Update on Workforce Modelling and Stakeholder Engagement in AST

On 13 February 2019, APEX attended a meeting at the Ministry of Health that had two major issues in focus:

1. Current availability of data on the Allied Scientific and Technical Health Professions, and potential of Workforce Modelling for Allied Health; and
2. Stakeholder engagement given recent changes in the Ministry, including the new Health Workforce Directorate and governance changes.

Martin Chadwick, our new Health Professions Officer, was in attendance for the day – his 6th day in the new role. If you recall, APEX successfully lobbied to have this position created sitting alongside the Chief Medical and Chief Nursing Officer in the “clinical cluster” at the MoH. This is an important step to support and advance recognition of the added value we bring to our sector and enable us to do the best we can for the delivery of health outcomes for our communities.

Interestingly maybe, the Chief Medical and Nursing Officers also attended on the day.

Others in attendance included lots of registration board people, AST leaders from the DHBs, TAS and other DHB agencies, a few university people and some professional bodies mainly from amongst allied professions (social work, dental, psychologists, podiatrists, audiologists, psychotherapist, OTs, dieticians, physiotherapists…) and APEX.

One thing that struck me about this group was the relative paucity of representatives of the professions themselves. The DHBs and their agencies don’t represent us, nor do the registration boards (whose role is to protect the public through regulation of the profession). Whether that was deliberate on behalf of the MoH or simply who turned up on the day, we are not sure.

Workforce Modelling

Developed by HWNZ and now sitting within the MoH is a workforce modelling tool that can monitor entry, exit and reentry rates by age and FTE for each profession. They rely on registration board data so where the registration board hasn’t provided data the model has not yet been applied. As a result for example pharmacists and dental therapists have been modeled, MITs have not.

The HPCAA is currently being changed to give the registration boards the authority to collect data and provide that to the Ministry so as to undertake more workforce modeling. The DHBs are also collaborating with the Ministry to apply a health practitioner index (HPI) – a unique number for each health practitioner – allocated to each of us. One question… whilst global workforce data is good, how will you feel if that drills down to your individual practice?

The model is now being refined to identify demand now and in the future using big data. But what is not yet being capturing is how many of us there should be including the potential that more (of us) will add greater value. This is a huge gap in our system: the value of investment in our workforces that would result from increasing numbers is not being demonstrated.

Issues that arose mirrored the feedback we had from delegates prior to attending the meeting suggesting we need:

• Whole of workforce data not just DHB sector; and
• Unmet needs data not just compliment data; and
• To be able to identify added value and return on investment propositions including within changing models of care, that support the value of additional FTE; and
• Pipeline support to get practitioners into the professions?

Stakeholder Engagement

HWNZ has now been subsumed into the Ministry of Health with the health workforce as a stand alone (new) directorate with its own Deputy Director General reporting to the Director General (Ashley Bloomfield). This directorate also houses the MoH’s employment relations (ER) team. Whilst we were assured the ER team would not drown out the workforce team, I was not convinced. In my experience where money is involved as it inevitably is with ER, it always takes priority. Given the issues we face currently trying to settle collective agreements for groups with workforce pressures (e.g. ATs) the preeminent role of the ER team reaffirms this dynamic.

The HWNZ board will be replaced with a new but interim group (chaired by Ray Lind) that will be advisory to the MoH directorate. The interim group will set up the terms of reference for a definitive governance group which will be informed by advisory groups for the various workforces. They have until April to complete these terms of reference. They will be focused on interdisciplinary workforces, especially amongst allied health practitioners and needs based workforces with a whole of population focus: NASC coordinators and navigators are examples of this type of workforce where those undertaking the role are not profession specific. So lots of restructuring, but what of stakeholder engagement? They asked the participants to say what we wanted more of (from the MoH) and what we needed less of. Needless to say, the “more of” list was long and the “less of” almost empty.

The entire session left me feeling a little disheartened: we still seem to be asking someone else to do everything for us. So I spoke up. Admittedly not everyone was in the room by a long shot, but one of the great things about AST is that whilst individually we may be small, collectively we are the second biggest group of health professions (behind nursing). And we are well connected and getting better at this as time passes. Within our own resources and entities, we have potential to do much more that would at least start the ball rolling, prove added value and thereafter attract some assistance from the likes of the Ministry. Waiting for someone else to “do it” for us is unlikely to be successful.

And we do have some additional resource – we have a new Health Professions Officer at the MoH who can assist connect us and will be a constant presence in political corridors. Instead of waiting with hands out, improved collaboration and pushing what we have to offer is much more likely to advance the proposition that as AST, we not only have a lot to offer, we have a lot more we could offer if….

As the only person in the room who has a role and overview that goes with that, representing the breadth of AST professions, playing our part in this may be important.

We welcome your thoughts and feedback.

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