The Aged Care Association (ACA) is calling for urgent action to address growing delays in access to dementia and aged care assessments, warning that older New Zealanders and their families are being left without safe options while waiting for access to care, and urging the immediate use of appropriately trained aged care clinicians to help reduce assessment backlogs and get people into the right care sooner.
Health New Zealand has acknowledged significant pressure within the Manawatū Needs Assessment and Service Coordination (NASC) service, citing more than a doubling in referrals compared with the same time last year, increasing complexity of cases and workforce shortages impacting assessment capacity.
ACA Chief Executive Tracey Martin said providers are reporting that the consequences are now being felt across families, facilities and the wider health system.
“Our members are telling us there are currently approximately 300 people waiting for dementia or aged care assessments in the Manawatū area alone. While that figure is based on provider reports rather than official published data, the consistency of what we are hearing should concern everyone.”
“We are also hearing reports of similar assessment delays emerging in parts of the South Island.”
Martin said assessment delays are not an administrative inconvenience.
“When someone reaches the point of needing an assessment, something has already changed. A spouse can no longer cope. Someone is becoming unsafe at home. Hospital discharge may be delayed. These are not people waiting for convenience. These are people waiting for care.”
Members report families are increasingly approaching aged care facilities directly asking whether there is any pathway to support while they wait.
“One provider described having to explain to families that even urgent needs assessments were taking six to eight weeks. Those are devastating conversations because families have usually reached the point where they have no safe alternatives left.”
Providers are also reporting examples of people entering temporary or lower-level arrangements while waiting for reassessment, only for their needs to escalate beyond what was originally assessed.
“In some cases providers are left managing risk they did not create because people are waiting too long to access the right assessment and the right level of care. That is not simply frustrating. It creates real risk.”
“Aged residential care providers are funded, staffed and certified to deliver specific levels of care. When someone’s needs change but the assessment system cannot respond quickly enough, providers are left caring for people whose actual needs may no longer match the care level they are approved to provide.”
“That puts older New Zealanders at risk of being in the wrong environment, places enormous pressure on families and leaves providers and staff trying to manage situations that are becoming clinically unsafe.”
“When assessment delays result in people being left or placed in the wrong level of care, the risk to that person increases. If something then goes wrong, the provider is often held accountable while the system factors that contributed to the situation are often swept under the carpet.”
“The answer cannot be to ask providers to continue holding higher and higher levels of risk while people wait. The answer must be getting people assessed and into the right care before a situation reaches crisis point. Our members should not be left carrying the consequences of a delayed assessment system.”
Martin said there is a practical solution available immediately.
“During COVID, appropriately trained staff within aged residential care facilities were able to undertake assessment activity for people already in their care. That reduced pressure on the system and helped people move more quickly into the right support.”
“We should immediately reintroduce the delegated model where appropriately trained and approved clinical staff within aged residential care can complete defined assessment functions for residents already receiving care.”
“This would not replace NASC or Health New Zealand. It would free assessment teams to focus on people in the community with urgent unmet need while using clinical capability that already exists.”
“Health New Zealand has advised that it is monitoring wait times, prioritising higher-needs cases, using temporary support packages and short-term care beds, and recruiting additional assessment capacity. However, monitoring pressure is not the same as relieving pressure, and too many older New Zealanders and their families are already on the brink of crisis.”
The ACA is calling for:
- Reintroduction of delegated assessment capability for appropriately trained aged residential care clinicians
- Immediate visibility of assessment waiting times by region
- Temporary surge capacity in areas experiencing significant backlogs
- Clear escalation pathways for urgent dementia and aged care assessments
- A national review of assessment workforce capacity and future demand
“Aged care is health care. If older New Zealanders cannot access assessment and move into the right care at the right time, the whole health system feels the impact.”
“Our election message is simple. Older New Zealanders deserve the right care, in the right place, at the right time.”
