Online version of the 2014-15 Department of Health Annual Report

Outcome 8: Health Workforce Capacity

Improved capacity, quality and mix of the health workforce to meet the requirements of health services, including through training, registration, accreditation and distribution strategies

Page last updated: 16 October 2015

Major Achievements

  • Achieved the national target of at least 50 per cent of GP registrar training placements under the Australian General Practice Training (AGPT) Program occurring in regional and rural areas.
  • Increased support for the AGPT Program by providing an additional 300 registrar training places from the 2014 academic year.
  • Implemented the Modified Monash Model as a new geographic classification system for health workforce programmes, to allow support and resources to be focused on areas of highest need.
  • Increased the number of training positions funded through the Specialist Training Program from 750 in 2013 to 900 in the 2014 academic year.
  • Increased the number of additional emergency medical specialist trainee positions delivered in emergency departments from 66 to 88 in the 2014 academic year.
  • Supported 4,338 practices through the Practice Nurse Incentive Programme to expand and enhance the role of nurses working in general practice.

Challenges

  • Assuming responsibility for essential functions of General Practice Education and Training Ltd and Health Workforce Australia, while ensuring no disruption to service provision.
  • Achieving a more equitable distribution of the health workforce to rural and remote Australia.

Looking Ahead

The redesigned General Practice Rural Incentives Programme (GPRIP) commenced from 1 July 2015. A streamlined Health Workforce Scholarship programme will increase flexibility to meet changes in supply and demand in specific areas of practice, commencing from 1 July 2016. Priority scholarship areas will be reviewed annually, informed by national health workforce planning, and will result in better targeted scholarships and better support for the rural and remote workforce.

Programmes Contributing to Outcome 8

Division Contributing to Outcome 8

In 2014-15, Outcome 8 was the responsibility of Health Workforce Division.

Programme Performance

In 2014-15, the Department worked to achieve this Outcome by managing initiatives under the following programmes.

Trends

The Department is continuing to invest in rural health education and training strategies, such as the Rural Health Multidisciplinary Training Programme and the redesigned General Practice Rural Incentives Programme, to increase the availability of health services in regional and remote communities. Across Australia there are significant variations in the availability of doctors, nurses and midwives, and allied health providers. The geographic spread of the health workforce does not currently reflect the distribution of the population, particularly in regional and remote communities. To provide health services that are accessible, it is essential to have the required number of health professionals, but it is also essential for those health professionals to be equitably distributed across the population.

The table below shows the density of health professionals across major cities, regional and remote areas of Australia.

Table 8.1: Health practitioner rate per 100,000 population

Practitioner rate (employed)
Medical practitioners
Nurses and midwives
Allied health38
2011
2012
2013
2011
2012
2013
2011
2012
2013
Major City
398
393
399
1,276
1,285
1,286
457
561
638
Inner Regional
262
258
264
1,349
1,271
1,276
313
388
437
Outer Regional
222
236
235
1,201
1,212
1,214
256
298
368
Remote/Very Remote
226
222
222
1,258
1,279
1,227
175
232
268

Programme 8.1: Workforce and Rural Distribution

Programme 8.1 aims to increase investment in medical training and education, and provide support for health professionals in rural, regional and remote areas.

Increased investment in medical training and education

The Australian General Practice Training (AGPT) Program provides postgraduate vocational training placements for medical graduates wanting to pursue a career in general practice in Australia. At least 50 per cent of all AGPT Program training is undertaken in rural, regional and remote locations to encourage health professionals to work in these areas. Commencing registrar training places in the AGPT Program were increased from 1,192 places in 2014, to 1,500 places in 2015.

In the 2014 academic year, the Department continued to support the delivery of specialist training in expanded settings outside traditional public hospital teaching environments, and in regional, rural and remote areas. In partnership with 12 medical specialist colleges, the Department funded 900 training positions through the Specialist Training Program, with almost 45 per cent of these positions involving some training in rural and regional areas and 43 per cent providing training experiences in the private sector.

Quantitative Deliverable: Number of new GP training positions funded through the Australian General Practice Training Program.
2014 Academic Year Target: 1,192
2014 Academic Year Actual: 1,192
Result: Met
The number of training places increased from 1,108 in 2013, to 1,192 in 2014. The selection process was undertaken in 2013 by General Practice Education and Training Ltd to recruit doctors for entry into the AGPT Program in 2014.39
Quantitative Deliverable: Number of training positions funded through the Specialist Training Program.
2014 Academic Year Target: 900
2014 Academic Year Actual: 900
Result: Met
In 2014, the Department funded 900 training positions through 12 medical specialist colleges.
201120122013
518600750
Quantitative Deliverable: Number of additional emergency medicine specialist trainee positions delivered in emergency departments.
2014 Academic Year Target: 88
2014 Academic Year Actual: 88
Result: Met
In 2014, the Department funded 88 medical specialist training positions through the Australasian College for Emergency Medicine.
20122013
4466

Increase the supply of, and support for, health professionals in regional, rural and remote Australia

In 2014-15, additional scholarships were awarded to nursing and allied health students and professionals to support professional training, continuing professional education, clinical placements, and return or transition to practice. The scholarships were targeted to key Government priorities including: rural areas; increasing training in the private sector; and in primary care, aged care and mental health care.

The General Practice Rural Incentives Programme (GPRIP) was introduced in 2010 to attract and retain doctors in regional, rural and remote Australia. In 2014-15, to address ongoing concerns about programme effectiveness, an Independent Expert Panel was appointed to consult with key stakeholders and rural doctors. The Panel reported its recommendations to Government for a redesigned GPRIP that more effectively targets financial incentives to doctors working in smaller regional and rural towns and in remote communities.

From 1 July 2015, GPRIP will be delivered through the Modified Monash Model, to allow support and resources to be focused on areas of highest need – in small rural and remote communities. This follows consideration and consultation by an Independent Expert Panel, which reported in 2015, on how to best transition the GPRIP to this new system.

Qualitative Deliverable: Support general practices and Aboriginal Medical Services across Australia to employ practice nurses and Aboriginal and Torres Strait Islander Health Workers in an enhanced role.
2014-15 Reference Point: Incentive payments paid quarterly to all eligible practices.
Result: Met
Incentive payments were paid to all participating practices.
Qualitative Deliverable: New nursing and allied health scholarships delivered.
2014-15 Reference Point: Nursing and Allied Health Scholarship and Support Scheme arrangements varied to deliver up to 500 additional scholarships over three years.
Result: Met
The original contracts with the administrators for these scholarships were varied, with a total of 181 scholarships across nursing and allied health disciplines awarded out of the three-year objective of 500 scholarships. Scholarships included undergraduate, postgraduate, continuing professional development, re-entry and clinical placements scholarships. Similar numbers are expected for the next two years and will see this three-year objective being met.
Quantitative Deliverable: Percentage of medical students participating in the Rural Clinical Training and Support Programme – 1 year rural clinical placement.
2014 Academic Year Target: ≥25%
2014 Academic Year Actual: 33%
Result: Met
This programme provides funding to participating universities to establish and support medical student training in rural areas, supporting 17 Rural Clinical Schools nationally. In 2014, 866 medical students spent a year at a Rural Clinical School.
201120122013
36.6%32%33%
Quantitative Deliverable: Number of rural placements by University Departments of Rural Health.
2014 Academic Year Target: 3,700
2014 Academic Year Actual: 5,402
Result: Met
The University Departments of Rural Health (UDRH) Programme is a multidisciplinary rural education and training, research, professional support and services development initiative, with 11 UDRHs across Australia. In 2014, 5,402 undergraduate and postgraduate students undertook rural placements (two weeks or longer) through UDRHs.
201120122013
4,2104,8514,871
Quantitative KPI: Number of practices supported through the Practice Nurse Incentive Programme.
2014-15 Target: 4,100
2014-15 Actual: 4,338
Result: Met
At 30 June 2015, 4,338 practices were supported through the Practice Nurse Incentive Programme, compared to 4,236 in 2013-14.
11-1212-1313-14
3,5173,9784,236
Quantitative KPI: Number of suitably qualified overseas-trained doctors recruited under the International Recruitment Strategy.
2014-15 Target: 125
2014-15 Actual: 127
Result: Met
The Department supports the recruitment of overseas trained doctors through the International Recruitment Strategy. International medical graduates recruited to Australia receive case managed support from Rural Health Workforce Australia and the Rural Workforce Agency network to ensure their recruitment translates into longer term service in regional, rural or remote communities.
11-1212-1313-14
82124125

Programme 8.2: Workforce Development and Innovation

Programme 8.2 aims to develop a more efficient health workforce, including through increased investment in the dental workforce.

More efficient health workforce development

The essential functions and activities of Health Workforce Australia and General Practice Education and Training Ltd have been fully integrated into the Department of Health with all current funding agreements continuing to be honoured.

The Department is committed to the ongoing improvement, collection and publication of nationally consistent and authoritative health workforce data in Australia. The Department continues to undertake workforce planning and analysis using workforce data collected and stored on the National Health Workforce Dataset.

Management of the AGPT Program, including the selection of registrars, has continued with similar numbers to previous years.

Qualitative Deliverable: HWA wound up and functions transferred to the Department.
2014-15 Reference Point: Health Workforce Australia (Abolition) Bill 2014 introduced to Parliament, HWA functions, assets and liabilities successfully transferred to the Department.
Result: Met
The essential functions of Health Workforce Australia were transferred to the Department of Health with effect from 7 August 2014. Repeal legislation for HWA passed through the Parliament on 22 September 2014, and the Proclamation enacting the Health Workforce Australia (Abolition) Act 2014 came into effect from 8 October 2014.

Investment in the dental workforce

The Oral Health Therapist Graduate Year Program and Voluntary Dental Graduate Year Program provide oral health therapist graduates and dental graduates with a structured programme for enhanced practice experience and professional development opportunities, increasing the oral health and dental workforce capacity, particularly in the public sector.

The programmes require an administrator to allocate and administer 50 graduate placements per programme for each calendar year, and deliver the curriculum integral to the programme.

Quantitative KPI: Number of dental graduates participating in the Voluntary Dental Graduate Year Program.
2014 Academic Year Target: 50
2014 Academic Year Actual: 49
Result: Substantially met
In 2014, fifty graduates commenced participation in the Voluntary Dental Graduate Year Program, with one withdrawal prior to completion. Twenty-one graduate placements were in metropolitan areas; 18.5 placements in regional areas; 4.5 placements in remote areas; and five placements crossed various remoteness areas. Placements can be undertaken in various locations with graduates working across regional and metropolitan locations as part of state-wide or cross regional provider service delivery.
Quantitative KPI: Number of oral health therapist graduates participating in the Oral Health Therapist Graduate Year Program.
2014 Academic Year Target: 50
2014 Academic Year Actual: 49
Result: Substantially met
In 2014, fifty graduates commenced participation in the Oral Health Therapist Graduate Year Program, with one withdrawal prior to completion. Twenty graduate placements were in metropolitan areas; 23.5 placements in regional areas; 1.5 placements in remote areas; and four placements crossed various remotness areas. Placements can be undertaken in various locations with graduates working across regional and metropolitan locations as part of state-wide or cross regional provider service delivery.

Outcome 8 – Financial Resource Summary

  Budget
Estimate
2014-15
$’000
(A)
Actual
2014-15
$’000
(B)
Variation
$’000
(B) - (A)
Programme 8.1: Workforce and Rural Distribution
Administered expenses
Ordinary annual services (Appropriation Act No. 1)1,181,3861,135,232(46,154)
Departmental expenses
Departmental appropriation135,15832,570(2,588)
Expenses not requiring appropriation in the current year21,6912,166475
Total for Programme 8.11,218,2351,169,968(48,267)
Programme 8.2: Workforce Development and Innovation
Administered expenses
Ordinary annual services (Appropriation Act No. 1)169,980140,776(29,204)
Departmental expenses
Departmental appropriation19,0068,465(541)
Expenses not requiring appropriation in the current year2431563132
Total for Programme 8.2179,417149,804(29,613)
Outcome 8 Totals by appropriation type
Administered expenses
Ordinary annual services (Appropriation Act No. 1)1,351,3661,276,008(75,358)
Departmental expenses
Departmental appropriation144,16441,035(3,129)
Expenses not requiring appropriation in the current year22,1222,729607
Total expenses for Outcome 81,397,6521,319,772(77,880)
Average staffing level (number) 232 231 (1)
  1. Departmental appropriation combines ‘Ordinary annual services (Appropriation Act No. 1)’ and ‘Revenue from independent sources (s74)’.
  2. ‘Expenses not requiring appropriation in the budget year’ is made up of depreciation expense, amortisation, make good expense and audit fees.