Supporting equitable and timely access to
aged residential care

Following the 2018 release of Caring for our older Kiwis: The right place, at the right time, the NZACA has released an updated report titled Supporting equitable and timely access to aged residential care in which we share analysis of data collected through interRAI during 2020/21.

The analysis strongly suggests that the decisions around both when a person can access ARC, and the level of care they receive when they do, continues to vary according to where they live. This raises serious concerns that must be addressed about how we are supporting some of our older New Zealanders to live as well as they can in their most vulnerable years.

While there are regions which are showing some improved access to care, and care at the right level, it is very challenging to see how little progress overall has been made since these issues were raised in the Caring for our Older Kiwis, and that in fact, some regions have actually gone backwards.

What’s also deeply concerning is the clear evidence supporting the feedback from providers that the acuity of residents’ needs on admission to each care level are increasing, and that the consequent increase in average cost of care at each level is not being compensated for in funding.

The aim of this new report is to assist the newly created Te Whatu Ora Health New Zealand and Te Aka Whai Ora Māori Health Authority in their goals of improving both equity and access to healthcare for New Zealanders.

New Zealand has an aging population, and with the ongoing impact of the pandemic and nursing shortage on already stretched resources in the sector, change isn’t an option, it’s an imperative.

The NZACA is calling on the Government and the newly established health authorities to address these issues of equity and access as a matter of priority, to ensure that there is a nationally standardised process and criteria for determining eligibility for ARC that is used, and responded to, in a consistent way across every region in New Zealand. Our older people deserve nothing less.

Supporting equitable and timely access to aged residential care - Report

The NZACA would like to acknowledge and thank John McDougall (NZACA Data and Insight Specialist) who undertook the data analysis as well as CHT Healthcare Trust whose Aged Care Fund provided funding for this research. We also thank those who have given their time to provide insights and commentary, or other support, for this publication:

  • Carriann Hall Chief Executive, CHT Healthcare Trust
  • Graeme Titcombe Chief Executive, Home and Community Health Association
  • Anna Blackwell NZACA Nursing Leadership Group and owner/manager of Cook Street Nursing Care Centre
  • Rhonda Sherriff NZACA Clinical Advisor and co-owner of Chatswood Retirement Village
  • Te Hopai Home and Hospital Wellington

Report highlights aged care crisis

5 July 2022

Increased severity of illness in older people entering aged care, increased care costs and serious inequities in access to care highlight a sector in crisis, according to new research from the New Zealand Aged Care Association.

The report Supporting equitable and timely access to aged residential care, analyses anonymised 2020/21 data from InterRAI, the mandatory clinical assessment tool for aged residential care and home and community services for older people.

It aims to assist the newly created Health New Zealand/ Hauora Aotearoa and Māori Health Authority / Te Mana Hauora Māori in their goals of improving both equity and access to healthcare for New Zealanders.

Simon Wallace Chief Executive of the New Zealand Aged Care Association says the data shows that change is desperately needed to ensure a future of equitable and timely care for New Zealanders as they age.

“Many older New Zealanders are waiting too long to access the care they need, and access to that care is dependent on where they live. This is leading to serious inequities both for an older person’s health and wellbeing and for viability of the facility providers.

“We have a situation where some providers are having to provide unfunded hospital level care to individuals put in rest-home level beds, either because the District Health Board is only funding the resident for rest-home level care when they need hospital-level care or there are no beds available that are certified to hospital level care.”

The research updates and compares with previous analysis in the NZACA 2018 report Caring for Our Older Kiwis.

It shows that while use of interRAI by DHBs is mandatory to assess older people’s care needs, its use is not only increasingly inconsistent, but has declined across DHBs over the last four years – from 13.6 percent of those aged 80+ receiving assessments to 11.2%.

“This is contributing to the postcode healthcare lottery that way too many people are experiencing. It also is a serious impediment to nationwide studies of equitable access of older people to the care they need whether in a facility of home setting.”

The NZACA is calling for a nationally standardised process and criteria for determining eligibility for ARC that is used in a consistent way across every region in New Zealand.

Carriann Hall, Chief Executive of the CHT Healthcare Trust, which funded the research through is CHT Aged Care Fund, says that at the same time as the new health system is being established, our aged care sector is in crisis.

“Funding disparities and immigration settings are contributing to staffing shortages which put further pressure on a system already trying to manage the fact that, as confirmed in this report, residents are entering ARC in greater need.

“We cannot rely on market forces alone to drive the provision of aged care beds and determine who has access to them.”

Meanwhile the research reinforces the benefits of ARC shown in the previous study, demonstrating the significant improvements in the health and wellbeing of older people in the six months after they entered an aged care facility.

A total of 95.9% residents report either improved or sustained levels. In addition, 74.7% of people showed an improved overall health stability score, with 92.5% reporting either improved or sustained levels.

Additionally, the analysis reinforces previous results showing the significant reductions in loneliness for people entering ARC. Of those who reported being lonely at the time of their final home care assessment, 82% reported not feeling lonely after around six months of aged care.

“This is very encouraging especially against the backdrop of Covid-19 restrictions and stringent health measures to ensure the safety of older residents. It is a testament to the creativity of our providers that they have continued to ensure their residents are well supported socially during the pandemic.

“Ultimately, behind the numbers and percentages presented in this report are lives. The lives of our most vulnerable New Zealanders. They are our parents, grandparents, great grandparents and they have made a contribution to New Zealand through living and working here and raising families. How we treat our older New Zealanders reflects on our values as a nation.

“As a sector and on behalf of all New Zealanders, we see potential for a better future and sincerely hope Health New Zealand and the Māori Health Authority will take on this comprehensive data to ensure they meet their goals of improving both equity and access to healthcare for New Zealanders.”


Please direct all media enquiries to Alice Taylor, 021 02785648.