6 minute read
Supporting Our OT Workforce Community
Michael Barrett, OTA National Manager, Government and Stakeholder Relations
Every day, Australia’s occupational therapists demonstrate their value to our communities. Whether it be in health and community services, residential aged care facilities, schools, workplaces, or private homes, occupational therapists enhance the quality of life—and often the productivity—of their clients.
And this value is being increasingly recognised. That is why demand for occupational therapists has long outstripped supply. Despite new undergraduate courses being established almost every year, those graduating often have multiple job offers. OTA members operating larger practices routinely tell us they cannot fill job vacancies, despite the often very generous packages on offer.
Two things are abundantly clear. First, the problem is growing. Second, it will generate new opportunities for individual practitioners while posing profound challenges to the profession as a whole.
The workforce shortage will become more pronounced as the NDIS continues its rollout, and more Australians with disabilities are deemed eligible to join it. The NDIS has already drawn significant numbers of allied health professionals from other areas of practice, and there is no apparent reason why this trend would suddenly stop.
We can expect to develop shortages in areas of practice that cannot compete with the NDIS hourly fees. At this point, Australia’s veterans and war widows have become victims, as the DVA finds it unviable to pay experienced occupational therapists their hourly rate. But veterans may prove to be the canaries in the mineshaft, as other client cohorts may soon also find themselves struggling to maintain long-standing relationships with occupational therapists.
And, of course, demand for occupational therapists will boom as our population ages. Whether opting to age at home or move into a residential aged care facility (RACF), Australia’s rapidly growing elderly population will need occupational therapists to ensure their physical safety, health, mental wellbeing, and quality of life.
The Royal Commission into Aged Care Quality and Safety is due to release its final report—and most likely a suite of sweeping recommendations—to government early this year. Indications to date—particularly recommendations made in a separate report by the commissioners into the management of COVID-19 in RACFs—suggest a call for a much greater allied health presence in these facilities. Occupational therapists, more than other allied health professionals, are trained to prevent functional decline and enable meaningful activity and participation—an expertise that will be fundamental to 21st century aged care in Australia.
Given there are too few occupational therapists to go around now, how will Australia find potentially several thousand more, and at very short notice? Assuming the Federal Government does not want to be politically compromised by its inability to implement a key recommendation of the royal commissioners—and possibly only 10 months out from a federal election—the government may well seek a quick fix.
Any government, irrespective of party, will likely subordinate considerations of clinical excellence to considerations of a pressing political nature. Herein lies the challenge to our profession, and to the quality of occupational therapy in Australia.
The government may resort to three obvious quick fixes that would present serious threats to the occupational therapy profession. First, allowing other allied health professions to move into areas of practice traditionally, and quite rightly, within the occupational therapy scope. From time to time, OTA receives reports of such practices, sometimes done with implicit approval of the responsible department or agency, which itself must answer to a minister in search of an immediate solution.
While OTA will raise such practices as a matter of urgency with the appropriate authorities, it is fair to say there is a discernible drift towards professional incursion. This represents a threat to the quality of care being delivered to Australians who rightly should be in the care of a fully qualified occupational therapist.
The second quick fix allows allied health assistants to undertake tasks that are properly the responsibility of a registered occupational therapist. OTA is on the record as supporting allied health assistants when properly qualified and appropriately deployed. Under no circumstances, however, and regardless of the political climate, should allied health assistants be undertaking OT related tasks for which they are not properly trained or without the supervision of a registered occupational therapist.
The third quick fix would fast track the immigration and registration of overseas trained occupational therapists. OTA has no objection to this, as long as their training and clinical competence are examined via the existing, very robust process put in place and overseen by the Occupational Therapy Board of Australia. Under no circumstances should this rigorous process be compromised.
There is, however, a relatively straightforward measure to address the workforce shortage which OTA would endorse. The problem of workforce retention is as acute as that of supply, and could be swiftly and effectively addressed by a few simple measures.
In a recent report, the Victorian Occupational Therapy Workforce and Professional Issues Committee refer to a survey of the occupational therapy workforce commissioned by Victoria’s Department of Health and Human Services in 2018. This found that while 58 per cent of respondents intended to remain in the profession for 10 years, 88 per cent of them expected to change role and sector. Those intending to leave the profession reported lack of career growth and burnout as their reasons. The committee writes:
Experienced practitioners who wish to return to work after a period of absence due to caregiving responsibilities can find it difficult to re-enter the workforce. There is an absence of support to upskill practitioners whose registrations have lapsed, and for part time employees with caring responsibilities, workforce practices are inflexible. These factors result in experienced practitioners leaving the workforce as evidenced by the reduced number of practitioners over 34 years of age (26 per cent of practitioners compared to 41 per cent of younger therapists). Together, these factors leave a skills shortage in the profession with less support for junior practitioners and limited expertise to advance quality of care.
These findings are supported by an abundance of anecdotal evidence with which OTA is very familiar. And, of course, the problem exists across all jurisdictions.
If federal, state and territory governments worked together—as these issues cross all levels of government—re-registration and re-entry to the workforce could be simplified, and movement within and between areas of practice facilitated. Such coordinated action would support the retention of occupational therapists and go some way to addressing the workforce shortage. The advent of client directed care, particularly in the fields of disability and aged care, has changed the landscape markedly. New graduates who might once have found themselves working alongside highly experienced occupational therapists in a block-funded residential facility, may now find themselves effectively working alone for very large, often somewhat impersonal, companies. All too often these inexperienced employees are denied the supervision and peer support that play such a valuable role in the development of professional expertise and self-confidence.
Furthermore, as the authors of the report cited above note, the departure of middleaged occupational therapists from the profession leaves a disproportionate number of younger practitioners, creating “a concerning situation where young, inexperienced occupational therapists are now receiving inadequate supervision, mentoring, or guidance in practice-related issues”. If these younger occupational therapists burn out after ten years, the problem becomes self-perpetuating.
OTA will continue to support the introduction of new undergraduate occupational therapy courses in universities, and will work with the sector to ensure training reflects the new needs of those entering the workforce.
We will continue to support new graduates with relevant and accessible CPD, our mentoring program, and topical conferences and events. And we will continue to lobby governments across the country to ensure any measures designed to address workforce shortage are likely to be effective without compromising quality of care.
