Health workforce education & training – a statewide perspective Judith Abbott Manager, Workforce Strategy & Regulation 5 February 2007

Overview Workforce challenges: State wide issues and responses to date National reforms Clinical placements: challenges and opportunities Clinical placements agency: what might it do, what are the issues? Next steps

Workforce challenges Insufficient Victorian undergraduate training numbers Workforce maldistribution Changing service models & patient expectations Education & service delivery intertwined Long lead times for change Complex mix of state & federal responsibilities for health & education

Victorian response Substantially increase supply Progress strategies to improve distribution & retention Examine alternative training & workforce models Address barriers to innovation Integrated approach required, recognising that activity in one area will impact on potential outcomes in another

National reforms Supply growth from 2007 Improved national linkages between health & education National agreement on annual planning health education numbers through MCEETYA Clinical training costs Productivity Commission & COAG DEST review of undergraduate funding National health workforce taskforce National accreditation & registration

Clinical Placements: drivers for reform? Growth in training numbers Changing service & workforce models Concerns regarding efficacy of existing models Reported difficulties sourcing sufficient placements in some disciplines &/or settings High level of interest in area, lots of activity, need to be strategic with investment of time & resources

Clinical placements strategy Increase undergraduate clinical training capacity Promote more strategic, state wide approaches to planning & management Promote innovative training models Emphasis on cross disciplinary approaches

Innovation Pilot projects Establish/expand training in non-acute settings Clinical skills centres Progress competency-based approaches Registration & accreditation reforms DEST review of the impact if the Higher Education Support Act 2003 Funding Cluster Mechanisms Released in late Dec 2006. Submissions due 26 February. More information can be obtained from the DEST website:

Funding DEST review Cost sharing arrangements Review of acute funding model for medical & nursing undergraduate training DEST review of the impact if the Higher Education Support Act 2003 Funding Cluster Mechanisms Released in late Dec 2006. Submissions due 26 February. More information can be obtained from the DEST website:

Planning & evidence Establish statewide planning processes Establish regular, consistent clinical placement data collections Support & disseminate research Update & refine additional supply requirements

Capacity building Template agreement (includes cost sharing) Pilot clinical placements agency concept Develop IT systems for statewide application that links into broader planning & allocation processes

Why consider a clinical placement agency ? Current arrangements: Resource intensive, potential duplication of effort Profession specific, limit potential for interdisciplinary approaches Do not ensure available capacity is used optimally Restrict capacity for more strategic approach to planning & accommodating future needs       The current approach to organising placements is resource intensive & potentially involves significant duplication of effort. ·          Current decentralised arrangements, with minimal reporting of future requirements or availability, limit the capacity to plan for future clinical placement requirements, which is likely to become increasingly problematic as the supply of students seeking clinical training grows. ·          Courses that are perceived to be less prestigious &/or are delivered by training providers who do not have longstanding relationships with certain health services experience difficulties sourcing placements & in some instances, report their students being displaced &/or ‘shut out’ by those of other providers who have such relationships. There are also reports of training providers competing for places by offering higher levels of payment or other benefits that may not be possible for all.       ·          Available capacity is not always used optimally. For example, there are some reports of overbooking by training providers, where more than the required number of places are reserved, ostensibly to cover unexpected cancellations of placements, & then cancelled at the last minute. This prevents the utilisation of existing health service capacity. There may be untapped capacity in the system. For example, some rural services & community health services report potential capacity to increase their clinical training load if suitable supports including coordinating resources were available.. This is despite such clinical training having a significant impact on how – & where – graduates practise in their chosen field, & an acknowledged shortage of health practitioners in rural & regional areas.

What might it achieve? Promote local innovation &/or local roll out of successful innovation piloted elsewhere Facilitate access to ‘new’ placement settings Promote more effective, team based approaches Minimise administrative burden on health services & training providers Improve data collection & planning exploring a streamlined approach to clinical placement management Benefits for health services & training providers could include: Streamlining administrative procedures Maximising existing capacity Achieving economies of scale & building capacity Cohesive approach for future placement planning

Issues & challenges How to accommodate multiple: disciplines? training providers? services? Existing relationships Funding

Next steps Agency Clinical placements strategy IT system National reforms Clinical placement innovation projects Forums? For more information: www.health.vic.gov.au/workforce