A coherent national health workforce reform strategy should be a high priority for the Jobs and Skills Summit, according to Kylie Woolcock, CEO of the Australian Healthcare & Hospitals Association.
Kylie Woolcock writes:
With the Jobs and Skills Summit being held this week, the complexity of matching and forecasting the needs, demands and supply of the health workforce is once again in the spotlight.
Proposals for both immediate and longer-term solutions are sought. What is imperative, but not expressed, is that these immediate solutions be framed and pursued in the context of the longer-term vision.
Almost four decades have passed since Medicare revolutionised healthcare in Australia. However, much has now changed in both the health conditions that people manage and in the way care can be delivered. Globally, technology has advanced; new workforce roles have emerged.
Yet policy has not sufficiently evolved to enable Australia to harness the benefits of innovation in a timely way.
As recently reported by the Productivity Commission, the recommendations from the 2017 Shifting the Dial report continue to be relevant today. The rigidities of existing service models, the lack of integration across the system, inadequate use of data, and poor diffusion of best practice remain consistent themes.
Compounded by burnout
With the healthcare workforce still mobilised to deal with the pandemic, 2022 has seen the health system attempt to adapt to reduce the significant impacts of burnout on the mental health and wellbeing of an already outstretched workforce.
While burnout manifests in individuals, it is widely accepted that it is fundamentally rooted in systems.
And it is not only about the working conditions, but also those conditions placing pressures on a workforce that disconnects them from their own values in the way care is provided. The longer-term solutions for our workforce must support an alignment with intrinsic motivations.
Five calls to Summit participants
1. A coherent workforce policy
The AHHA Blueprint for Health Reform highlights the need for a national health workforce reform strategy that goes beyond the adequacy, quality and distribution of the workforce as it currently exists.
Such a strategy must link workforce development approaches with regional needs assessments and strategies for models of care.
2. Place-based and whole-of-system planning
With regional planning driving workforce modelling and reform, it will be critical to mitigate against single sector and uncoordinated approaches to health service design.
The hospital, primary care, aged and disability care sectors must not compete for our workforce, but act together to attract and retain a workforce to meet the region’s health needs.
3. Teams to meet chronic and complex needs
Similarly, narrow profession-centric views will also ultimately undermine sustainability of both the workforce and the system.
Team-based models of care have been promoted for decades to address current healthcare needs – with teams being from both clinical and non-clinical disciplines, across various settings and broader than health care.
However, operationalising such models continues to be challenged.
Last year, AHHA published a supplement to its Blueprint on enabling person-centred, team-based care. Again, no part of the system can develop such a workforce in isolation. It requires attention to clinical governance, data-driven models of care and population health planning, and funding models, highlighting again the interrelatedness of our workforce with the models of care in our system.
4. Access to the evidence
We must simplify access to the available evidence about workforce models.
Debate about alternative models of care and workforce scopes of practice should not be played out in the media. Rather, we should embed a system that ensures consideration of international evidence and progresses local pilots in a way that assures not only safety and desired outcomes, but also identifies any unintended impacts on the capacity for the health system to respond to the broader needs of the community.
Establishing a national framework for evaluating models of care in terms of the outcomes they achieve for people and communities for the resources used would be a good starting place.
It should be complemented by a repository of evidence on models of care, framed to allow comparisons of models of care in the context of the populations and geographies served.
5. A shared, whole-of-system vision
Importantly, strategies to establish and maintain the health workforce Australia needs cannot be done in isolation of health policy more broadly.
As the World Health Organization recommends, workforce transformation needs to consider changes across health employment, health education and health service delivery to maximise future returns on investment, with governments adopting policies to cover performance of the whole sector.
Without a shared vision for what the future of healthcare looks like for Australia, any forecasting and strategies will be moot.
Previous Croakey coverage of the Jobs and Skills Summit
The physio will see you now. Why health workers need to broaden their roles to fix the workforce crisis: By Professor Henry Cutler
See Croakey’s archive of articles on health reform
