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A core part of a frontline leader’s role is to develop strong and capable teams, to ensure quality service delivery. The data shows us that people with a disability often have poor general health outcomes and are dying of preventable causes. Frontline leaders have a role to play in ensuring that all workers are trained to confidently promote the health, safety and well-being of the people they support.
Why is this important?
The statistics from the Disability Royal Commission’s (DRC) Final Report are confronting and provide a powerful insight into the current state of healthcare for people with disability.
The Report found:
- People with disability have worse health outcomes and lower life expectancy than people without disability.
- An estimated 400 deaths each year of people with intellectual disability, aged 20 and above, were potentially avoidable.
- Analysis by the Australian Institute of Health and Welfare (AIHW) suggests the rate of potentially avoidable deaths for people with disability, under age 75, is 3.6 times higher than for the general population.
- Modelling prepared for the Royal Commission estimates that every year 550 people with disability experience a potentially avoidable death as a result of violence, abuse, neglect and exploitation.
During the public hearings, the DRC heard a case where a provider failed to properly document and record information about somebody’s bowel health, which resulted in a significant medical event, hospitalisation and a lot of pain for the participant. The hearing observed in this case, that not documenting correctly constituted neglect.
What are the barriers to great health outcomes and what is being done about it?
There has been extensive research in this space, and we’ve seen a national commitment to addressing poor outcomes through Australia’s Disability Strategy, updates to Practice Standards and Practice Alerts. However, there is still a lot of work to be done, especially at the frontline. Support workers play a critical role in supporting people with their health, yet they often have little training in this area.
Often, disability providers rely on healthcare providers for prompts about when someone should have health checks or vaccinations. But this regularly doesn’t occur, leading people to miss important screenings and regular checks.
What obligation do Frontline Leaders have in ensuring people get excellent healthcare?
So, what can and should frontline leaders do to change these stats?
Frontline Leaders can:
- Promote a culture where disability support workers know how to support people to understand and communicate their health needs. This might involve focusing on accessible health literacy and preventable health.
- Ensure teams are providing people with accessible preventative health information and training on how to advocate for information from healthcare professionals.
- Train support workers to understand signs of health decline in the people they support.
- Keep health records up-to-date.
- Ensure people attend all short- and long-term follow-ups with healthcare professionals.
- Ensure people can connect with relevant healthcare providers.
It can be as simple as training workers to develop an understanding of dental hygiene and what steps to take if someone raises a dental complaint.
What obligations do the NDIS Practice Standards provide when supporting health?
There are references to supporting health in:
Provisions of supports (support planning)
- ‘Each participant’s support plan includes arrangements, where required, for proactive support for preventative health measures, including support to access recommended vaccinations, dental check-ups, comprehensive health assessments and allied health services’
An example could be putting processes in place to ensure people get regular dental check-ups.
Responsive Support Provision:
- ‘For each participant (with their consent or direction and as agreed in their service agreement) links are developed and maintained by the provider through collaboration with other providers, including health care and allied health providers, to share their information, manage risks to them and meet their needs.’
An example could look like keeping a record (with consent) of a participant’s chosen healthcare providers in their profiles.
Provision of Supports Environment
- ‘For each participant requiring support with communication, clear arrangements are in place to assist workers who support them to understand their communication needs and the manner in which they express emerging health concerns.’
- ‘To avoid delays in treatments for participants: a) protocols are in place for each participant about how to respond to medical emergencies for them; and b) each worker providing support to them is trained to respond to such emergencies (including how to distinguish between urgent and non-urgent health situations).’
- ‘Systems for escalation are established for each participant in urgent health situations.’ This might involve ensuring people have clear communication plans in place to express health needs (where appropriate).
There are also specific Practice Standards around Mealtime Management and High Intensity Daily Personal Supports, that outline health requirements for providers registered to deliver these services.
What resources are out there to help?
There are a number of great resources available to support frontline leaders. A great starting place is the resources and fact sheets about health checks and services developed by Council for Intellectual Disability: Intellectual disability health issues - Council for Intellectual Disability
We are also running a 3-hour workshop to equip Frontline Leaders with the knowledge and tools to help their teams support participants' health. The workshop will unpack the provider’s obligations, how to navigate dignity of risk in healthy living decisions, overseeing teams providing High Intensity Supports and exploring advanced care planning and end-of-life care. To learn more, go to: Frontline Practice Leadership Training.
Stats from:
Disability Royal Commission Final Report
Health of people with disability - Australian Institute of Health and Welfare
National Roadmap for Improving the Health of People with Intellectual Disability
