Health Workforce ENewsletter Edition 2

Welcome to the second edition of Health Workforce Update.

Page last updated: 01 March 2019

A Word from the CMO
Vital mental health outreach services in the bush
The RFDS flying high with two new aircraft
Workforce Incentive Program consultations ongoing
Streamlining General Practice training arrangements
Supporting Non-VR GPs
MBS rebate changes
Visas for GPs - new requirement
Australia's Health Workforce data resources
Workforce planning tool Beta release

A Word from the CMO

Chief Medical Officer
Professor Brendan Murphy
Health data, and access to it, has become an increasingly valuable commodity in recent years. It contributes to health workforce planning, policy development, safety and quality, funding decisions and medical education planning. Health workforce data more specifically, is integral to ensuring the right medical professionals are deployed in the areas they are needed most.

The Department is striving to provide a range of data that is openly accessible for a variety of users, for a variety of purposes. In the previous edition of the newsletter, we introduced the new HeaDS UPP tool and the benefits it will provide in the health workforce planning space. In this edition we would like to direct you to a suite of other useful data resources such as datasets and fact sheets for you to explore. We trust they will prove useful in your own workforce planning activities.

Finally, thank you all for your positive feedback on the first edition of the Health Workforce Update. We look forward to providing you with more news of the progress from the Department’s Health Workforce activities.

Vital mental health outreach services in the bush

In response to the shortage of mental health services in rural and remote Australia, from 1 January this year the Royal Flying Doctor Service (RFDS) will be providing mental health outreach services to these areas. There is a high need for mental health services in rural and remote areas, however, these areas often face health workforce challenges.

The iconic service has received $20 million over four years from the Australian Government to provide a variety of services such as face-to-face treatments and interventions, individual, family and group sessions, and support for telehealth services. Services will be catered to the distinct needs of each state and territory.

With 90 years in operation, the RFDS know well the challenges in delivering mental health services outside the major metropolitan areas of Australia. Limited numbers of mental health services and mental health professionals, a reluctance to seek help, poor access to primary care, concerns about stigma, the distance and cost of seeking mental health services are all barriers to people in the bush receiving the mental health care they need.

The RFDS anticipate delivering crucial mental health services to around 150 locations nationally by the end of June 2019. To find out more visit the RFDS website.

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The RFDS flying high with two new aircraft

The Australian Government has provided a $4.5 million contribution towards the purchase of two new Pilatus PC-24 jet aircraft for the RFDS Western Operations Section.

The jets will be fitted out as in-flight emergency wards, with capacity for three stretchered patients and two medical teams and the capability for short landings and take-offs on unsealed airstrips. The jets will also halve the time for long-haul patient critical scenarios for remote parts of the state and boost overall fleet capacity for the RFDS in Western Australia.

The first jet touched down in Broome in early December 2018 and is expected to begin active service this month. Visit the RFDS website for more information.

Workforce Incentive Program consultations ongoing

The Department of Health and the Department of Human Services are continuing to work on the implementation of the Workforce Incentive Program (WIP). The WIP will replace the Practice Nurse Incentive Program (PNIP) and the General Practice Rural Incentives Program (GPRIP) from 1 July 2019. Medical practitioners and practices participating in the PNIP and the GPRIP on 30 June 2019 will automatically transition to the WIP.

As part of the implementation process the Department has been holding a series of consultations with health professionals and practices participating in the GPRIP and PNIP, as well as with organisations across the health workforce sector, including medical, nursing, Aboriginal and Torres Strait Islander health and allied health organisations, and Primary Health Networks. To date, 22 consultation sessions including teleconference, face to face and focus groups have been held involving 124 participants.

The consultations have provided an opportunity to hear more about how the current programs work to inform implementation of the WIP and will also support future improvements and enhancements to the WIP. The Department is working on finalising program guidelines ahead of the 1 July 2019 start date for the WIP.

More information on the WIP, including questions and answers, is now available on the Department’s website.

Streamlining General Practice training arrangements

New arrangements commenced at the beginning of the year that will simplify the pathways to specialist General Practitioner (GP) status. Under the simplified process there will be two pathways through the General Practice Colleges, instead of nine.

The two new General Practice Fellowship Programs allow each College to create a single, clearly-defined pathway to Fellowship. Both of these Fellowship Programs are supported by multiple training streams that cater to both Commonwealth-supported and independent trainees.

The Australian College of Rural and Remote Medicine (ACRRM) Fellowship Program consists of the following streams:
  • Australian General Practice Training (AGPT) Program
  • Remote Vocational Training Scheme (RVTS)
  • Independent Pathway (IP)
The Royal Australian College of General Practitioners (RACGP) Fellowship Program consists of the following streams:
  • Australian General Practice Training (AGPT) Program
  • Remote Vocational Training Scheme (RVTS)
  • Practice Experience Program (PEP)
Further detail on the Fellowship Programs can be found on the ACRRM and RACGP websites.

Supporting Non-VR GPs

A new Commonwealth-funded program to support non-vocationally registered doctors to achieve Fellowship launched at the beginning of this year. The Fellowship Support Program (FSP) is being run by the two GP Colleges, with delivery through the Australian College of Rural and Remote Medicine’s (ACRRM’s) Independent Pathway (IP) and the Royal Australian College of General Practitioners’ (RACGP’s) Practice Experience Program (PEP). The program aims to encourage non-VR doctors to achieve specialist general practice qualifications by partially subsidising the cost of their training.

The first intake of participants training under the FSP on the PEP program commenced their training in January 2019. A second intake will start in July 2019 and applications are now open until Friday 29 March 2019. More information is available on the RACGP website.

Applications for ACRRM’s IP are open year-round with selection occurring at multiple times in line with intakes. Applications for the July 2019 intake of ACRRM’s IP close Monday 25 March 2019.

Non-VR doctors on both pathways will be able to train towards Fellowship while continuing to practise and provide primary care services to the Australian community (predominantly in MM2 –MM 7).

Non-VR medical practitioners interested in applying should refer to the ACRRM and RACGP websites for information on eligibility requirements and how to apply.

MBS rebate changes

A new rebate structure under the Medicare Benefits Schedule (MBS) was introduced in July 2018 for non-vocationally recognised (non-VR) doctors. This new structure means non-VR doctors can claim 80% of the equivalent VR GP item for services. This change was made to better recognise the significant skills and knowledge VR GPs possess.

Some existing Non-VR medical practitioners can claim the full general practice items by participating in an Other Medical Practitioners (OMPs) Program. OMPs participants will be grandfathered for up to five years over which time current arrangements will remain in place. This workforce must attain Fellowship or join a Fellowship program through the Colleges to maintain access to the highest tier MBS items after the grandfathering period.

The recently-launched Non-Vocationally Registered Fellowship Support Program will provide a partially subsidised pathway to Fellowship through the GP colleges’ Fellowship Programs for these doctors.

These changes help ensure the number of specialist GPs entering the workforce meet the needs of the Australian community and non-VR doctors are supported to become general practitioners.

The Department of Health has worked with RACGP and ACRRM to co-develop Fellowship Program Placement Guidelines to support the commencement of the new GP training programs and access to MBS rebates.

The Department of Health continues to work closely with the two GP colleges to fully transition responsibility of delivering and managing general practice training by 2022.

More information is available on the DoctorConnect website.

Visas for GPs - new requirement

New requirements for employers sponsoring overseas doctors to work in Australia are planned to commence on 11 March 2019, subject to relevant legislative instruments taking effect.

Under the Government’s Visas for GPs initiative, growth in Australia’s medical workforce will be better managed by regulating the number of overseas trained doctors (OTDs) entering Australia to work in the primary healthcare sector through the skilled migration program. The initiative will direct doctors into areas that have lower access to services such as rural, remote and regional areas of Australia.

All employers nominating a position to be filled by a doctor who needs a visa to work in the following Australian and New Zealand Standard Classification of Occupations (ANZSCO) will be required to obtain certification (a Health Workforce Certificate) from a Rural Workforce Agency (RWA). A Health Workforce Certificate is a letter issued by a RWA confirming the genuine need to fill a primary healthcare position at a given location in Australia by an overseas doctor in certain occupations.

A current Health Workforce Certificate must be provided as part of an employer sponsored visa nomination application for these occupations. Without the Certificate the nomination cannot be approved and the related visa cannot be granted.

Additional information on the new requirement can be found on the DoctorConnect website.

Australia's Health Workforce data resources

Analysis of health workforce data informs training programs for the medical professionals of the future, as well as the professional development of our existing workforce. All levels of government, non-government organisations and the private sector are becoming more adept at harnessing the power of health data in program development, program delivery and the distribution of workforce to achieve more comprehensive coverage and quality outcomes.

The National Health Workforce Dataset

Demographic and employment information for registered health professionals

The Australian Health Practitioner Regulation Agency (AHPRA), in conjunction with the national boards, is responsible for the national registration process for 14 health professions. The data from this annual registration process, along with data from a workforce survey that is voluntarily completed at the time of registration, forms the National Health Workforce Dataset (NHWDS). Data in the NHWDS includes demographic and employment information for registered health professionals.

The Department uses data from the NHWDS and other sources to produce a series of supply and demand studies of medical practitioners, nurses and midwives and other allied health professions. The Australia’s Future Health Workforce Reports, NHWDS fact sheets and other health workforce publications are on the Department’s Health Workforce Data website.

Health Workforce Fact Sheets by Profession

The NHWDS is used to populate profession-specific fact sheets, including information on areas of practice, work settings and analysis of the workforce. These fact sheets are updated annually and are available for download.

The latest collection of fact sheets to be released are on nursing and midwifery. The Nursing and Midwifery Fact Sheets 2017 are in a set of five with summary data on nurses and midwives, registered nurses, enrolled nurses, midwives (separately), and nurse practitioners. Data includes workforce numbers, demographics, work hours, replacement rates, areas of practice, practice settings, qualifications and more. We would encourage you to take the time to explore these sheets.

Similar downloadable fact sheets covering a broad range of medical professions such as general practice, surgery, intensive care, oncology, obstetrics and gynaecology, all the way through to a wide variety of allied health professionals have also been created. The full list of fact sheets available for download can be found. High level workforce summaries are also available for download.

Medical Education and Training (MET) Online Data Project

Information on medical education and training in Australia

The Medical Education and Training (MET) dataset is available online each year and reports the annual changes in medical education and training in Australia. The 2017 MET dataset is accessible via the online data tool and includes:
  • University medical education and training
  • Prevocational medical education and training
  • Vocational medical education and training
  • International supply of medical practitioners
  • Quality, distribution and access to programs (3GA programs)
A series of summary snapshots for the current year's data is available for each of the sections collected. These can be located in the tabs at the top of the MET online data tool page. The online data tool is accessible.

Workforce planning tool Beta release

The new Health Demand and Supply Utilisation Patterns Planning (HeaDS UPP) Tool will be a consistent, integrated, quality source of health workforce and services data.

The Tool will provide sophisticated and comprehensive evidence to inform primary health workforce planning and analysis. It will use newly defined geographic catchments to reflect where people live and where they access health services, as well as where health practitioners and services are located.

Beta release

Over the coming months the beta version of the HeaDS UPP Tool will be rolled out to a limited number of stakeholders to monitor and assess the Tool’s performance in the testing stage. This will allow the project team to gather feedback to inform the ongoing development of the Tool prior to the Live release in mid-2019.

During February 2019 the beta version of the Tool has been shared with a limited group of internal Health stakeholders including the Health Workforce Division and Indigenous Health Division.

New Tool introduces new data methodologies and geographical classification

A key aim of the Tool is to provide health workforce planners consistent, integrated, quality data about health workforce and services. The data methodologies used within the Tool are documented to ensure transparency and clear understanding of how the data has been prepared.

The HeaDS UPP Tool introduces a new custom geographical classification called General Practitioner (GP) Catchments. The GP Catchments provide an evidence base for where services are provided and where patients are accessing those services.

General Practice (GP) Catchments

The GP Catchments were constructed using the Australian Bureau of Statistics’ (ABS) Australian Statistical Geographical Standard (ASGS) 2016, along with five years’ worth of Medicare data, and demographic data such as the ABS Australian Population Grid and Residential Mesh Blocks 2016.

A total of 829 non-overlapping GP Catchments were formed by aggregating sub-catchments, taking into account a number of factors including:
  • patient flows using MBS patient and provider data over a five year period
  • population demographics, e.g. population size and distribution
  • GP workforce, e.g. location and number of GPs
  • GP infrastructure, e.g. location and number of practices
  • accessibility, e.g. catchment size, travel distance and road networks
  • topography, e.g. mountain ranges, national parks, water bodies, islands
  • recognition of other boundaries, e.g. state and territory borders, local government areas.
GP Catchment geographical classification is the first health workforce specific geographical classification to be completed as part of the HeaDS UPP Tool.

Additional health workforce geographical classifications, such as individual medical specialties, nursing, and allied health, will be developed and made available via the HeaDS UPP Tool in the coming years.

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