1. Service Planning for New Workforce Models Shelley Horne Director Clinical Service Reform, SA Health April 2011

2. SAs Health Care Plan Reforms aimed at: >Rebalancing the system components >Matching services to local population needs >Designing models of care informed by evidence >Achieving these outcomes within the constraints posed by future workforce availability

3. Statewide Service Plans >Some fundamentals >An iterative process >Layers of detail >First layer of recommendations Confirm system wide model of care To inform development of Master Plans Detail in relation to early priorities

4. Content >System level vision of Model of Care including: expected changes in trends in clinical practice Critical relationships Any changes required to improve quality and safety Information technology that may assist >System level identification of workforce issues requiring focus & description of future plans >Teaching and research issues

5. Regional Service Construct Integrated service delivery models including: >Prevention, screening, early intervention, primary health care services, community based specialist services, inpatient based specialist services, ongoing services and support >Agreed clinical protocols and patient pathways to ensure seamless transition. >Facility and Communication mechanisms to support Major hospital General hospitals GP Plus Health Care Centres GP Plus Health Networks

6. Service plans and reform focus areas >Plans from Clinical Networks: Cancer, maternal and neonatal, cardiology, mental health, renal, rehabilitation, orthopaedic, child health, stroke, palliative care, older people health services >Plans from focussed groups of clinicians Medical imaging, Paediatric Services, Allergy/ Immunology >Plans for specific populations Aboriginal health Care Plan, Veterans Health Care Plan >Service Redesign Outpatient services, acute medical units, direct admission arrangements,

7. Related Planning >Model of Care for the System – models of care developed by Statewide service plans and Clinical networks reflect this whole of system view >Application of Model of Care to facility design >Workforce arrangements reflect the needs of the model of care and models of care reflect known workforce availability >Teaching and research >Clinical Network outputs >Other Statewide Service plan outputs

8. Model of care - overview Reflects: >Future patient profile >Future patient needs >Arrangements that best suit optimum pathways >Groupings of patients with like needs >Contemporary clinical practice >Advances in functional design for optimal healing >Advances in technology

9. Enhanced roles within new service models >Significant growth in Nurse Practitioner and enhanced nursing roles across: ED, Palliative Care, Geriatric, Cancer, Midwifery, Mental Health, Chronic disease management Exploring potential for other roles in community settings: minor injury illness, allergy, >Exploring enhanced AHP, medical assistant roles.

10. An example >The Cancer Clinical Practice Nursing Director (CNAHS) will: >Provide advanced clinical nursing care to oncology patients/clients. >Provide corporate professional advanced clinical nursing advice, mentoring and leadership to cancer nurse practitioners and nurse practitioner candidates. >Provide strategic and operational leadership in the development of the cancer nursing clinical services across the CNAHS consistent with the principals and priorities of the SA Health Care Plan, Statewide Cancer Clinical Network and Statewide Cancer Control Plan.

11. Food for thought >Workforce planning incorporating new/ enhanced roles. How can planners understand the impact of new/ enhanced roles on existing roles? How will the staffing profile required for service delivery be determined? Balancing subspecialisation with generic requirements

12. A possible process >Start with patient/population needs. >Establish model of care >Match needs with skills & expertise. >Match skills/expertise with available optimised disciplinary roles. >Renegotiate roles. >Refine workforce projections.

13. A palliative care example Psychosocial Biomedical

14. A palliative care example Psychosocial Biomedical Medical Work Nursing Work Social Work Spiritual Care Work

15. A palliative care example Psychosocial Biomedical Palliative Medicine

16. A palliative care example Psychosocial Biomedical Palliative Medicine Nurse Consultant

17. A palliative example Psychosocial Biomedical Palliative Medicine Nurse Consultant Social Worker

18. A palliative care example Psychosocial Biomedical Palliative Medicine Nurse Consultant Social Worker Bereavement Councillor

19. A palliative care example Psychosocial Biomedical Palliative Medicine Nurse Consultant Social Worker Pastoral Carer Bereavement Councillor

20. A palliative care example Palliative Medicine Nurse Consultant Social Worker Pastoral Carer Bereavement Councillor

21. A palliative care example Palliative Medicine Nurse Consultant Social Worker Pastoral Carer Welfare Officer Bereavement Councillor

22. A palliative care example Palliative Medicine Nurse Consultant Social Worker Pastoral Carer Welfare Officer Bereavement Councillor

23. A palliative care example Palliative Medicine Nurse Consultant Social Worker Pastoral Carer Clin Psychol Welfare Officer Bereavement Councillor

24. A palliative care example Palliative Medicine Nurse Consultant Social Worker Pastoral Carer Clin Psychol Welfare Officer Bereavement Councillor

25. A palliative care example Palliative Medicine Nurse Consultant Social Worker Pastoral Carer Clin Psychol Welfare Officer Psych Bereavement Councillor

26. A palliative care example Palliative Medicine Nurse Consultant Social Worker Pastoral Carer Clin Psychol Welfare Officer Psych Bereavement Councillor

27. A palliative care example Palliative Medicine Nurse Consultant Social Worker Pastoral Carer Clin Psychol Welfare Officer Psych Bereavement Councillor

28. A palliative care example Palliative Medicine Nurse Consultant Social Worker Pastoral Carer Clin Psychol Welfare Officer Psych Pharm Bereavement Councillor

29. A palliative care example Palliative Medicine Nurse Consultant Social Worker Pastoral Carer Clin Psychol Welfare Officer GPSI Psych Pharm Bereavement Councillor

30. A palliative care example Palliative Medicine Nurse Consultant Social Worker Pastoral Carer Clin Psychol Welfare Officer GPSI Psych NP Pharm Bereavement Councillor

31. A palliative care example Palliative Medicine Nurse Consultant Social Worker Pastoral Carer Clin Psychol Welfare Officer Community Network Faciliator GPSI Psych NP Pharm Bereavement Councillor

32. A palliative care example Palliative Medicine Nurse Consultant Social Worker Pastoral Carer Clin Psychol Welfare Officer Community Network Faciliator AIN/PCW GPSI Psych NP Pharm Bereavement Councillor

33. A palliative care example Palliative Medicine Nurse Consultant Social Worker Pastoral Carer Clin Psychol Welfare Officer AIN/PCW The Therapists GPSI Psych NP Pharm Bereavement Councillor

34. A palliative care example Palliative Medicine Nurse Consultant Social Worker Pastoral Carer Clin Psychol Welfare Officer Community Network Faciliator AIN/PCW The Therapists GPSI Psych NP Pharm Bereavement Councillor