PHN Priorities: Workforce
With increasing demands for healthcare and increasing complexity of procedures, retaining and developing the healthcare workforce is at the forefront of thinking for most healthcare organisations. The following highlights findings from three recently released reports on the Australian healthcare workforce.
In Australia, retention of healthcare professionals in rural and remote regions is particularly challenging, and there is a strong dependency on international medical graduates (IMGs) to fill general practitioner (GP) positions. Mal-distribution of GPs is one of the major challenges currently being faced. However, a recent report from the national longitudinal Medicine in Australia: Balancing Employment and Life (MABEL) survey suggests that whether or not locally trained GPs remain in rural locations is significantly influenced by the provision of ongoing support for rural vocational training and recruitment of rural origin medical students (Figure 1)1. In addition to this, although based on a much smaller sample for IMG GPs, the results suggest that rural as opposed to metropolitan (metro) based training for IMGs may also make a long-term difference to sustaining services in rural communities.
Figure 1 GP final vocational training location and general practice location at 5 years post training. Approximate proportion based on McGrail 2016, each character represents 10% of all respondents.
In a 2016 report on the decision of nursing and allied health students and recent graduates to relocate to rural settings, 11 key recommendations were made to attract workers, including increased opportunity for rural placement and improved career pathways.2 One potentially influential but simple strategy highlighted by the report was to increase awareness of non-urban practice through positive promotion and marketing; “Most participants in this study reported little awareness of initiatives and incentives aimed at increasing rural recruitment”. Retention of nursing staff is another major challenge, with the recently released national survey of nurses showing that despite a high level of pride in their work, a significant proportion of nurses are likely to leave the profession (Figure 2).3 One major complaint arising from that survey was a lack of adequate support for training from their employer. Nurses are the largest healthcare workforce group in the Australian system, and as with the survey of rural GPs, when system strengths and weaknesses are revealed through survey of those at the ‘coalface’ it is important to respond in a way that ensures future sustainability.
Figure 2a. Selected healthcare workforce rates for full time equivalent employees per 100 000 Australian-population in 2014 (from AIHW);
2b. Selected responses from the 2016 national survey of nurses on workplace climate and well-being (approximate values).3
This week we take a look at some of the ways in which the healthcare community is contributing to our understanding of and support for the healthcare workforce of Australia.
PHNs actively involved in strengthening the healthcare workforce:
- To view local PHN workforce development initiatives including online training, visit the individual PHN websites. Examples include:
Research institutes and organisations involved in strengthening the healthcare workforce:
- Health Workforce Policies in OECD Countries—Right Jobs, Right Skills, Right Places. Released March 2016
- What Nurses & Midwives Want: Findings from the National Survey on Workplace Climate and Well-being. Associate Professor Peter Holland, Ms Tse Leng Tham, Dr Fenella Gill. Released September 2016.
Government involved in strengthening the healthcare workforce:
- AIHW 2015 healthcare workforce— data for nurses, midwives, and medical practitioners.
- Dynamic data display: AIHW Australia’s registered health workforce by location—an interactive map based on data for 2011–2014.
Community communication & engagement:
- What will it take to improve safety for remote area health professionals?, Melissa Sweet, Croakey, 12 October 2016
- Do we even need doctors?, Tim Senior, The Medical Republic, 17 October 2016
Learning from others involved in strengthening the healthcare workforce:
- King’s Fund Understanding pressures in general practice “The NHS is finding it difficult to recruit and retain sufficient GPs who want to do full-time, patient-facing work”, understanding the pressures in general practice is an important step towards addressing this challenge.
Research Profile members actively involved in strengthening the healthcare workforce:
- Caroline Laurence, Jonathan Karnon
Laurence C, Karnon J. (2016). Improving the Planning of the GP Workforce in Australia: A Simulation Model Incorporating Work Transitions, Health Need and Service Usage. Human Resources for Health, 14, 13.
- Michael Kidd
Kidd M. (2016). Global lessons for Australian general practice. Med J Aust, 205 (2), 52-53.
- Deborah Russell, Matthew McGrail
Russell DJ, McGrail MR. (2016). How does the workload and work activities of procedural GPs compare to non-procedural GPs? Aust. J. Rural Health, doi:10.1111/ajr.12321.
- John Humphreys
McGrail MR, Russell DJ, Humphreys JS. (2016). Index of Access: a new innovative and dynamic tool for rural health service and workforce planning. Australian Health Review, doi: 10.1071/AH16049.
- McGrail MR, Russell DJ, Campbell DG. (2016). Vocational training of general practitioners in rural locations is critical for the Australian rural medical workforce. Med J Aust, 205(5), 216–221.
- Sutton K, Waller S, Fisher K, Farthing A, McAnnally K, Russell D, Smith T, Maybery D, McGrail M, Brown L, Carey T. (2016). Understanding the Decision to Relocate Rural Amongst Urban Nursing and Allied Health Students and Recent Graduates. Newborough: Monash University Department of Rural Health. [PDF:4.2 Mb]
- Holland P, Tham TL, Gill F. (2016). What Nurses & Midwives Want: Findings from the National Survey on Workplace Climate and Well-being. Australian Consortium for Research on Employment and Work (ACREW), Monash Business School, Monash University. [PDF:4.2 Mb]
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