In 2013/14 I was engaged by Dental Health Services Victoria to work on projects in the Agency Relationship Team in Melbourne. My role focused on dental services delivered to priority groups and intitially involved reviewing uthe Australian Government's Grow Up Smiling policy and developing a project plan. After a change of Federal Government, the scheme was renamed as the Child Dental Benefits Schedule (CDBS). I handed over the work to a project officer specificically employed to implement the project in Victoria. I also supported another project to deliver specialist dental services in regional Victoria, reducing the requirement for patients to travel to the Royal Dental Hospital Melbourne for treatment.
The oral health in aged care project was motivated by the need to train and support staff of residental aged care facilities (RACFs) to provide assessments and daily care to the residents. The majority of facilities were satisfying the Aged Care Quality and Safety Commission's Standard 2.15: Oral and dental care - Care recipients’ oral and dental health is maintained. The quality of care varied significantly between RACFs, and assessments of the standard relied, in part, on satisfaction surveys with residents rather than oral examinations.
I gathered evidence of the current state of oral health in aged care. The data I was able to collect was insufficient, so I gathered evidence through conversations with dentists and public health services that delivered services to residental aged care. I accompanied the domicilary care dental team on a visit to aged care facilites and saw, first hand, the type of care being delivered and challenges faced by the dentists to gain access to residents. I also researched current programs conducted by other regions of Australia and found SA Health to be at the forefront of aged care dental and information, relating to training, produced by Hunter New England Health.
I used the information I had gathered to produce a toolkit for DHSV dental clinics across Victoria to share with their local residential aged care providers. This piece of work was run as a microproject and I presented my findings to the executive steering committee.
My employment relied on funding from the Federal Governement's National Partnership Agreement. The second payment, in 2014, was deferred and my position was defunded. I left the organisation before I was able to commence the implementation stage. Aspects of my work were transferred to the Health Promotion team and the toolkit was published on the organisation's extranet site.
On my last day at DHSV my manager asked me what I intended to do next. I was heading to Alice Springs to take up a position with the NT Medicare Local (now NT PHN) to deliver their Healthy Ageing program to residents of Alice Springs and remote communities in the Central Desert. However, I told my manager that I would continue the work I had commenced at DHSV, even if I had to fund it myself. My greatest concern was that my work would be for nothing and that the passion for preventative oral health would not deminish just because I was leaving the organisation. My words were "I would hate my work to be stuffed in a drawer and forgotten." In fact, the toolkit I had created was posted on the organisation's Extranet site, but (as far as I know) was never used for the purpose it was created. This was more likely due to a reduced workforce than a desire to use it.
My career led me in other directions, mostly focused on healthcare. I left salaried employment in 2021 and have established a microconsultancy. I have developed services supporting people with disabilties in employment, motivated by my own lived experience of non-visible disability. I now have the time to revisit my work from 2014 and take an updated approach to creating business case that employs a contemporary approach to delivery, through evidence based practises and robust measurement of outcomes and social impacts.
At the time of my original piece of work RACFs were assessed against Standard 2.15: Oral and dental care - Care recipients’ oral and dental health is maintained.
Since then, the assessment standards have changed and the current assessments apply to daily maintenance and management of oral health.
Standard 3
(2) The organisation delivers safe and effective personal care, clinical care, or both personal care and clinical care, in accordance with the consumer’s needs, goals
and preferences to optimise health and well-being.
The standards for which the RACH is measured against are
(3)(a) Each consumer gets safe and effective personal care, clinical care, or both
personal care and clinical care, that:
(i) Is best practice; and
(ii) tailored to their needs; and
(iii) optimises their health and well-being.
(3)(f) Timely and appropriate referrals to individuals, other organisations and providers of other care and services.
Although direct references to oral health have been removed, the Aged Care Quality and Safety Commission has published a fact sheet: A fact sheet for providers - Supporting daily oral health care in residential aged care that specifically mentions the sections of Standard 3, explained above. Reports completed by ACQSC assessors will only mention delivery of daily oral health care and dental referrals if the standard has not been met for those reasons.
A new set of strengthened standards have been developed and are currently in draft form. Starting 1 July 2025 those relating to oral health are now defined under Standard 5: Clinical Care, 5.5.7 Oral Health. The standard now identifies three activities: