The report into the Newmarch House COVID-19 outbreak provides a rich insight into systemic failure, demonstrating how, despite the best will in the world, 71 people in a Sydney aged care facility became infected.
It also reveals how the federal government talks a lot, and issues media releases, and blithely insists all is well, when reality is anything but.
In the end, 19 people died. And hundreds more have died in Victoria. So many the aged care minister loses count from day to day.
The Newmarch House report identifies a number of key problems: lack of PPE and infection control training; the inability of Hospital In The Home service to maintain standards of care for large numbers of residents; the conflicting advice Anglicare, which owned the facility, received.
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But the starkest issue that emerges from Newmarch House is the facility’s, and Anglicare’s, inability to secure enough staff to replace those either infected or quarantined because of infection risk.
The report shows that, despite a torrent of criticism of Newmarch House management and Anglicare at the time, both took pains to meet and exceed regulatory requirements. Newmarch had an “exemplary accreditation history” prior to the outbreak in April, meeting all 44 expected outcomes in the previous accreditation framework.
Anglicare thought it was ready: it had prepared a COVID action plan for its facilities, had a crisis management team and had begun training its own surge workforce to deploy if there was an outbreak. But its plan didn’t survive first contact with the enemy: “the plan could not have anticipated the scale of the outbreak or the sudden and extensive depletion of its regular staff (including two on-site managers and its surge workforce).”
It’s here that the federal government should have learnt a clear lesson. Two days after the start of the Newmarch House outbreak, Aged Care Minister Richard Colbeck boasted that the Commonwealth had emergency response teams to help aged care providers deal with a residential facility outbreak. Colbeck was unequivocal: “as unlikely as it might be, we have plans in place for worst case scenarios where an outbreak in aged care facilities mean local staff are unable to continue to provide care … while it’s unlikely, we need to ensure we’re planning for parts of the workforce being unable to work.”
Colbeck’s media release identified Aspen Medical and the Mable workforce platform as sources for emergency staff once providers “exhausted usual recruitment channels”.
“There’s every chance these extraordinary measures won’t be required in full,” Colbeck assured us, “but it’s vital we are ready.”
They weren’t ready. At all. Anglicare, as per Colbeck’s media release, exhausted the usual channels, and had prepared its own surge workforce. But after half of that was wiped out by infection and its other recruitment channels began to fail, it turned to Colbeck’s plan. When it did, it discovered “Mable was unable to meet the urgent requirement to identify appropriately credentialed staff … of 64 “expressions of interest”, there were just four suitable staff.”
The Mable team worked hard with Anglicare to source staff, but “many agency staff rostered during the outbreak, had little or no experience working in aged care”. Some agency staff would show up at Newmarch, discover it had a COVID-19 outbreak, and leave soon after. The remaining regular staff became scared of going to work, particularly with media camped outside the facility each day.
In the first few days after the outbreak began, the facility lost 25% of its rostered shifts. “The worst day was 20 April 2020, with the combined loss of Anglicare’s own staff, delayed availability of agency staff and many rostered staff simply failing to attend or cancelling at the last minute.”
Colbeck assured us that the federal government had a workforce plan to cover even the extreme case of local staff being removed. But the plan failed, despite the best intentions, hard work and preparation of the provider and one of the sources of staffing. Anglicare struggled to cover losing half its staff at Newmarch.
For Scott Morrison to say, as he did on July 29 in reference to St Basil’s in Melbourne, which lost all its staff, leaving residents to starve and dehydrate, that “this was a new situation that had not been anticipated or foreshadowed at a state level or considered at a federal level”, reflects quite remarkable ignorance. His own minister had insisted that that scenario had not merely been anticipated but planned for. Problem was that that planning had been demonstrated to be woefully inadequate.
No one seriously thinks planning for a pandemic in easy. It’s understandable that plans may prove inadequate in the real world. But it’s a legitimate expectation that the federal government would learn from what happened and improve its planning. Plainly it did not.
Tomorrow: Newmarch and the meetings from Hell…