Workforce shortages are among the most persistent barriers to delivering high-quality long-term care in Australia, particularly outside metropolitan regions. This paper presents new evidence on the geographic distribution of aged care workforce capacity, with a focus on quantifying unmet need in rural and remote areas and identifying where shortfalls are most acute.

Using microdata from the 2021 Australian Census, the study compares the capacity of the aged care workforce in regional and remote areas to metropolitan areas. We examine capacity across Aged Care Planning Regions (ACPRs), which are the basis for service allocation and policy planning. The study analyses the number of people aged 65 and over with varying levels of care needs, in both residential care and in-home settings. The analysis of the workforce uses six broad categories of care professionals—nurses, allied health, general practitioners, personal care workers, oral health, and administrative support.

The analysis reveals substantial regional disparities. Rural ACPRs require an estimated 95,342 full-time equivalent (FTE) aged care workers to match capacity in metropolitan areas, while remote ACPRs require an additional 12,958 FTEs. The gap is striking, as is the level of systemic needed to address the issue. Some of the largest gaps are in allied health, general practitioners, and administrative roles—functions that underpin coordination, prevention, and the delivery of person-centred care.

Regional variation is also significant: the most severe shortfalls are found in ACPRs along the eastern seaboard and inland regional centres, where ageing populations have outpaced workforce growth. This is compounded by infrastructure, transport, and housing constraints that hinder workforce attraction and retention.

These findings highlight systemic inequities in aged care provision that have direct implications for older adults’ ability to live safely and independently in their communities. In areas with limited service access, older people face higher risks of unmet care needs, functional decline, and premature entry into institutional care. Moreover, where the formal workforce is insufficient, the burden falls to family members and local community networks, whose contributions are often unsupported and unsustainable.

This study provides a detailed, region-level picture of the aged care labour force and its adequacy relative to the needs of older Australians. It contributes to long-term care policy and planning discussions by identifying where targeted investment, training, and reform are most urgently required. It also directly responds to a call to address inequities in long term care outlined by The Royal Commission into Aged Care Quality and Safety, and WHO’s Long-Term Care Framework.

Ensuring equitable access to long-term care is essential for upholding the rights and dignity of older people across Australia. Addressing workforce shortages—particularly in rural and remote settings—is not only a matter of access but also of system resilience, care quality, and the capacity to maintain function and autonomy in later life.

 

Irene Blackberry, Nicholas Morris, Sue Jaffer, Stacey Rich, Kate Syme-Lamont

Professor Irene Blackberry is the John Richards Chair and Director of the Care Economy Research Institute at La Trobe University. Professor Blackberry is a health services and implementation science researcher of complex multifactorial care. She has over 20 years of research experience across the care economy in Australia and abroad, predominantly in healthcare, aged care and informal care sectors. Research examines access to care and models of care that are innovative, effective and sustainable, building skills in individuals and greater capacity of the whole-of-community to support people from diverse background and rural communities.

 

Research focuses on addressing care crisis by breaking down the siloing of care sectors. She is the leading force behind Australian’s Care Economy research including developing an industry-led research partnership program on Care Economy, establishing the Care Economy Collaborative Network and becoming the Inaugural Director of Australia’s first Care Economy Research Institute at La Trobe University. And leads a team of 140 mutidisciplinary researchers and collaborates with 100 industry partners.

 

Irene is the Past President of Australian Association of Gerontology Victoria, member of the NHMRC Council and Principal Committees 2021-2024 Triennium, on the editorial board of several international journals and expert advisors to government and not-for-profit organisations. She has attracted over $135M in competitive research funding and published 150 reports and journal articles. She has supervised 20 research students to completion and currently supervises 9 PhD students and mentors 10 academics. She holds a bachelor’s degree and PhD in Medicine and a postgraduate study in Program and Economic Evaluation.