Community Provider Workshops Summary of Feedback Prepared for a Joint Meeting of DSAC and CPHAC 19 May 2009

Overview  “Big Picture” Issues  Service Delivery Issues  Funding & Contracting  Business Issues  Sector Issues  General Workforce Issues  Professional Rural Workforce  Maori Workforce  Unregulated workforce  Volunteers  Other rural issues  Existing strategies  Proposed strategies  Next steps

Purpose of the Workshops “Build the Strategic Capability of our Workforce”. A workshop to be organised for CPHAC & DSAC to meet interested parties to explore means of working together to develop confidence in achieving a sustainable, renewable and integrated community healthcare workforce with the purpose of: Advising the Board Informing the next District Annual Plan

Workshop Discussion Questions  What are our local workforce issues, strategies and priorities?  What is our local workforce development activity?  From the feedback consider the identified priorities what are the most pressing for your group and why?  How can we in the community work together on this and what can we commit to doing now and in the future?

“Big Picture” Issues  Recruitment  Retention  Government Policy; immigration etc  Remuneration (inadequate, inequitable)  Funding & Contracting  Sense of sector disconnection locally, regionally, with each other, with the DHBs

Funding & Contracting  Term of contract may limit longer term NGO HR planning  Inflexibility; lack of trust; unclear direction  Funding models need to differentiate between rural and urban; one size doesn’t fit all  Pay discrepancies between DHB and NGO

Issues affecting Business  Costs of recruitment, competition for scarce staff  Multiple small overlapping providers  Multiplicity of backroom functions  High cost of business compliance requirements

General Workforce issues  Younger people’s expectations, commitment  No sector wide proactive planning for workforce  Ageing workforce; more injuries, more part-time; not available to mentor  Distance and time for education opportunities  Continued professional development outside of work time  Ability to back fill to release staff

Professional Workforce  Difficult getting clinical academic staff for training providers  Insufficient graduate placements available (nurses, allied health)  Scopes of practice e.g. (Nurses working below skill level because of a lack of Nurse Aides)  Locums expensive, transient, competitive market

Professional Workforce  Lack of professional development, support and supervision. Professional isolation.  Orientation to NZ way of life  Barriers to overseas professionals and people re- entering workforce (registration, HPCA Act)  Career pathways  End of career issues; GPs can’t sell their practices;  Ageing Workforce

Unregulated Workforce  Travel costs for low paid workers, particularly in rural areas  Inability to recognise training through higher wages  Casualised hours  High turnover

Volunteers  Overly relied on  Diminishing resource

Rural Sector  Rural voice not being heard  Lifestyle no longer offsets lower salaries  Reduced service delivery due to travel time  One size does not fit all  Rural training difficult; cost & lack of backfill  High consumer expectations of health and disability workers (always available)  Trend to increasing specialisation difficult to transfer to rural setting  After hours requirements (never off duty) = Burnout

Existing Community Strategies  Some provider networks exist (e.g. rural hospitals, aged care facilities, mental health providers etc)  Support for families of new rural clinicians  Relationships with training providers e.g. SIT, Otago Poly, University of Otago  Some activity around exploring new ways of working

Strategies Proposed from Workshop Recruitment/Retention  Promotion of our region as employment destination of choice  Promotion of health as an attractive career option  Settlement support  Recruitment and retention collect data / monitor  Retention > Training of staff > Models of practice – job satisfaction Workforce Information  Collect valid and comparable workforce data

Strategies Proposed continued Professional development  Training & Scholarships  Use of networks to communicate opportunities  Increased intakes to training  Career pathway development  Support for new graduates (NETP)  Workforce Education  Facilitate placement of ALL graduates  Reducing inequalities > All organisations – organisation staff development

Strategies Proposed continued Networks and Relationships  Mental Health network  Strong relationships  Network with other agencies (Social, housing, etc)  Sharing of resources e.g. competency, education, backfill for staff release, illness  Build on current frameworks – not everyone is a health worker – use teachers, police etc  DHB needs to take a wide view > Include the community perspective / input

Strategies Proposed continued Service Delivery  Changing models of care  Investigating different model of care  Community ownership of infrastructure Priority Workforces  Maori workforce development > collect data (MPDF) > recruitment and retention – monitor / support  Maori workforce is not strong enough to support Maori participation  Disability workforce participation

Next Steps  CPHAC & DSAC Discussion  Verification from invited participants