Australia’s health and aged care systems are currently under immense pressure. Demand for aged care is growing as more older Australians require support, yet supply, funding, and workforce capacity are struggling to keep pace. Hospitals continue to feel the strain, with delayed discharges impacting patient flow throughout the hospital, including emergency department congestion, and longer elective surgery waitlists. This is partly due to systemic pressures that result in older people remaining in hospital longer than necessary when they could be supported through the aged care system at home or in residential care.

Older Australians account for a disproportionate share of ED presentations and longer stays. And delayed access to aged care compounds these pressures, as aged care supply is tight – national occupancy averages at 94% while the aged care provision ratio is falling, meaning there are fewer beds available per older person.

Residential aged care beds are not being created fast enough, and the new Support at Home program is not helping to quickly alleviate the pressure.

These challenges are not new. However, they are becoming more acute as demand rises due to Australia’s ageing population and the interdependencies between hospitals and aged care deepen.

Unlocking capacity across hospital and aged care is complex. There is no single fix: the solutions required sit on a spectrum, ranging from short-term, localised actions to longer-term, system-wide reform. What is clear is that action and intervention must occur now, with the time for talking about the challenges and discussion with no action on strategies long expired.

Whilst the situation is critical, particularly for older Australians, there are pragmatic, actionable steps that can be taken individually and collectively across the health and aged care sectors and beyond to unlock capacity and deliver sustainable improvement, ensuring older Australians receive care in the most appropriate setting for their individual needs.

Addressing capacity pressures across health and aged care requires a shared understanding of capacity as a whole-system issue, rather than a challenge located within any single service or sector. Leveraging eight key solution domains, short-term actions to relieve current pressures and medium-term actions to improve sustainability are addressed.