REDEFINING THE FUTURE OF WORK THROUGH HEALTH WORKFORCE OPTIMISATION

Globally, healthcare systems are struggling. Rising costs, increasing demand, more expensive technologies, all compounded by critical staff shortages.

Scopes of practice in the health professional workforce are diverse but not used effectively. Better utilisation can deliver improved access to healthcare, new models of care and enhanced health outcomes.

Globally, healthcare systems are struggling. Rising costs, increasing demand, more expensive technologies, and the growing burden of chronic conditions are straining services and systems. These demands are compounded by critical staff shortages across all healthcare professions including doctors, nurses, and allied health professionals. The COVID-19 pandemic exacerbated these difficulties and emphasised the need to redesign and strengthen health systems to make them more resilient. At the core of strong healthcare systems is an agile and capable workforce in which the skills of each professional and the skills mix employed in service delivery are optimised to deliver the best outcomes.

As the World Health Organisation states, there is “no health without a workforce” (WHO 2013). Attraction, training, and funding are part of the solution, but some of the most exciting gains to be made are by optimising health workforce utilisation to make full use of the available skills and scopes of practice.

In Australia’s health and medical professions, scopes of practice are diverse and progressive, but they are often not used effectively. Allied health professionals such as physiotherapists, dieticians, speech pathologists, and professions such as nurses, and pharmacists are healthcare resources that are often under-utilised and could help deliver improved access to healthcare, new models of care and better health outcomes.

While there is growing evidence that alternative workforce models can improve access to high quality services for patients and promote efficiency, large-scale implementation and sustainability of new models is yet to be successfully achieved in Australia’s complex healthcare context.

There is a pressing need for more holistic approaches to health workforce design that bring together multidisciplinary expertise and health sector leadership to:

• Address what needs to change to realise health workforce optimisation at scale.

• Determine how the change can be achieved in local implementation contexts.

• Test outcomes in close partnership with who the change impacts.

Healthcare workforce research is typically undertaken by specific disciplines as relevant to their fields of practice and with a focus on generally traditional roles.

Australia’s Primary Health Care 10-year Plan 2022-2023, stresses the importance of better use of the primary health care workforce, including nurses and nurse practitioners, allied health professionals and pharmacists, working to full scope of practice and as part of multidisciplinary teams. The strategy also calls for greater leadership and cultural shifts to support effective team-based care across professions to work to full scope of practice and maintain high quality standards.

The EvolveHealth (Health Workforce Optimisation) program aims to model the trans-disciplinarity and agility that we strive to cultivate in Australia’s health workforces.

Shifting attention in policy and practice away from the traditional roles of professions and the characterisation of healthcare as doctor-led; instead, emphasizing the requirement to focus on patient-centred care needs and identifying the skills required to address them, informed by a holistic understanding of the skills available across the health-provider sector.

To achieve this, it is essential that we engage across occupations and disciplines, breaking down siloes and encourage a culture of outcomes-driven innovation in health workforce practice and planning. The EvolveHealth program aims to redefine the future of work in the Australian healthcare sector.

Moving from a stock and flow approach to planning and delivery of workforce, to a strength-based skill and capability methodology, driven by patient and service need and driven by value-based care, equity, and data. It will accelerate resilience, agility, and capability in the healthcare workforce by reimaging our utilisation of health workforce.

Author: Professor Lisa Nissen is Program Director of EvolveHealth (Health Workforce Optimisation), Centre for the Business and Economics of Health at The University of Queensland. She has been a health practitioner, leader, educator, researcher, and implementation scientist in Australia for more than 25 years. Her focus is on health services optimisation and her research has led to major health system changes, including the introduction of immunisation services by pharmacists throughout Australia, and development of national policy frameworks for prescribing by allied health and nursing professionals.