Home' Australian Ageing Agenda : AAA Spt-Oct 2014 Contents Stephen Muggleton initially jokes
about his "grey hair and balding
head" when asked about aged
care reform, but it's not long
before the chief executive of
RDNS leads the conversation to the more
serious topic of the "accelerating rate of
change smashing into the sector."
He runs through the list: "We've had
Hogan, the Health and Hospital Review
Commission, the Productivity Commission,
Living Longer Living Better, we've seen
NDIS appear and then shape shift because
of fiscal constraints, we've just seen the
emergence of Medicare Locals and their
conversion into primary health networks,
significant change with aged care moving
from health into social services, and the
transition of HACC from state governments
across to the Commonwealth."
Behind all this were the major themes
of tighter funding, organisations having
to cope and adjust, and the spectre of
considerable increased contestability in
the sector, he says.
So accelerated has the pace of
change become, Muggleton believes,
the traditional hierarchal management
structures underpinning aged care
organisations simply will no longer cut it.
"They just don't work in the
environments experiencing rapid change,"
he says. The solution? Organisations
need to avoid getting trapped making
"micro adjustments" to their operations
in response to change and instead have a
"laser focus on clients," he says.
"Ultimately it's redesigning the
organisation around agile teams of staff
cells that are fully empowered with
decision rights and can respond to those
Paramount to this is Muggleton's
view that organisations are only the sum
total of one-on-one interactions between
frontline staff and clients.
"The more trusted, empowered,
focused and motivated frontline staff
is, the better the care and, therefore,
the better the outcomes will be. That
subsequently informs your marketing,
reputation and profile."
Muggleton's view is informed by his 25
years' experience leading some of Australia's
major hospitals and aged care organisations.
Prior to taking the top job at RDNS in 2010,
he was CEO of major not-for-profit provider
Blue Care for seven years.
He has also served on numerous
government bodies and reviews,
including the Federal Government's
Ageing Consultative Committee (from
2004 to 2010) and the National Health &
Hospital Reform Commission's Aged Care
Taskforce in 2009.
Those who work with Muggleton at
RDNS say that he is painfully aware of
the need for organisations like his to
change and adopt new ways of doing
business in order to survive in the
"This will not sit too well with staff that
enjoy the status quo," says a colleague,
"but the good thing is that the majority
of RDNS's 2,500 strong workforce
understand the realities of aged care
business in a global environment and that
to stand still and continue doing same-
old-same-old will mean a swift demise."
Standing still is certainly not something
RDNS could be accused of.
From the early adoption of telehealth
in care to developing innovative programs
with acute care providers and putting
an almost unrivalled focus on research,
the organisation has been pursuing an
impressive agenda over the past few years.
And that's before mentioning its rapid
expansion across Australia and into New
Zealand and China.
New Zealand, where RDNS now has
full coverage, is a "really interesting
space" Muggleton says, in particular the
competition there with Bupa and Medibank.
"It's fascinating to see their expansion into
service provision in Australia and see them
popping up in New Zealand."
This, he believes, is a sign of the
future: "Traditionally the sector has seen a
combination of for-profit and not-for-profit
organisations, but now we're seeing the
emergence of the big health insurers in
service provision. Combined with increased
contestability, it's almost a seismic shift."
The move into NZ has been a learning
curve for the organisation, he says. "NZ
has experienced financial pressure for
some time and they've innovated quite a
lot around coordination between hospitals,
community care and aged care. Being there
we have learned more about coordinated
care and lessons we can apply here."
At the same time, RDNS has been busy
in China, having partnered with several
private universities to deliver some of
the 130 specialist aged care and chronic
disease courses run at its training college
There is also Zhongshan College, in
Jiangsu Province, where RDNS is involved
in the design and management of a
complex consisting of 1,500 retirement
living and residential aged care beds and a
400-bed rehab hospital.
'An opportunity to
The scale of sector change is such
it's time to throw out the traditional
management structure and empower
frontline staff, says RDNS chief executive
Stephen Muggleton. He speaks to
Darragh O'Keeffe about surviving
in the new landscape, innovation and
42 | SEPTEMBER -- OCTOBER 2014 | AAA
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