Shaping the future of palliative care leadership: taking the reins Deborah Law Program Manager Workforce Innovation and Reform Health Workforce Australia Palliative Care Victoria Melbourne 23 – 24 August 2012

Today’s presentation 1.About Health Workforce Australia 2.Health Workforce Workforce innovation and reform 4.Caring for older people program

About Health Workforce Australia  Building a sustainable health workforce that meets the healthcare needs of all Australians  This workforce should have the capacity to meet the growing demands on Australia’s healthcare system, arising from: an ageing population growth in chronic disease increased community expectation  A Commonwealth Government statutory authority

HWA: Our four key programs  We are working in four key areas: Information, analysis and planning Workforce innovation and reform Clinical training reform International health professionals

Health Workforce 2025 Health Workforce 2025 Doctors, Nurses and Midwives Volumes 1 and 2

NURSES  Short term: supply of nurses is stable  Long term: significant shortfall (109,490 by 2025) due to: ageing workforce poor retention rates population health trends  Some areas of nursing are especially at risk in terms of supply: mental health and aged care

WORKFORCE INNOVATION AND REFORM: A national approach to reform  Large-scale workforce reform is necessary to meet Australia’s future health needs Business-as-usual is not going to cut it  Delivering a national program of health workforce innovation and reform by leading and adding value to current reforms and innovations being undertaken in the health and education sectors  The work program is guided by the National Health Workforce Innovation and Reform Strategic Framework for Action

WORKFORCE INNOVATION AND REFORM: National framework The framework provides action in five inter-dependent domains for health workforce reform Domain Health workforce reform 1 Health workforce reform for more effective, efficient and accessible service delivery 2 Health workforce capacity and skills development 3 Leadership for the sustainability of the health system 4 Health workforce planning 5 Health workforce policy, funding and regulation

WORKFORCE INNOVATION AND REFORM: Caring for Older people (CfOP) program  Aimed at enhancing the capacity and capability of the health workforce to improve older peoples’ health service experiences and outcomes  Designed to test a number of hypotheses whilst using the best available evidence regarding transformational change  19 projects were implemented to trial strategies and explore various scopes of practice in an effort to work towards the optimal use of current workforce skills and adaptability

CARING FOR OLDER PEOPLE PROGRAM: Using the evidence  Demonstrated shifts in how and where we are using Australia’s health workforce  Collaborated on and established relationships with a broad range of stakeholders including jurisdictions, aged care peak organisations, education and VET sectors and private providers  In 2012 we have funded grants for 26 projects across various sectors, settings and geographies to: implement evidence of workforce re-design assess productivity impacts on a larger scale determine support required for national adoption

CARING FOR OLDER PEOPLE PROGRAM: Evidence of what works  Building on the outcomes of CfOP projects, jurisdictional initiatives and international best practice  Service and workforce reform are interdependent  Developing leadership capacity at all organisational levels to support and lead health workforce innovation and reform  Single role workforce change versus large scale change  Improving silos of action across boundaries through collaboration  Working back from client needs with a competency based approach  Importance of wellness and early intervention  Measuring success and time

WORKFORCE INNOVATION AND REFORM: Fit for purpose workforce Service and skills pyramid

WORKFORCE INNOVATION AND REFORM: The five pillars of workforce change  Competency based role re-design  More efficient utilisation of skills for assistants, generalist and clinical roles  Partnering across the continuum of care  Building leadership for change  System enablers

 Fit for purpose workforce  Leadership in different forms across all levels  Culture and change management  Ambitious reform and resilience for emergence  Toolkits  Communities of practice  Managing partnerships and sponsors to achieve mutual outcomes  Stimulating, incubating and accelerating

WORKFORCE INNOVATION AND REFORM: Next practice innovation model © The Innovation Unit (2007)

 The right leadership can turn around deeply rooted institutional and professional cultures, organisational structures and social dynamics that can act as barriers to adopting workforce innovation  Health care delivery and professional/clinical leadership needs to be supported by the system  Local and systems level enablers are vital  Integration and care coordination are required to sustain change

 Development of an enrolled nurse role into the role of team leader, with distance supervision via telehealth to address workforce shortages in residential aged care  Introduction of an extended palliative care carer specialist role, mentored by a clinical nurse consultant in residential aged care  Re-design of an assistant in nursing role in a resident focussed model of care assigned to residents rather than assigned tasks  Incorporation of more clinical service provision and care coordination and less administration and management into a registered nurse role CARING FOR OLDER PEOPLE PROGRAM: Evidence of what works continued

Summary  HWA has compiled evidence about what workforce changes should be delivered and how  “Whole of workforce approach” – strong leadership capacity will be required across all levels of the system to guide the workforce changes to support national reforms  Development of leadership competencies in the health workforce is necessary and a national approach will improve consistency and reduce the duplication of effort  The CfOP report is available on the HWA website

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