Jennifer Doggett reports from Adelaide:
The gulf between education/ training and workforce policies within the health sector was a recurring theme at the Health Workforce Australia Conference in Adelaide yesterday.
A number of speakers in both the plenary and concurrent sessions highlighted the disconnect between the way in which we train health professionals and our expectations of our future health workforce.
Ben Wallace, Executive Director of Clinical Training Reform at Health Workforce Australia, argued that seeing our health workforce as a national resource and using it wisely is the first step to aligning education and training with future workforce needs.
He feels that the current funding system for health education and training is a major barrier to effective workforce planning.
He said: “There is a very complex, fragmented and opaque system of funding education and training of health professionals which works against any sort of national planning, accountability and transparency. Improving future workforce planning needs to start with a more streamlined funding system.”
The need for better coordination of training, at both the national and local level, through clinical training networks, was highlighted in his presentation.
He also discussed the need to be more scientific about the delivery of education and training. For example, he pointed out that there is little evidence for the current requirements for clinical placements in health and medical courses.
While clearly clinical experience is necessary, there needs to be more research done on what type and length of placement I optimum. Clinical placements are resource intensive and reduce the productivity of our existing health workforce.
Therefore, we need to ensure that they are used to deliver optimum outcomes and – where possible – are supplemented by simulation and other forms of training.
A consumer focus for education and training
Dr Joshua Tepper, CEO of Health Quality Ontario, also highlighted the need for a more consumer-focussed approach to health education and training. He said that education lags behind other sectors of the health system in its approach to consumer and the community engagement.
Dr Tepper argued that consumers are the ultimate recipients of care and just as a large corporation would go out and talk to its customer base before designing a new product, so too should providers and funders of health and medical education talk to consumers before developing a new health care education and training program.
Dr Tepper also highlighted the trend towards shifting more health care provision into the community setting, either in people’s homes or in community-based health services.
Yet tertiary level institutions are where most medical and nursing students receive the bulk of their care. This does not equip future doctors and nurses for a career in which they are likely to be working across a variety of community-based settings and working in a more autonomous, flexible and less hierarchical environment than a teaching hospital.
One example he provided is that most people would prefer to receive care in their homes or a community-based setting and that is reflected in the trend towards providing more care out of hospitals. Yet most medical training is provided in the hospital/acute care setting.
As an example of community engagement in medical education he described how the Northern Ontario Medical School consulted the community prior to it establishment on what its members wanted from this new training facility.
The input from the community – in a rural area of Canada with workforce shortages – significantly changed the way in which the school now operates and the content of its curricula.
The Swedish example
The need for an overall patient-centred vision for the provision of health and medical care was highlighted by Agneta Jansmyr, CEO of Jonkoping County Council in Sweden.
Jonkoping’s vision for its citizens is ‘A happy life in a beautiful county’ and its health, education, welfare and other social services are all aligned to promote this vision.
Agneta described how she can use the twin levers of health and education, in a de-centralised health system, to deliver coordinated and patient-centred care.
A key message from her presentation was the importance of continually placing patients at the centre of the system and asking the question ‘how do you want to participate in your own care?’ rather than imposing expectations of their involvement on them. (Click on image below to see in greater detail).
At the conference today, sessions on evidence-based workforce planning, building strong workplace cultures, clinical training reforms and Closing the Gap in Indigenous health will enable delegates to explore these issues in more depth and develop strategies to improve workforce planning processes within their own workplaces.
There was a veritable flood of tweets in the #HWA2013 stream yesterday. Below is a brief selection.
Some happy snaps
And some feedback to conference organisers and presenters…