferris, et al, ‘A compelling case for the development and adoption of data standards and interoperability in the Australian aged care sector – White Paper,’ The Centre for Health Services Research within The University of Queensland, 31 August 2021, accessed April 2023. Return to footnote 90 ↩
91. Productivity Commission, 'Volume 1: Advancing Prosperity'. [31]Return to footnote 91 ↩
92. BETA, NDIS workforce retention; E Harper, S McGrath-Champ and R Wilson, The early learning work matters project: Findings from phase II. Return to footnote 92 ↩
93. Department of Health, Background Paper Aligning regulation across Australia’s care and support sectors, 2021, accessed April 2023. Return to footnote 93 ↩
94. Department of Health, ‘2020 Aged Care Workforce Census Report,’ Department of Health, September 2020. Return to footnote 94 ↩
95. Australian Government, Summary of consultation findings: Consultation on harmonisation of care and support regulation – Phase 1, Department of Health, 2022, accessed March 2023. Return to footnote 95 ↩
96. Australian Law Reform Commission, 'Regulatory theory', For your information: Australian privacy law and practice, Australian Law Reform Commission, 2010, accessed April 2023. Return to footnote 96 ↩