The way Australians are assessed for home-based aged-care funding is being investigated by the Commonwealth ombudsman.

Critics say assessment for funding under the Support at Home program is flawed, leaving some older people unable to access the right level of care they need to safely live at home.

Complaints about the process are increasing significantly. Even an expert who helped design the system is unhappy.

Here’s why the Commonwealth should reconsider its approach.

What’s the key issue?

The new Support at Home program was introduced in 2025. One of its aims is to support more Australians to remain at home rather than moving into residential aged care.

When an older person wants to join the program, they are assessed in an interview with a structured digital assessment known as the “Integrated Assessment Tool”. This tool assesses the support they need – physical, cognitive and psychosocial. It also assesses the urgency and the level of assistance required.

An algorithm then analyses the answers and determines Support at Home funding levels.

To be useful, assessments need to predict the actual service levels required for high-quality outcomes for older people with different levels of need.

In developing assessment tools, the gold standard is to first conduct a large number of assessments to see what kind of care older people need, and at what level. The next stage is to determine if the services actually provided produce high-quality outcomes for people with different levels of need.

But there is no publicly available evidence this has been done.

Instead, a second-best option was adopted. Experts gave a score to estimate what level of support someone would need based on answers to assessments.

But there is room for expert disagreement even when they use well developed tools.

The Integrated Assessment Tool includes 11 separate validated tools, each with an inherent error rate. These error rates compound when they are combined.

Worse, given there are no studies of the extent to which integrated assessments predict actual services and outcomes, it is difficult to say how good the algorithm is. Lack of transparency means it’s a black box, which is why the ombudsman’s inquiry is welcome.

This is particularly true because funding determined by the algorithm may be systematically lower than funding determined by experts. This means elderly people may have their cognitive, safety and complex care needs underestimated.

How about human oversight?

Despite the limitations and against expert advice, the Commonwealth has explicitly removed the power to manually override the algorithm’s allocation of support levels. The idea is for the algorithm to provide consistent results for thousands of older people.

However, this approach has a number of serious potential consequences.

The Support at Home Program has eight levels of support ranging from A$10,731 a year for level 1 (the most basic support) to $78,106 a year for level 8 (the highest level of support).

If the algorithm allocates one level of support higher or lower than what a person actually needs, this can mean a difference of between $5,300 and $20,000 a year depending on the level.

Appeals are increasing

If an older person or their family wants to question the funding allocation, they can appeal. But they often don’t know the specific reasoning behind the scoring that led to their allocation. And the appeals process can be cumbersome and stressful.

Some 800 older people have requested a review of their assessment since the introduction of the new system.

The Older Persons Advocacy Network says requests for information and advocacy have gone up by 50% in the three months in the same period.

One of the system’s designers, Lynda Henderson, said she felt “fury” that the tool she helped design has been turned into a prescriptive algorithm.

What needs to happen next?

The Robodebt Royal Commission warned government agencies that automated systems must ensure transparency, fairness and human oversight.

But this has not happened when assessing individuals’ circumstances for home-based aged-care funding.

The best approach is to use the algorithm as a guide for making individual decisions about older people’s support needs and to allow assessors to override the algorithm when the circumstances warrant it.

Systems-level data should then be used to refine the algorithm and provide guidance to assessors as the system matures.

Hal Swerissen, Emeritus Professor of Public Health, La Trobe University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

We usually have to wait until winter approaches before we see an increase in cases of influenza, or the flu. But we have already seen a lot of flu this year, with 25,000 cases reported from January to March – and that’s only a fraction of actual case numbers.

Most people with the flu recover without treatment. But it can cause serious complications in older people, young children, pregnant women and those with underlying chronic diseases such as asthma or heart disease. Influenza kills around 3,500 Australians a year and lands 18,000 in hospital.

Vaccination is the best way to protect against flu and is recommended for everyone over the age of six months.

Flu vaccines are free for certain risk groups. Others can access them (usually for a fee) at pharmacies, GP clinics and local council clinics in some states and territories. Some employers also offer vaccinations for staff.

Influenza has been unpredictable since the COVID pandemic, with off-season circulation. There are also concerns protection might lag at the end of winter. So when is the best time to get vaccinated?

What are the symptoms and how does it spread?

Flu symptoms include a cough, sore throat, fever, body aches and fatigue.

Flu spreads from person to person via small respiratory droplets when you talk, cough and sneeze. It may also spread by touching a surface or object where infected droplets have landed, but this is less common.

So if you have flu-like symptoms, it’s important to stay at home.

Flu spreads more in winter months due to increased contact between people and time spent indoors. Some studies also suggest influenza viruses transmit better in the cold.

What strains are around this year? And what is super-K?

Typically, human flu cases are caused by four virus strains, A(H3N2), A(H1N1), B/Victoria and B/Yamagata.

So far this year in Australia, almost 98% of cases have been influenza A(H3N2) and the remaining have been influenza B/Victoria.

In late 2025, a new variant of the H3N2 strain known as subclade K or “super-K” emerged in the northern hemisphere winter.

Super-K contributed to the unusual increase in flu numbers over summer in Australia. But there is no evidence to suggest it’s more severe than other H3N2 strains.

What does this year’s vaccine protect against?

Each year, the flu vaccine is designed to protect against a mix of different virus strains, depending on what strains are currently circulating.

This year’s flu vaccine contains two new strains for the influenza A(H1N1)pdm09 and A(H3N2) subtype virus components and an existing B strain:

• an A/Missouri/11/2025 (H1N1)pdm09-like virus
• an A/Singapore/GP20238/2024 (H3N2)-like virus
• a B/Austria/1359417/2021 (B/Victoria lineage)-like virus.

The Singapore strain in the vaccine is closely related to the super-K strains that have been circulating, so should provide better protection than the vaccine used last year in the northern and southern hemispheres.

The composition of the southern hemisphere vaccine for use in Australia is different to the northern hemisphere composition for the 2025–26 winter.

How effective will this year’s vaccine be?

It’s too early to know how well the vaccine will work against preventing infection and severe disease.

Preliminary Australian data suggests people who received the flu vaccine in 2025 were 53% less likely to be hospitalised with influenza or visit a GP for flu symptoms compared with unvaccinated people.

In the UK, during the 2025–26 winter, influenza vaccines were 72–75% effective at protecting against flu cases needing medical attention in children and adolescents, including infections caused by super-K.

Herd immunity from influenza vaccines can also help prevent transmission to others who are unable to get vaccinated.

A three-year study in the United States, which ended in 2020 found influenza vaccines were 21% effective at preventing infection among others household members.

Another study in the UK and Ireland from 2010 to 2017 found vaccinating school-aged children reduced the amount of respiratory illnesses GPs saw across all age groups.

When does the flu season peak?

While we see flu cases throughout the year, the “flu season” in temperate Australia typically lasts from May to October, peaking in June to July.

Theoretically, the best time to get the flu vaccine is about two weeks before flu cases start to rise.

However, this is difficult to predict and the rise can start anywhere between April and July in temperate Australia, and even earlier in tropical northern Australia.

How long does the flu vaccine last?

There is some evidence the protection provided by influenza vaccines falls over six months. Immunity to flu is optimal for three to four months after you are vaccinated.

However, some studies suggest this may be an artifact of the methods by which vaccine effectiveness is measured.

Other factors may also be important. Waning protection may be more prominent in older people and may also depend on the degree to which mutations in circulating influenza strains accumulate during the season.

So when is the best time to get vaccinated?

When working out when is the best time to get your flu vaccine, you might be balancing a theoretical benefit by waiting, against a chance of actually getting the flu before you get vaccinated.

Our advice is to get the vaccine when it’s available and convenient, sometime around April or May.

But if you’re travelling overseas, particularly for those travelling to the northern hemisphere in winter, aim to get your flu vaccine around two to four weeks before you leave.

If you’re pregnant, an ideal time to get the influenza vaccine is with RSV (respiratory syncytial virus) and pertussis vaccines from 28 weeks of pregnancy. This protects both mother and baby.

Finally, young children getting their first flu vaccines should have two doses four weeks apart. Getting their first dose in earlier in the season will leave plenty of time for the second dose before the influenza season starts.

Meru Sheel, Professor of Infectious Diseases and Global Health, University of Sydney and Allen Cheng, Professor of Infectious Diseases, Monash University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

As Britain’s longest‑reigning monarch, and one rarely out of the public eye since childhood, Queen Elizabeth II left behind a wardrobe so extensive and meticulously archived that the curators at Historic Royal Palaces have had an embarrassment of riches to draw upon for a new exhibition at the King’s Gallery in Buckingham Palace.

Queen Elizabeth II: Her Life in Style bills itself as the largest exhibition of the late monarch’s wardrobe ever mounted, and the scale alone is arresting. More than 300 items, many on public display for the first time, attempt a sartorial biography spanning every decade of a life that lasted almost a century.

The result is a masterclass in what the Royal Palaces do best: celebrations of the British monarchy – their pomp, pageantry and performativity – delivered through the medium of clothes. It also underscores why Her Life in Style, rather than in fashion, is such an apt title.

Queen Elizabeth II valued constancy, a deliberate contrast to the restless churn of high fashion. As a figure who embodied Britishness while standing on a global stage, her appearance had to resonate widely, and what read as high style in Britain could easily have seemed out of place in parts of the Commonwealth. In such a negotiation subtlety trumped bravura.

The Queen’s wardrobe reads like a roll call of British heritage makers: Molyneaux, Burberry, Hawes and Curtis, Kinloch Anderson, Bernard Weatherill Ltd, Philip Somerville, and Gieves Ltd. Norman Hartnell and Hardy Amies appear with predictable regularity, which will come as no surprise to anyone familiar with the Queen’s sartorial loyalties. But the exhibition also highlights the quieter and long-enduring relationships with tailors, dressmakers and milliners who helped craft her public image.

For example, her dresser Angela Kelly created a style for the Queen which she favoured in her later years. As an assistant dresser, then dresser and finally called designer, Kelly was intimately familiar with the Queen as a woman long before her sartorial interventions. But the exhibition seems to reveal more about the designers, who saw the dress as the main event, than about someone like Kelly, for whom the Queen herself was always the focus.

What emerges most strongly is the centrality of collaboration in the crafting of her style. The Queen was not a mannequin at the mercy of designers, but a woman who presided over her wardrobe with clear autonomy and a keen understanding of the symbolism her clothes carried.

Public service, personal style

The exhibition opens with a brisk chronological sweep from infancy to early adulthood. The transition from baby clothes to the military ensembles worn during her late teenage years make plain how abruptly she was thrust into public service.

Here, however, as is the case throughout, the curators favour the makers over the meaning. The garments are beautifully displayed, but the interpretive text often stops short of probing the “why” behind stylistic shifts and choices. For instance, the Queen’s later‑life preference for a straighter silhouette is asserted but not explored, a missed opportunity given the exhibition’s ambition to chart a life through her style.

The exhibition curation borrows liberally from recent V&A fashion blockbusters to great success. Most notably the double‑decker display technique used to kaleidoscopic effect in Gabrielle Chanel: Fashion Manifesto and the circular and tiered arrangements of Dior: Designer of Dreams. In Queen Elizabeth II: Her Life in Style a double-stacked rainbow wall of colour‑blocked coats and suits is visually striking but also underscores the sameness that defined the Queen’s wardrobe.

That said, individual garments indicate occasional moments when she embraced stylistic choices that felt markedly more daring, such as a First Nations jacket that she wore with an evening dress in 1970. The exhibition makes clear, however, that once her style was set in the 1950s, evolution was subtle and nuanced rather than flamboyant or bold.

Her sartorial consistency seems to have become a kind of representation of national reassurance: a stability of taste, of choice of makers, and silhouette across a near century of life defined by political and social change.

The contributions by Erdem Moralıoğlu, Richard Quinn and Christopher Kane, who have produced contemporary reimaginings of the Queen’s style, are well executed but ultimately redundant. Her fashionable legacy speaks loudly enough without reinterpretation.

Meanwhile navigation through the exhibition can be challenging. The King’s Gallery becomes a rabbit warren of narrow corridors and bottlenecks, exacerbated by the otherwise informative audio guide that slows foot traffic to a crawl. Still, the text panels are excellent – clear, concise, and often illuminating – and the overall display is both attractive and thoughtfully arranged.

The final room is a crescendo of encrusted and bejewelled gowns, which almost, but not quite, overwhelm the coronation dress. It is a fittingly theatrical conclusion, a reminder of the Queen’s ceremonial presence and the role fashion played in projecting it.

Even in death, she seems to transcend mortality here. Despite the diminutive stature of the mannequins proxying the royal body, her physical and ceremonial presence evoked through her luxurious couture gowns feels mighty.

The exhibition has arrived at a moment when an evocation of her popularity and a celebration of the British royals is needed for their brand now more than ever. Public appetite to celebrate the woman who represented an untarnished royalty – which now seems more remote than ever – is clearly voracious judging by the queue outside the exhibition. In this setting, even as the nation moves on, her reputation has settled into a rich and celebratory one.

Ultimately, the exhibition succeeds not simply because it dazzles, but because it reveals Queen Elizabeth’s harnessing of the soft power of clothing in shaping a public life. Through tweeds and tiaras, coats and coronation gowns, the exhibition charts a life defined by duty, diplomacy, and an unwavering sense of self, expressed always through fashion.

Hannah Rumball-Croft, Lecturer in Cultural Studies and Fashion Design, School of Arts, University of Westminster

This article is republished from The Conversation under a Creative Commons license. Read the original article.