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The new Aged Care Act, which came into effect on 1 November 2025, is being widely described as a once-in-a-generation reset.
After a Royal Commission, exhaustive reports, and years of stalled and piecemeal reforms, Australia finally has a rights-based framework that places older people at the centre of policy, practice and funding. This reshapes how aged care is regulated, how programs are structured, and what obligations fall on providers.
This shift is both significant and overdue, and a welcome step. But for hospital leaders watching emergency departments continuing to fill and older people continuing to remain in acute beds for weeks or months, the immediate question is a tad more blunt:
Will the new Act and accompanying standards fix the bed-block problem?
The short answer is no.
Unless clinical and system leaders treat this reform as the start of a sustained, operational campaign rather than a policy panacea.
What the Act can and can’t do
The new legislation fundamentally reframes aged care as a rights-based, person-centred system. It updates the Quality Standards, reshapes programs through the new Support at Home model, and introduces reforms that are designed to better match people with available places. It also strengthens the regulatory oversight of providers.
These are essential structural improvements. Over time, they should reduce the mismatch between what older people need and what the system can offer.
However, it is important to recognise what this legislation cannot do:
- It cannot instantly create new residential beds.
- It cannot conjure up a larger, skilled workforce.
- It cannot rapidly expand transitional care options or community-based supports.
- And it cannot fix misaligned funding incentives between hospitals and providers overnight.
Many of the root causes of the current bed block are operational and market-driven, not legislative. The number and distribution of residential places, the capacity of short-term restorative services, workforce shortages (especially in nursing and allied health) and the availability of suitable housing options, all continue to constrain timely discharge.
So while this Act can provide a better scaffolding for what is needed, it cannot generate capacity by itself.
The current reality: older people are still stuck in hospitals
Recent data shows thousands of older Australians remain in acute hospital beds far longer than medically necessary. Many wait months for an appropriate aged-care placement.
This creates a chain reaction:
- ED wait times blow out.
- Elective surgery backlogs worsen.
- Staff experience higher burnout.
- And older people deteriorate physically and cognitively.
Whilst the reform agenda acknowledges these issues, the day-to-day reality on hospital wards remains unchanged. At least for now.
How the new Act can help
Noting it isn’t an instant fix, there are at least three ways in which the Act can however reduce this issue of bed blocking over time:
1. Better allocation and matching
The new programs aimed at allocating residential places to older people (e.g. the “places to people” initiatives) are intended to make it easier to match older people with suitable residential options more efficiently. Doing so should theoretically reduce the delays caused by poor visibility and inconsistent information, which should then speed up the transitions out of acute care.
2. Strengthening home-based alternatives
The move to shift more resources to home-based supports and short-term restorative care, can reduce demand for residential beds and provide safer alternatives to hospital discharge.
3. Higher standards and improved oversight
By lifting standards and embedding rights-based care, these reforms may increase confidence among clinicians and families that aged-care placements are safe, thereby reducing any reluctance to discharge when a bed is available.
The catch here though, is timing.
Building capacity, whether that’s beds, community packages, or a trained workforce, will take months and years, not weeks. Administrative rollouts, IT integration between hospitals and My Aged Care, and the cultural shift needed for clinicians to rely on community alternatives will all take time.
Meanwhile though, the hospitals will continue to remain full and at crisis levels.
What this means for hospital and health system leaders right now
If you are a chief executive, director of nursing, or head of patient flow, the new Act should change your long-term strategy, but it should not change your sense of urgency. Leaders need to treat these reforms as an opportunity to accelerate local operational changes, not continue to wait for system-level fixes.
Here are practical, immediate responses that we suggest should be considered alongside system advocacy:
Suggestion 1: Reframe bed block as a safety and quality risk
Long-stay older patients are exposed to harm. Positioning the issue as a safety concern rather than a throughput problem activates clinical governance levers and gets board attention.
Suggestion 2: Localise and operationalise the reforms
Don’t wait for perfect national systems. Create dedicated local teams that engage daily with aged-care providers, using real-time bed-availability tools for identifying restorative options and transitional pathways. Even imperfect local partnerships can materially shorten discharge times.
Suggestion 3: Invest in in-reach and transitional care models
Models where aged-care clinicians work alongside hospital teams to assess and prepare residents for discharge whilst they are in hospital, and co-design the discharge plans, result in transitions that are much smoother. Short-stay step-down units, transitional beds and restorative therapy options can then significantly reduce length of stay.
Suggestion 4: Build workforce pipelines collaboratively
Partner with local providers, TAFE and universities to create fast-track training for aged-care nursing and allied health workers. Incentivise placements and shared rostering arrangements that increase workforce flexibility to work between acute and aged-care settings.
Suggestion 5: Strengthen data and local metrics
Build dashboards that show not only occupancy, but the clinical risk of inpatients who are awaiting placement. Use this data to then prioritise resources and to make the public and political case for targeted investments.
Policy changes that’re still needed
Alongside the local action though, hospital leaders must still continue advocating for policies that will amplify the Act’s impact.
The three key asks in this space should include:
- Surge funding for transitional and short-term beds,
- Rapid expansion of home-support packages in regions worst affected by bed block, and
- National investment in integrated, real-time bed-visibility platforms.
These measures directly affect the operational bottlenecks hospitals face every day. And we won’t be able to legislate our way out of a capacity shortfall without these basic and tactical investments.
A Leadership Mandate
The new Aged Care Act is a landmark reform, but its success depends on how health and aged-care leaders respond.
That means shifting mindsets from seeing bed blocking as an aged-care problem or a hospital flow issue, to treating it as a clinical and governance risk that must be managed with the same rigour as things like sepsis or falls prevention.
If hospital leaders act now, combining strong advocacy with practical local change, these legal reforms can be more than just symbolic. They can become the scaffolding for an ageing system that actually works for both older Australians and the acute system that serves them.
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