Aged Care Leadership Imperative

28 Feb 2025

Rejoice! The new Aged Care Act has passed the parliament.

So, what happens next….?

Many aged care services are still going broke. Still unable to find all the staff needed to provide good care. Still overburdened by punitive and admin heavy regulation. And all with limited support to affect lasting change.

A new Aged Care Act is the starting line of transformational change for Australia’s aged care system. With the end goal being a high performing, respected and sustainable aged care system, delivering quality care and support for older Australians, irrespective of the complexity of need, geographic location or social status.

How we get there from here will take a lot of heavy lifting. Central to this task will be leadership.

It is widely acknowledged that the aged care sector’s unique attributes create a challenging environment for leaders. With the Productivity Commission noting that Aged care is ‘a unique industry to lead and manage and also one of the most complex from a leadership and management perspective’ (Productivity Commission 2011).

In considering their wide-reaching recommendations to transform Australia’s aged care system, the Aged Care Royal Commissioners stated that ‘to support and drive the reforms that we recommend, consistent and confident leadership at all levels of aged care organisations will be essential’ (Aged Care Royal Commission Final Report).

A recent survey conducted by Mirus (2024) found that 94% of respondents ‘agreed’ or ‘strongly agreed’ that ‘the aged care sector requires a more structured approach to develop emerging leaders and retain experienced ones’.

This is counterbalanced by an aged care sector survey that found only 2 out of 5 (40%) of aged care services staff have confidence in their organisations’ management/leadership (ACCPA 2024).

So, whilst the Government works out the ‘how’ of implementing the new Aged Care Act, aged care providers are ‘on notice’ that change is coming. And that this change will demand a renewed focus on leadership.

The ACQSC recently opined that ‘the work of the reforming the sector relies on new leadership logic and changed practices. This is quite different work to managing the mechanics of an organisation and its regulatory environment This is about the conscious choice to lead in a way that shapes and steers organisations to align with purpose, deliver on their promise and have impact that reflects the needs of all stakeholders including employees, older Australians generally and consumers’ (ACQSC Leading the Transformation 2024).

That is easy for others to say but challenging to do when you are struggling on a daily basis to deliver the best care and support possible in challenging circumstances and with limited resources.

Experienced aged care leaders well know the challenges that change brings. Whilst progressive aged care providers are also seeing the opportunities. The difference between the two comes down to….leadership.

Now, more than ever, there is a leadership imperative in aged care. The looming choice for providers is ‘do I wait for change to be done to me’ or ‘do I get in front of the change and ride the wave’. The latter is appealing but hard to do when BAU pressures and priorities dominate, as providers struggle to cover shifts, continue to lose money, and are regulated to the point of despair.

Deep within the challenge of dealing with the day to day operational pressures of doing our best to provide good quality care lies the opportunity to transform the narrative, and the reality, of aged care service delivery. To successfully master the simultaneous and competing drivers of BAU and transformation requires a combination of leadership skills and support at all levels within aged care organisations – Boards, Executives, mid-level managers and on the frontline.

The psychology of change in organisations tells us that change can be either motivating or threatening. For change to be motivating it needs to be driven internally, with positivity and providing a clear sense of control and direction. Conversely, change is threatening when it is perceived to be imposed externally, with little local control and low degrees of agency.

So, the presenting problem set is nested in a context that already sees people and organisations under pressure to do all they can to deliver business as usual. Whilst charging towards them is a wave of fundamental changes whose content, volume and pace is not yet clearly defined. This will test the capacity and capability of services providers to translate reform intent into action and outcomes, whilst simultaneously meeting day to day operational needs.

In practice, progressive CEOs are investing in leadership development at all levels– Boards, Executives, mid-level managers and on the frontline. Their focus right now is on being proactive. Leading change rather than reacting to change. This includes tailored leadership frameworks and development programs, building the collective capacity of executives, middle managers, frontline leaders in leading change; not just through formal leadership development but action-learning sets with peers, as well as involving them in change or learning by doing’ and providing additional support to reinforce the learning such as peer-to-peer learning networks, buddy systems and executive coaching.

This is being evidenced by the ACQSC when they said recently that ‘to lead effectively during times of disruption, complexity and transformation, leaders are not only investing effort in cultivating new and different skills, but also adopting new mindsets and managing their own and collective capacity’. (ACQSC Leading the Transformation 2024).

As a new era in aged care dawns we are not to be daunted by the task ahead, rather we can be inspired. You are not alone. By working together, within and across organisations, in positive and proactive ways, we will collectively find the way forward to address the leadership imperative and transform the sector.

With this in mind, I would like to invite aged care executives to be part of building a community of leaders that are at the forefront of transforming the sector. If you are interested in exploring working together in a facilitated, peer to peer, action learning program, aligned to leading people and organisations through aged care sector reform change then please register your interest here.