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Industry Skills and Workforce Development Report: June 2012
The Workforce Council acknowledges Aboriginal and Torres Strait Islander people as the original inhabitants of Australia and recognises these unique cultures as part of the cultural heritage of all Australians. We respectfully acknowledge the traditional custodians of the land on which we do our work across Queensland. For more information on our commitment to Reconciliation visit www.workforce.org.au/about/reconciliation All portraits are a part of the Workforce Council’s Photo Exhibition http://www.workforce.org.au/gallery/our-people.aspx
Contents 4 5 8 10 13 15 18 20 21 21 22 Industry Sector Profile Training Profile Economic. training quality and delivery methods Key Achievements Ten Year Skilling and Workforce Development Outlook Five Year Skilling and Workforce Development Priorities Priorities for action over the next year Primary Health Care Sector Industry Skills and Workforce Development Report: June 2012 3 . social demographic. environmental and technological factors Government Policies impacting on the industry’s workforce Identification and Prioritisation of gaps between the existing workforce and future workforce needs Demand and supply disparities Advice concerning training product. pathways.
This report summarises information related to the Queensland Primary Health Care Sector to date. Health and community services labour force 2006.3 The most recognisable services in the primary care sector are general medical practices.1 In addition. there are evident shortages in general practice. dentistry. Primary Health Care Reform in Australia: Report to Support Australia’s First National Primary Health Care Strategy.pc.pdf (accessed March 15th 2012) 7 Commonwealth of Australia.au/internet/yourhealth/publishing. community health services.au/internet/yourhealth/publishing. 2009.nsf/Content/nphcdraftreportsupp-toc/$FILE/NPHC-supp. In addition to providing direct medical care.gov. http://www. Productivity Commission report on Australia’s health workforce. National Health Reform . health promotion. It forms part of the Industry Skills and Workforce Development Report for the Community Services and Health Industries. acupuncture.nsf/Content/nphcdraftreportsupp-toc/$FILE/NPHC-supp. and involves collaboration and partnership with other sectors to promote public health. Commonwealth of Australia. how they pay for them.org. HWL 43.gov. Primary Health Care Reform in Australia Report to Support Australia’s First National Primary Health Care Strategy. nursing and some key allied health areas. etc. Australian Government.au/documents/items/2011/02/363952-upload-00001. Currently. 2009.yourhealth.yourhealth.healthissuescentre. Information in this report has been validated through consultation with industry stakeholders. speech pathology. Primary Health Care Reform in Australia Report to Support Australia’s First National Primary Health Care Strategy. private clinics and Aboriginal medical services. a commonly used definition of primary health care developed by the Australian Primary Health Care Research Institute is: socially appropriate. Primary Health Care Reform in Australia Report to Support Australia’s First National Primary Health Care Strategy.gov. 2009).nsf/Content/nphcdraftreportsupp-toc/$FILE/NPHC-supp. Many primary health services also provide preventive health.pdf (accessed March 15th 2012) 3 Department of Health and Ageing. 2009. education and care coordination services to the community. 2005. fragmented and often uncoordinated delivery systems that operate across primary health care that have implications for the services individuals receive. Commonwealth of Australia. so instead of a system it is often described in terms of occupations that work within it such as general practitioners. 42. http://www. Canberra: AIHW 5 Productivity Commission. Australia’s primary health care sector operates as a disparate set of services.National health labour force series no.yourhealth. primary health care is increasingly being seen as all health care services provided outside the hospital. Commonwealth of Australia. the new Medicare Locals (replacing previous Divisions of General Practice). June 2012. counselling and psychology services.5 Creating a strong. http://www.7 However.6 The primary health care sector plays an important role in the health care system with four out of five Australians attending a General Practitioner or other primary care professional at least once a year. flexible and responsive primary health care sector and workforce is critical given the complex. and how care providers interact and provide care. universally accessible. participation and control.pdf (accessed March 15th 2012) 2 Department of Health and Ageing. 24. 2009.4 Though precise quantification is difficult.pdf (accessed March 3rd 2012) 4 Health and Community Services Workforce Council . scientifically sound first level care provided by health services and systems with a suitably trained workforce comprised of multi-disciplinary teams supported by integrated referral systems in a way that: gives priority to those most in need and addresses health inequalities. these services also commonly provide allied health services such as physiotherapy.2 In the Australian context.Improving Primary Healthcare for all Australians. Commonwealth of Australia. 2011. 4 Australian Institute of Health and Welfare. Cat no. PROFILES Primary health care is commonly viewed as the first level of care or as the entry point to the health care system for consumers.pdf (accessed April 4th 2012) 6 Department of Health and Ageing. Industry sector profile 1 Department of Health and Ageing. http://www.gov.au/__data/assets/pdf_file/0003/9480/healthworkforce. http://www. Australia’s Health Workforce. maximises community and individual self-reliance. the Australian primary health care system is facing workforce shortages.au/internet/yourhealth/publishing. (Canberra. various medical specialty areas.
practice nurses. Delivery of the Certificate III peaked in 2008/09 following the introduction of this qualification in the 2007 Health Training Package.pdf (accessed March 4th. and pharmacists. http://www. The General Practice sector in Queensland has begun utilising national training package qualifications.gov.8 Training Profile Qualifications in Aboriginal and/or Torres Strait Islander Primary Health Care represent the most significant area of delivery for the primary health care sector. community health workers. physiotherapists.health. 8 Department of Health and Ageing. The Certificate IV in Medical Practice Assisting is designed to support an emerging role for administration staff in general practice to support patient care. Enrolments in the Certificate IV are gradually increasing thanks to targeted strategies in both Queensland Health and the Aboriginal Medical Services. and some of the Medicare Locals and the state body are delivering training in partnership with registered training organisations. Building a 21st Century Primary Health Care System Australia’s First National Primary Health Care Strategy.au/internet/yourhealth/publishing. enrolments this financial year will be similar to 2010/11. delivery of Practice Management and Population health qualifications is emerging. Numbers in this qualification have dropped in the following two years and on the basis of data for the period 1 July 2011 to 31 March 2012. 2010.nsf/Content/3EDF5889BEC00D98C A2579540005F0A4/$File/6552%20NPHC%201205. As a result. These qualifications are directly related to Indigenous Health Worker roles within Queensland Health as well as Health Workers employed in Aboriginal Medical Services. 2012) Primary Health Care Sector Industry Skills and Workforce Development Report: June 2012 5 . Commonwealth of Australia. psychologists.
Current industry and workforce reforms are being driven through national and state government policies and mandates which are vital in altering the structural design of the system 6 .
Primary Health Care Sector Industry Skills and Workforce Development Report: June 2012 7 .Indigenous Environmental Health qualifications are used by Queensland Health to support a relatively small workforce in Indigenous communities in the Cape and Gulf regions.
2012. Closing the gap in a generation: health equity through action on the social determinants of health. 2008.” BMC Health Services Research 8 (2008) 11 Humphreys and Wakerman. public and non-government environments.who.pdf (accessed March 25th 2012) 8 Health and Community Services Workforce Council . This creates an imperative to understand the Queensland environment to inform an appropriate and effective approach to the implementation of workforce strategies. to 220 in 2002. Australian Institute of Health and Welfare 2006). http://www. “Identification of recruitment and retention strategies for rehabilitation professionals in Ontario. 12 World Health Organisation. the number of people working in health occupations increased by 11. http://whqlibdoc. increasing health care costs.000 in 1997.4% compared with an 8. Demographics The primary health care workforce. an ageing population with multiple co morbidities. allied health and pharmacy services. World Health Organization.biomedcentral. A Healthier Future For All Australians – Final Report of the National Health and Hospitals Reform Commission. Primary health care in rural and remote Australia: achieving equity of access and outcomes through national reform. social demographic. Queensland varies from other states in many areas including population. Townsville and Cairns in Queensland. regional and state landscape. decreasing from 236 per 100. Canada: results from expert panels. However. geographical dispersion. Current industry and workforce reforms are being driven through national and state government policies and mandates which are vital in altering the structural design of the system. advances in technology and changes in inter-professional service delivery models of care. distribution of population and workforce.12 In 2002 Queensland had the lowest number of registered medical practitioners per head of population in Australia. impact of resources boom and the political environment which all shape the local.pdf (accessed February 26th 2012) 13 Commonwealth of Australia.ruralhealthaustralia. These approaches include utilising the social determinants of health promoted by the World Health Organisation as a tool for locating specific pre-dispositions to disease across Queensland to inform deployment of health care workforce.CHALLENGES IMPACTING ON THE INDUSTRY’S WORKFORCE Economic. Sunshine Coast.com/1472-6963/8/249 10 Tran.int/publications/2008/9789241563703_eng. This is particularly concerning when Queensland has experienced unprecedented levels of population growth..700 medical specialists in Australia who work in primary care settings (Australian Institute of Health and Welfare 2006). et al. http://www. based on people employed in general practice medical services and community-based dental. environmental and technological factors The demand for primary health care services is expected to increase due to such factors as the rise in chronic and complex disease. workforce shortages in other parts of the health system. 2009). au/internet/rha/publishing. is around 137. Australia is not considered to have a critical shortage of health workers.nsf/Content/EBD8D28B517296A3CA2579FF000350C6/$File/NationalStrategicFramework.600 equating to approximately 25% of the health workforce (Department of Health and Ageing 2009. Outside capital cities. including nurses. This includes 20% of the 17. From an international perspective.gov. (Canberra. the implementation of workforce changes ultimately occurs at the local level by practitioners and organisations themselves across private.13 9 National Health and Hospitals Reform Commission. D. the fastest growth in 2008-09 occurred along the Australian coast especially in the regional areas of the Gold Coast.7% increase in the total civilian workforce. Final Report of the Commission on Social Determinants of Health. National Strategic Framework for Rural and Remote Health. Geneva. (2008).91011 A health system approach advocated by government reports has implications for workforce development.
900) after NSW (152. In 2006.hwa.pc. 2009. 2009.16 There are significant gaps in Indigenous participation in the health workforce. Cat. it relies on exponential growth in 14 Commonwealth of Australia.au/__data/assets/pdf_file/0003/9480/healthworkforce.abs.gov. http://www.gov. No 3238.nsf/mediareleasesbytitle/5D8264F4B08 3F282CA25762A002726E3? (accessed 24/04/12) 17 Health Workforce Australia.National health labour force series no. Australian Bureau of Statistics. 2012. 2009. National Health Workforce Innovation and Reform Strategic Framework for Action 2011–2015. In 2006. significant disparity in the number of health care professionals between metropolitan and the most remote parts of Australia. Australian Government. Canberra: AIHW 16 Australian Bureau of Statistics. Cat no.64 allied health workers per 100 000 population compared to 354 per 100 000 in major cities. Queensland had the second largest number of Aboriginal and Torres Strait Islander people (144.5% of the population of Queensland.gov. 2011.0. Components of that growth are important for establishing health care where the service is needed. Experimental Estimates and Projections.ruralhealthaustralia. Aboriginal and Torres Strait Islander Australians. This model relies on a Community Health Plan and a Health Services Plan. however.pdf (accessed March 25th 2012) 15 Australian Institute of Health and Welfare.pdf (accessed April 4th 2012) Primary Health Care Sector Industry Skills and Workforce Development Report: June 2012 9 . while Aboriginal and Torres Strait Islander people made up 3.There is however. registered nurses and allied health workers per 100 000 population compared to major cities . 42.15 This pattern of health worker disparity in rural and remote areas is exacerbated within the primary health care workforce.4% of the health workforce was indigenous (Australian Institute of Health and Welfare 2008). au/internet/rha/publishing. HWL 43. National Strategic Framework for Rural and Remote Health.14 In 2006 the most remote areas had significantly fewer general medical practitioners.9% by 2021. Regard for the types of needs of the community and matching the skills to those needs is essential with an overarching focus on well-ness to prevent disease. Health and community services labour force 2006.au/sites/uploads/hwa-wir-strategic-framework-for-action-201110. Ageing Workforce Generational changes mean that many providers are not working the same long hours or practising in the same way as their predecessors17 The informal carer workforce currently providing much of the services to the aged18 is likely to diminish as people stay longer in the workforce and are less available to assist the aged and chronically ill to stay at home. Workforce planning is considered a major problem in the primary health care sector for Aboriginal and Torres Strait Islander services. Productivity Commission report on Australia’s health workforce. the Indigenous population of Queensland is projected to be the fastest growing of the states and territories which will grow by 34.gov. Australia’s Health Workforce. https://www. Thorough though this model is. The warning is that number alone will not address the ageing workforce challenges.700).nsf/Content/EBD8D28B517296A3CA2579FF000350C6/$File/NationalStrategicFramework. in indigenous health. http://www. 2005. These workers are unevenly distributed across the state in ways that impact on Aboriginal and Torres Strait Islander health services. particularly health professionals. only 1. The Queensland Aboriginal and Torres Strait islander Health Council (QAIHC) advocates under the reform of Medicare Locals a new model of the QAIHC Comprehensive Primary Care Model in response to the workforce impacts on service provision for the Indigenous part of the sector.pdf (accessed April 20th 2012) page 3 18 Productivity Commission.au/ausstats/abs@. 1991 to 2021. http://www. There is a relatively small number of Indigenous people in the health workforce and a shortage of workers.
The introduction of primary health care organisations in Australia follows the international trend with the establishment of Primary Care Trusts in the United Kingdom and Primary Health Organisations 19 Australian Institute of Health and Welfare.the workforce and the expansion of current knowledge and skills to move to a community approach to the social and environmental determinants of growth. Queensland Strategy for Chronic Disease 2005-2015. no.health. These primary health care organisations are charged with responding to the health needs of their communities. 0. in Indigenous health. Aboriginal and Torres Strait Islander Health Performance Framework.2% of specialists. Workforce disadvantage in the Indigenous sector of primary health care has two aspects.21 Government policies impacting on the industry’s workforce National Health and Hospitals Reform One of the key initiatives of the National Health and Hospitals Reform is the establishment of Medicare Locals from the previous Divisions of General Practice. particularly health professionals. while Aboriginal and Torres Strait Islander people made up 3. no. 0.pdf (accessed February 13th 2012) 10 Health and Community Services Workforce Council .gov. The first is the relatively small number of Indigenous people in the health workforce and the second is the shortages of workers. 2008 report: Detailed analyses. 2008 report: Detailed analyses. In 2006.4% of midwives. These will be unevenly distributed across the state in ways that impact on Aboriginal and Torres Strait Islander health services. 2005. http:// www. 1.au/chronicdisease/documents/strat2005to15_full.6% of nurses working in mental health were Indigenous. These figures demonstrate significant gaps in Indigenous participation in the health workforce which is a major problem given national and international recognition of the importance of engagement of communities in their own primary health care if appropriate outcomes are to be achieved. Shortages of workers in Indigenous health are widely acknowledged. IHW 22 20 Australian Institute of Health and Welfare. to 220 in 2002.2% of GPs. decreasing from 236 per 100. Medicare Locals have been created as independent legal entities (not government bodies) and act as regional primary health care organisations. Queensland is the country’s most decentralised state and in 2002 it had the lowest number of registered medical practitioners per head of population in Australia. Aboriginal and Torres Strait Islander Health Performance Framework. Cat. National data show that the Full Time Employment (FTE) rate of employed primary care practitioners was highest in areas where less than 1% of the population was Indigenous (108 per 100. Medicare Locals have entirely new governance arrangements for the provision of primary health care than previously was the case under Divisions. 2008. only 0. 2008.4% of the health workforce was Indigenous. promoting a healthier Queensland.19 Nationally.000 population) and lowest in areas where more —10% of the population was Indigenous (87 per 100.0% of nurses in community health and 0.20 Other professions are also in short supply in Queensland including experienced nurses and allied professionals.qld. only 1. Cat.000 population).5% of the population of Queensland. especially in rural and remote areas where many Aboriginal and Torres Strait Islander people live.000 in 1997. IHW 22 21 Queensland Government.
au/communityservices/about-us/corporate-plans/queensland-compact-towards-a-fairer-queensland (accessed February 12th 2012) 28 Naccarella. Both the New Zealand and United Kingdom primary health care arrangements have been established for close to ten years. J. What focus the government will place on the on the primary health care sector and its policy position on the national reforms remains to be seen.pdf (accessed April 24th 2012) 26 Skills Queensland.29 Industrial and Regulatory The reform around Medicare Locals with independence from uniform industrial relations is predicted to impact each Medicare Local as it undertakes workforce planning to meet the needs in each community.nsf/content/medilocprofiles. Queensland Government .gov. health.gov. Buchan. People Potential Prosperity http://www. Consumer and community engagement framework. • Securing a Skilled Future Skills and Workforce Development Investment Plan. 2012. http:// www.csiro.au/Functions/Workforce-development/skills-and-workforce-development-investment-plan.gov. 2008.qld. Through the National Health and Hospital Reform Queensland has a total of 11 Medicare Locals.26 and • The Queensland Compact.d. 2009. Primary Health Care Reform in Australia Report to Support Australia’s First National Primary Health Care Strategy. and Newton. and Brooks.27 In the midst of the roll out of national and state reforms and policy initiatives. promoting a healthier Queensland.health. www. P .au/hcq/publications/consumer-engagement.. This may result in significantly increased public investment in the training system and an altered relationship between student and training organisation.publish.au/internet/yourhealth/publishing. http://www.28 Consequences of other reforms such as the introduction of an entitlement model within the Vocational Education System are also yet to be clearly understood. the sectors ability to attract attention and investment levels required to successfully implement change framed through the national reforms must remain an area of priority for the primary health care sector.gov. 2012. http://www. The currency and size of some reforms for example. Commonwealth of Australia.L. skills. 2012.23 Adding to this environment of change is a range of state based policy initiatives which directly impact on the primary health care sector. (accessed February April 4th 2012) 24 Queensland Government.in New Zealand22 (Department of Health and Ageing 2009)..aspx#Securingaskilledfuture (accessed May 3rd 2012) 27 Queensland Government. Skills and Workforce Development Investment Plan 2012-2013. 2012 saw a change in government in Queensland to the Liberal National Party. The 11 Medicare locals were introduced through a staged National process between 1 July 2011 and 1 July 2012. the establishment of Medicare Locals.pdf (accessed February 13th 2012) 25 Health Consumer Queensland. 2012-2013. Queensland Strategy for Chronic Disease 2005-2015. These include: • the Queensland Chronic Disease Strategy 2006-201524 • The Health Consumer Queensland Consumer Engagement Framework25 (Health Consumer Queensland).Prepared for Queensland Industries Reference Group Meeting 29 March 2012 Primary Health Care Sector Industry Skills and Workforce Development Report: June 2012 11 .yourhealth..qld. None the less.) My Medicare Local.qld. 2011.au/internet/yourhealth/publishing. Queensland Compact. This includes key elements such as clarity about the governance arrangements of organisations involved in implementing primary health care workforce reforms. Learning from these experiences particularly in terms of the potential funds management role and the impact of this would prove useful in shaping Australian policy. 2005. B.communities. http://www. The entitlement model will allow individuals to choose their course and their registered training organisation funding following them.qld.gov. The new environment in primary health care will have implications for the 22 Department of Health and Ageing. requires greater clarity as to their impact and role in workforce reforms and workforce issues. Policy Analysis.au/journals/ahr (accessed March 15th 2012) 29 Health and Community Services Workforce Council. Towards a Fairer Queensland. Queensland State Election.pdf (accessed March 15th 2012) 23 Department of Health and Ageing (n.yourhealth.nsf/Content/nphcdraftreportsupp-toc/$FILE/NPHC-supp. Unpublished document . Role of Australian primary healthcare organisations (PHCOs) in primary healthcare (PHC) workforce planning: lessons from abroad Australian Health Review 35: 262–266.gov. http://www.au/chronicdisease/documents/strat2005to15_full.
These include the Closing the Gap initiatives through the Council of Australian Governments.34 Such examples include different industrial instruments across private. a single National Registration and Accreditation Scheme.ruralhealth. 2012. For example.au/resources/publications/ (accessed March 15th 2012) 32 Commonwealth of Australia. Medicare Locals are charged with stronger engagement with the aged and community care sector.ruralhealthaustralia.30 Some examples of system wide workforce initiatives include substantially increasing the number of clinical training places. In particular Aboriginal Health Worker accreditation has produced problems which are outlined later in the report. http://cpd.gov.pdf (accessed April 12th 2012) 34 Health Workforce Australia. Workforce rising to the challenge. Workforce rising to the challenge.au/sites/uploads/hwa-wir-strategic-framework-for-action-201110. 2011.33 Exacerbating and limiting workforce change are industrial and regulatory issues which need to be addressed to realise fundamental changes in job design.qaihc. P . http://nrha. National Health Workforce Innovation and Reform Strategic Framework for Action 2011–2015. au/internet/rha/publishing. 2007. 2011. P . Technology The National e-health strategy whilst not a specific workforce reform will have a substantial impact on how the workforce operates.nsf/Content/EBD8D28B517296A3CA2579FF000350C6/$File/NationalStrategicFramework. which is vital in the management of chronic disease.pdf (accessed April 20th 2012) 35 Brooks. Operating in a more electronic and technologically connected environment will require not only system and structure changes but a particular focus on enhancing the skills and capability of the workforce. scope of practice.hwa. These issues have a significant impact on the ability of the workforce to introduce changes such as creating new roles and or expanding the scope of others. government and non-government funded services.pdf (accessed March 25th 2012) 33 National Rural Health Alliance. Ellis.35 The National Accreditation Scheme introduced in 2009 does attempt to address some of these issues through the introduction of national accreditation and registration arrangements for key professions.org.gov. Health Workforce Australia. There are current regulatory barriers to ongoing reform of the health workforce with professional accreditation bodies’ policy and practices being both enablers and barriers to workforce reform. Health workforce reforms. http://cpd. Ellis. https://www.au/article/health-workforcereform-rising-to-the-challenge [Verified July 2008] (accessed 16th March 2012) 12 Health and Community Services Workforce Council .31 the development of a Rural and Remote Health Workforce Innovation and Reform Strategy by Health Workforce Australia32 and the production of a 20 point plan twenty steps to equal health by 2020 by the National Rural Health Alliance. N. http://www. This is of particular relevance for the primary health care sector where a key concept underpinning the approach within the sector is the role of the health professional as part of a health care team. professional demarcation and the creation of new roles.org. Regional Clinical Training Networks. N. changing the skill mix and extending the roles of health workers to improve resource utilisation and better meet patient needs.. The building of Australia’s E-Health skills capacity and 30 Brooks. Health workforce reforms.. Official Launch October 2011.au/article/health-workforcereform-rising-to-the-challenge [Verified July 2008] (accessed 16th March 2012) 31 Queensland Aboriginal and Islander Health Council.com. a sector which has recently amalgamated a number of organisations to produce a single national voice.org. 2007. http://www. 2012. and the progression of the national e-health strategy. establishing lead agencies and entities including. A Blueprint for Aboriginal and Islander Health Reform in Queensland. Workforce reforms underway focus on increasing workforce supply through education/training initiatives. National Strategic Framework for Rural and Remote Health. Health related reform initiatives and strategies are being progressed to improve health services and increase the health workforce in rural and remote areas that ultimately can improve the health and welfare of Indigenous Australians.au/cms/uploads/publications/twenty_steps_to_equal_health_for_ website_11may2012. Twenty Steps to Equal Health by 2020: The NRHA’s 20-Point Plan for improving health services and health workforce in rural and remote areas. rigid regulatory arrangements often influenced by professional groups and the inflexibility and inconsistency in regulatory and accreditation arrangements.identity of the primary health care sector.
pc. 2010.43 To achieve the shift from profession and discipline-based workforce development requires fundamental structural and cultural change.australia2020. J. National e-health Strategy Summary. http://www. and role delineation. http://www. P .. Australia 2020 Summit Final Report.ahmac. and has been responsive primarily to funding streams. Whilst 36 Australian Health Ministers Advisory Council. North. N.. prevention and primary health care if it is to be sustainable in the future.. National Health Workforce Innovation and Reform Strategic Framework for Action 2011–2015.. http:// www.36 Major national health initiatives in recent years have emphasised the need for the health industry to refocus on wellness. Sydney..gov. P .au/sites/uploads/hwa-wir-strategic-framework-for-action-201110. Ellis. R. distribution.hwa...3738 Meeting the aims of primary health care is labour-intensive and calls on many professions. Carswell. COAG Response to the Productivity Commission Report on Australia’s Health Workforce.Challenging Workforce planning approaches Asia Pacific Journal of Health Management 2010. A. R. P . http:// www. 2005.42 Despite this over the last 10 years workforce planning has continued to be organized around professions. Gauld.gov.Information Paper. 2006. 2008.gov.pdf (accessed April 20th 2012) 38 Commonwealth of Australia. Brooks.gov. N. J. Commentary . 2009. changing demands.au/documents/Publications/2005/A%20models%20of%20care%20approach%20to%20health%20workforce%20planning. December 2008.capability will require the national coordination of changes to vocational and tertiary training programs. A long-term national health strategy.org. http://www.3940 The key challenges for Australia’s primary health care workforce are across the areas of supply. L. Glasgow. https://www. 2008. Wakerman. Health Workforce Information Paper 1. N.44 These mechanisms have driven a continued focus on Australian health and workforce reforms and have recognised the need to think differently and re-engineer our system and our workforce to focus more on the primary health care setting. Such a change will require re-configuring not only the workforce but the education and training programs that prepare and support them. Humphreys.au/coag_meeting_outcomes/2006-07-14/docs/attachment_a_response_pc_health_ workforce. Australia’s Health Workforce. Frith. 5:2 Identification and prioritisation of gaps between the existing/ forecasted workforce and future workforce needs Primary Health Care Sector Industry Skills and Workforce Development Report: June 2012 13 . K. au/__data/assets/pdf_file/0003/9480/healthworkforce.au/cms_documents/National%20E-Health%20Strategy.gov. W.. J. Laurann. http://cpd... Workforce rising to the challenge. not targeted to primary health care specifically..41 Workforce planning in the health industry has traditionally been based around professions and occupations.pdf (accessed March 15th 2012) 39 Commonwealth of Australia. 37 Health Workforce Australia. Research report. Australia’s primary health care workforce — research informing policy.. Health workforce reforms. Wells. S. K.ahwo.coag.pdf (accessed 23rd May 2012). 2011.au/article/ health-workforcereform-rising-to-the-challenge [Verified July 2008] (accessed 16th March 2012) 44 Francis. 2005.au/docs/final_report/2020_summit_report_5_health. 2007.gov.pdf [Verified October 2008 (accessed April 3rd 2012) 41 Douglas. A shift towards methods. E.pdf (accessed March 14th 2012) 43 Brooks. including models of care approaches that facilitate the integration of new approaches to workforce design and workforce planning has been emphasized. Canberra. S. Australia is facing a primary health care workforce shortage exacerbated by increasing complexity and fragmentation in the health system. Medical Journal of Australia Volume 191 Number 2 42 Australian Health Workforce Advisory Committee and Australian Medical Workforce Advisory Committee. A Models of Care Approach to Workforce Planning .pdf [Verified September 2008] (accessed March 17th 2012) 40 Council of Australian Governments.
Buchan. J. despite the national emphasis on overall strengthening of the primary health care system. confusing and ineffective funding mechanisms and a lack of a whole-of-system approach to building capacity is a challenge for practitioners. B. Buchan. and an ongoing preference to describe the sector in terms of occupations. 45 Department of Health and Ageing.net. primary health care policy. 2010. PRIORITIES Increase capacity of the sector to carry out workforce planning based on agreed scope of the primary health care sector Explore new models which provide for discipline-based workforce development in addition to the more traditional professional based workforce development Increase the provision of training and development in workforce management of multi-disciplinary teams in integrated service models of care Increase leadership and change management training and professional development to ensure a capacity to prepare and manage a diverse and flexible workforce Training and development programs redesigned to enable new and changed roles and respond to the multiple reforms in the industry. http://www. 2012) 46 Naccarella. Role of Australian primary healthcare organisations (PHCOs) in primary healthcare (PHC) workforce planning: lessons from abroad Australian Health Review 35: 262–266.. power inequities created through strongly established occupational hierarchies. and Brooks. P . J.au/policyStatementsInterim. www.au/journals/ahr (accessed March 15th 2012) 47 Public Health Association of Australia. B..48 There continues to be inconsistent interpretations of the sector by experts within it concerning the scope of service and support within the sector. Although there is recognition that alternate approaches to workforce planning are required.au/internet/yourhealth/publishing.publish. P .L.nsf/Content/3EDF5889BEC00D98C A2579540005F0A4/$File/6552%20NPHC%201205.php#p (accessed March 18th 2012) 48 Naccarella. Role of Australian primary healthcare organisations (PHCOs) in primary healthcare (PHC) workforce planning: lessons from abroad Australian Health Review 35: 262–266.L.csiro.the importance of the primary health care sector is specifically acknowledged through Building Block 3: A Skilled Workforce within the National Primary Health Care Strategy45 there is a lack of targeted and tailored attention to lead an industry driven whole of primary health care sector workforce vision and related workforce strategies at national and state levels. Building a 21st Century Primary Health Care System Australia’s First National Primary Health Care Strategy.. Policy at a glance. The lack of clarity and debate concerning the approach to the primary health care workforce hampers the ability to facilitate a whole-of-sector approach to planning.. and Brooks. 2011. managers and leaders. counselling and community mental health. Facilitating change in an environment characterised by extreme politicisation. www.health. http://www.publish. Commonwealth of Australia.pdf (accessed March 4th. Increase provision of training and skills in areas expected to increase in demand into the future including dementia care.phaa. and Newton.au/journals/ahr (accessed March 15th 2012) 14 Health and Community Services Workforce Council ..46 There continues to be insufficient investment in research and workforce development in primary health care in Australia..gov.47 The primary health care system is complex and there is acknowledgment of the need to build the capacity of the sector to shift the paradigm of health care in Australia. 2011. a lack of debate exists about primary health care workforce planning. and Newton.csiro. 2011.
2010. There is a need for capacity to be developed particularly for the Closing the Gap workforce.. there are no specific career pathways for these positions even though 49 Public Health Association of Australia. Health Workforce in Australia and Factors for Current Shortages April 2009. Workers such as personal carers.49 This is particularly complex given the scope of the primary health care workforce which encompasses not only traditional or clinical health workers. promotion. Gauld.au/policyStatementsInterim. Wakerman.net. people and organisational culture. N. Carswell. North.. A pressing area of concern currently is the registration of Aboriginal and Torres Strait Islander Health Practitioners.gov. As with the health industry more broadly. North. Currently.. workforce development and behavioral change. Commentary . R. J.Challenging Workforce planning approaches Asia Pacific Journal of Health Management 2010. http://www. Brooks.. assistants and support workers. National Health Workforce Taskforce. Policy at a glance.50 Given these complexities strong management and leadership capacity to steer the sector through the current and future changes will be needed.ahwo. primary health care policy. P . P . professional roles.Challenging Workforce planning approaches Asia Pacific Journal of Health Management 2010.pdf (accessed 16th March 2012) 51 Francis. N. particularly in terms of self-management and care. Currently there is a gap in the delivery of the Cert IV Aboriginal and Torres Strait Islander Primary Health Care (Practice) qualification which is the requirement for Aboriginal Health Workers to be registered as Practitioners.au/documents/NHWT/The%20health%20workforce%20in%20Australia%20and%20factors%20influencing%20current%20shortages. and it is this group that has expertise in issues of change management. appropriately trained staff and clinical placements. The need for leadership is broadly acknowledged however the value of management is often underrated. S. 2010. J. In addition to the diversity of the workforce within the sector are the changing expectations of workers about their work and in particular the hours they are prepared to work. prevention and early intervention workers and indigenous health workers are a critical part of the overall primary health care sector. such as the tobacco action workers. funding mechanisms.. 5:2 Primary Health Care Sector Industry Skills and Workforce Development Report: June 2012 15 . In the context of a shift in balance of care from acute to primary care examining the implications for skill mix and identifying areas of skill development required will be vital. P . 2009. http://www. Carswell. healthy life style workers and Indigenous Outreach Workers. Wakerman.. Gauld. P .51 To truly transform the delivery of care it is critical to invest in the change management skills required to alter the patient journey. Educators will need to play a strong role in developing a future workforce that is not only clinically and technically competent but which also understands the context and aspirations of primary health care and its role in meeting those objectives. Worker preferences are influencing the overall supply as workers opt for fewer hours or more flexible working arrangements. 2011. Commentary . R. There is a need within the sector to attract and then retain workers who understand the philosophy and approach to primary health care broadly. primary health care currently struggles with a lack of suitable and skilled workers to fill current roles.Demand/supply disparities Attracting and retaining workers to the primary health care sector is a core driver in current workforce reforms. Brooks. S. The supply is impacted by the capacity of RTOs to meet the requirements of the qualification with problems of funding.52 Another side to the supply side is that the new jobs created by the Closing the Gap and the Medicare Local policy requiring new clusters of skills for Aboriginal and Torres Strait Islander workforces particularly.phaa.. A number of Registered Training Organisations (RTOs) have this qualification on their scope.php#p (accessed March 18th 2012) 50 National Health Workforce Taskforce... 5:2 52 Francis.. One critical role the education system has in achieving this need is ensuring that the education system itself prepares the future workforce by integrating the appropriate and changing philosophies of primary health care in its curriculum.
Raise awareness of primary health careers to increase participation and retention of Aboriginal and Torres Strait Islander people in the primary health care workforce Support the leadership capacity of the Aboriginal and Torres Strait Islander health workforce Create capacity to supply increased number of Aboriginal Health Workers to satisfy requirements of the regulatory body Increase the capacity of the education and training sector to deliver Certificate IV in Aboriginal and Torres Strait Islander Primary Health Care Develop industry led initiative which aims to identify the skill mix requirements and consequent skill gaps Implement prolongation and participation programs for the ageing workforce such as re-entry programs. At the state level there is currently a strong economic outlook driven by a strong resources sector and the consequent workforce demand is having an impact on the primary health care sector workforce.qld. skills.au/Functions/Workforce-development/skills-and-workforce-development-investment-plan. Some of the major problem to date is the capacity of RTOs and schools to establish from scratch the coordination and delivery these qualifications given that lack of experience with the training package HLT 07 for schoolbased qualifications and the commitment and capacity of schools to introduce Health traineeships/ qualifications in general. refresher courses. Skills and Workforce Development Investment Plan 2012-2013. 53 Skills Queensland.53 This creates competition for staff with the mining sector in some regional areas that are being leaving the sector in pursuit of attractive wages and conditions offered by the mining sector.the responsibility for this workforce can be quite complex and in most cases there have only been certain skills sets and orientation programs identified and developed by the Aboriginal Controlled Community Health Services sector to address workforce development. Involving primary health care and the broader health industry in cross-industry and regional economic planning is vital to ensure a coordinated place-based approach that balances competing requirements in the interests of regional communities. 2012. occupational transition. The other major concern for Aboriginal Health Worker workforce is the gap in school-based training delivering health qualifications traineeships/apprenticeships and particularly delivering the Aboriginal and Torres Strait Islander Primary Health Care qualifications.aspx#Securingaskilledfuture (accessed May 3rd 2012) 16 Health and Community Services Workforce Council . knowledge management programs. There is a need for the recognition that a strong primary health care environment is vital for the sustainability of communities.gov. PRIORITIES Develop strategies to increase skills in workforce management of multidisciplinary teams in integrated service models of care and complex service delivery across organisations and institutions. People Potential Prosperity http://www.
There is a need for the recognition that a strong primary health care environment is vital for the sustainability of communities 17 .
N.gov.pdf (accessed March 3rd 2012) 18 Health and Community Services Workforce Council .gov. H. workforce planning. This has left a significant gap in the capacity of the Queensland training system to deliver the Aboriginal and/or Torres Strait Islander Primary Health Care qualifications. the National Skills Body. There have also been concerns about the quality of delivery of these qualifications in Queensland. and concerns from some of the community controlled sector that some TAFE institutes have been 54 Douglas. https://www. A healthier future for all Australians . M.pdf (accessed March 3rd 2012) 57 Bennett. These reforms include the Review of Australian Higher Education (2008) which is driving changes in the university sector and integrated package of reforms. or horizontal integration of curriculum. http://www. both specialised and general. Wells.au/sites/uploads/hwa-wir-strategic-framework-for-action-201110. E. 7:2 58 Commonwealth of Australia. there is a relative lack of interdisciplinary learning opportunities. S. Geelhoed. 2009. one of the two Aboriginal community controlled RTO delivering health qualifications.56 Facilitating a breadth of clinical placements which include the primary health care setting is critical in creating a career pipeline. Yeatman.59 Education reforms attempt to address some of these outlined challenges and issues. developed by Skills Australia. G. Medical Journal of Australia Volume 191 Number 2 55 Health Workforce Australia. P . E.. Paving Pathways: shaping the Public Health workforce through tertiary education. http://www.nsf/Content/1AFDEAF1FB76A1D8CA257600000B5BE2/$File/Final_Report_ of_the%20nhhrc_June_2009. Flexible.. au/internet/rha/publishing. starting at school level with programs that will articulate through the whole education framework..hwa.ruralhealthaustralia. 2009. Parker.. R. J.55 There is currently a heavy focus on preparing primary health care students through hospital placements which does not encourage or prepare them to work in the primary health care setting should they choose this path. Skills for Prosperity – a road map for vocational education and training. training quality and delivery methods As service delivery changes. pathways.Advice concerning training product. Australia and New Zealand Health Policy 2010. K. K..Final Report of the National Health and Hospitals Reform Commission. ATSICHET.pdf (accessed April 20th 2012) 56 Commonwealth of Australia. Laurann. Glasgow. A healthier future for all Australians . Lilley. Efficiency. this is occurring at the same time that theTraining Initiatives for Indigenous Adults in Regional and Remote Communities (TIFIARRC) funding program has been discontinued. 2012.57 Significant barriers exist between professional disciplines and within training institutions and these impede the ability to further develop and implement a more multi-disciplinary approach and broader scope of practice.gov. Humphreys.58 Within clinical education and training of health professionals.nsf/Content/EBD8D28B517296A3CA2579FF000350C6/$File/NationalStrategicFramework.. http://www. K.health.. In early 2012. Robinson. Australia’s primary health care workforce — research informing policy. There is a need to develop career structures and training pathways for workers that enable career development in the primary health care setting. Hanna.54 To attract and retain a sustainable health workforce requires multiple entry points to health training and careers. L.. National Health Workforce Innovation and Reform Strategic Framework for Action 2011–2015.. E. folded. National Strategic Framework for Rural and Remote Health.Final Report of the National Health and Hospitals Reform Commission..gov. W. there is an increased need for high – level skills in workforce management. cost-effectiveness and return on investment will be increasingly important in the design and delivery of services and workforce models. 2010. 2011.. J.pdf (accessed March 25th 2012) 59 Commonwealth of Australia. The tertiary sector needs to support a range of programs.au/internet/nhhrc/publishing.. Unfortunately. C. change management and innovation as services will increasingly be required to adapt to their surroundings as they keep up to date with changing policy and client expectations of the service. A lack of core competency based framework as part of teaching and learning curricula for health workforce has been acknowledged. Frith. responsive and contemporary education models and pathways which allow mobility within and throughout the health industry and primary health care sector are a significant challenge. preferably within a flexible model that allows articulation with formal qualifications. E.au/internet/nhhrc/publishing.nsf/Content/1AFDEAF1FB76A1D8CA257600000B5BE2/$File/Final_Report_ of_the%20nhhrc_June_2009. A.health. to meet the range of short course and professional certificate educational needs. 2009.
This assessment should include the availability of Aboriginal and/or Torres Strait Islander trainers and viability in the absence of TIFIARRC Primary Health Care Sector Industry Skills and Workforce Development Report: June 2012 19 . PRIORITIES Expand the scope of clinical training placements to maximize learning opportunities and future career choices in the primary health care sector Clearer articulation of training and career pathways for workers through improved collaboration across education systems Explore more flexible models of delivery of education and training Increase inter-disciplinary learning opportunities and horizontal integration of curriculum Greater use of skill sets to augment current qualifications. role design and regional training networks. Support for regional clusters of service providers. education and training providers and policy-makers to facilitate regional workforce planning. Instigate contemporary learning models to better prepare a workforce for initiating innovation in the emerging policy environment Investigate the capacity of training providers in Queensland to deliver ATSI Primary Health Care qualifications to meet industry’s need. This assessment should include the availability of Aboriginal and/or Torres Strait Islander trainers and viability in the absence of TIFIARRC. Improve industry’s understanding of VET and industry’s role in influencing the training system and the training they purchase. – including strengthening collaboration stakeholders at the regional level. Explore the capacity for e-learning and e-health in parallel with the roll out of the National Broadband Network. There is an urgent need to assess the capacity of training providers in Queensland to deliver these qualifications and whether this capacity meets the level of demand.delivering the qualifications without Indigenous staff.
o Over 75 representatives from government departments. 20 Health and Community Services Workforce Council . o The seminar marked one of the first opportunities for Queensland industry representatives to collectively explore relevant issues. This is a critical forum in the context of significant change occurring in the health industry as a result of the National Health and Hospital Reforms o In November 2011 the Health Workforce Leaders Group hosted a workshop with over 40 people with the CEO of Health Workforce Australia. consulting with members of the Health Leaders Group. Outcomes for the seminar included: o Workforce Council has continued engagement with health industry stakeholders. This workshop was open to health industry stakeholders and provided an opportunity to discuss the implementation of national strategies in Queensland.g. outlining some of the key elements and strategies necessary for such a regional workforce planning process. General Practice Queensland Reference Group. o The June 2012 Industry Skills Body report will have a stronger emphasis on Primary Health Care and will focus on the workforce skilling and planning needs for the Health Industry in response to the health reforms. o Focused on the vital need for strategic workforce planning to support the new health reforms. CEO of Skills Queensland also attended this workshop. training and government stakeholders committed to seeking innovative solutions to our health workforce crisis.KEY ACHIEVEMENTS • Workforce Council continues to support the Health Leaders Group in partnership with key industry. Community Health Services Network Group and Medicare Locals. peak bodies and service providers attended to discuss the workforce implications of the Medicare Locals scheme and the need to integrate strategic workforce planning within the new primary health care structure. A range of initiatives commenced through the health skills formation strategy continues through funded initiatives and industry partnerships: o Chronic condition self-management o Indigenous health o Health careers promotion o Overseas skilled health professionals o Recognized prior learning o School-based traineeships in health o Health career pathways o Articulation and Recognition to higher education • Planning for your Medicare Local Breakfast Seminar o In June the Workforce Council hosted a breakfast seminar exploring the workforce implications of health reforms. e. Mark Cormack. LHHN’s and Medicare Locals • Health Workforce Leaders Group working with Health Workforce Australia o The Health Workforce Leaders Group established through the Health Skills Formation Strategy 2007-2010 continues to meet together to explore and identify workforce strategies. Rod Camm.
refresher courses. in turn will places increased pressure on the training and education sectors. • Develop industry led initiative which aims to identify the skill mix requirements and consequent skill gaps • Implement prolongation and participation programs for the ageing workforce such as re-entry programs. and availability of clinical placements to support training will remain a potential blockage in developing the future health workforce. The focus of priority will continue to move toward the community setting and on preventive and primary health services. occupational transition. Ten Year Skilling and Workforce Development Outlook Health industry will continue to grow rapidly over the next decade. Significant changes to the structure and funding of key parts of the industry will have significant impact on the work roles and career pathways. Five Year Skilling Workforce Development Priorities • Design training and development programs to enable new and changed roles and respond to the multiple reforms in the industry.Outcomes for the group include: o Workforce Council has continued engaged with health industry leaders across all sectors to support a whole of system approach to workforce planning across Queensland o Strong connections have been established with the National Health Workforce Agency. particularly in primary health care. • Explore more flexible models of delivery of education and training • Increase inter-disciplinary learning opportunities and horizontal integration of curriculum Primary Health Care Sector Industry Skills and Workforce Development Report: June 2012 21 . Health Workforce Australia which will support future planning and implementation of national reform strategies within Queensland o The mechanisms established including the Health Workforce Leaders Group will be accessed by Health Workforce Australia to support their planning • Productivity Places Program o Workforce Council has brokered 160 Primary Health Care qualifications to Queensland employers. knowledge management programs. The industry will continue to experience significant skill and labour shortages. New technologies and advances in health care will continue to create rapid changes in the nature and complexity of health services. This.
22 Health and Community Services Workforce Council . Priorities for Action Over the Next Year • Increase capacity of the sector to carry out workforce planning based on agreed scope of the primary heath care sector • Explore new models which provide for discipline-based workforce development in addition to the more traditional professional based workforce development • Increase the provision of training and development in workforce management of multidisciplinary teams in integrated service models of care • Increase leadership and change management training and professional development to ensure a capacity to prepare and manage a diverse and flexible workforce • Increase provision of training and skills in areas expected to increase in demand into the future including dementia care. • Raise awareness of primary health careers to increase participation and retention of Aboriginal and Torres Strait Islander people in the primary health care workforce • Support the leadership capacity of the Aboriginal and Torres Strait Islander health workforce • Create capacity to supply increased number of Aboriginal Health Workers to satisfy requirements of the regulatory body • Increase the capacity of the education and training sector to deliver Certificate IV in Aboriginal and Torres Strait Islander Primary Health Care • Expand the scope of clinical training placements to maximize learning opportunities and future career choices in the primary health care sector • Develop articulated training and career pathways for workers through improved collaboration across education systems • Greater use of skill sets to augment current qualifications. This assessment should include the availability of Aboriginal and/or Torres Strait Islander trainers and viability in the absence of TIFIARRC. counselling and community mental health. • Investigate the capacity of training providers in Queensland to deliver ATSI Primary Health Care qualifications to meet industry’s need. role design and regional training networks. education and training providers and policy-makers to facilitate regional workforce planning. • Improve industry’s understanding of VET and industry’s role in influencing the training system and the training they purchase. • Instigate contemporary learning models to better prepare a workforce for initiating innovation in the emerging policy environment • Support the development of training capacity in the Aboriginal community controlled health sector and linkages with RTOs. • Develop strategies to increase skills in workforce management of multi-disciplinary teams in integrated service models of care and complex service delivery across organisations and institutions. – including strengthening collaboration stakeholders at the regional level. • Support for regional clusters of service providers.• Explore the capacity for e-learning and e-health in parallel with the roll out of the National Broadband Network.
au p. info@workforce. 303 Adelaide Street Brisbane QLD 4000 Unit 1. Ground Floor. (07) 3234 0190 f.org.org.Health and Community Services Workforce Council Inc.au w. Level 2 390 Flinders Street Townsville QLD 4810 e. (07) 3234 0474 Primary Health Care Sector Industry Skills and Workforce Development Report: June 2012 23 . www.workforce.
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