Albury Wodonga Health – The Best of Health
Patient & Client Focused – Equity – Trust – Ethical – Respect – Compassion – Accountability - Teamwork
Regional and rural workforce: the role of higher education in health
Adjunct Professor Susan O'Neill, CEO Albury-Wodonga Health
Overview
• Higher education
• Employment and education
• Health and the economy
• Critical disruptions
• Employment and education relationship
• Regional specifics
• Big picture thinking
Higher Education
• Exploring • Learning • New pathways• Possibilities & opportunities• Develop society• Judgments and dignity• Innovation • Research • Ticket to future prosperity?• Getting a job….
Current state regional variances
• University education 25-39 year olds
– Melbourne 40% vs regional areas 21%
• University education double likelihood of having a job earning > $52 000/year
• Aim to provide 80% self sufficiency
• 20% flow out for high risk and low volume care
• <20% people have tertiary qualification
• >70% health workers need tertiary qualification
Source: Health workforce Australia reports
Social Determinants of Health & Wellbeing
Source: Public Health Association of Australia: Submission to Senate Standing Committee on Community Affairs, Inquiry into Income Inequality in Australia, Aug 2014
From Dr Michael Walsh AWH Strategic Planning presentation December 2014
Health as a Local Economic Driver
• Employment
• Local Spending
• Importance of the workforce to the local community
• Healthcare as an attractor
BUT:
• The misdistribution in medicine, dentistry and allied health is a global problem
• HWA predicted shortages of skilled health workers by 2025-Drs & Nurses (mental health and aged care)
Source: Health workforce Australia reports
Albury Wodonga Health – The Best of Health
Patient & Client Focused – Equity – Trust – Ethical – Respect – Compassion – Accountability - Teamwork
What is happening in heath?
Critical Disruptions
The Five Forces Shaping Health Care’s Future
• The Greying Patient (and Provider)
• The Lifestyle Epidemic– fat, sugar, ice & heat
• The Information Revolution
• The Blessing and Curse of Clinical Technology
• The New Health Care consumer– Google informed
Source: The Advisory Board Company – Research Briefing – Five Disruptive Forces Affecting Health Care, Washington USA 2014
0-45-9
10-1415-1920-2425-2930-3435-3940-4445-4950-5455-5960-6465-6970-7475-7980-84
85+
60 50 40 30 20 10 10 20 30 40 50 60Population in thousands
Males Females
Source: ABS
Year 1933
SA Male and Female Population by Age
0-45-9
10-1415-1920-2425-2930-3435-3940-4445-4950-5455-5960-6465-6970-7475-7980-84
85+
60 50 40 30 20 10 10 20 30 40 50 60Population in thousands
Males Females
Source: ABS
Year 2006
SA Male and Female Population by Age
0-45-9
10-1415-1920-2425-2930-3435-3940-4445-4950-5455-5960-6465-6970-7475-7980-84
85+
60 50 40 30 20 10 10 20 30 40 50 60Population in thousands
Males Females
Source: ABS
Year 2040
SA Male and Female Population by Age
TheGreying Patient (and Provider)
1950ratio >65yrs=7:1
2010ratio >65yrs=2.1:1
The Lifestyle Epidemic
• Lifestyle related diseases• obesity, cardiovascular, respiratory, diabetes, renal, cancer
• 76% of deaths worldwide – a higher proportion in Australia
• Prevention a priority but not a magic bullet
• The need for hospitals will not fade relative to community based services according to AIHW
• Master planning to increase hospital services in regional areas
Source: The Advisory Board Company – Research Briefing – Five Disruptive Forces Affecting Health Care, Washington USA 2014
Technology
• Technology the biggest driver annual growth of expenditure on health care;
• “mechanical era” (implants, imaging, radiation, robotics) to the “biotechnical era” (stem cells, molecular medicine, gene therapy, tissue engineering);
• Degree of readiness of current workforce and facilities to adapt to these changes, affordability
Source: The Advisory Board Company – Research Briefing – Five Disruptive Forces Affecting Health Care, Washington USA 2014
Employment and education changes
Current trends
• Automation and technology
• Oxford report probability of automation – Pharmacy workers
– Journalists
– Drivers
– Paralegals
– Hospital and medical workers
– Pilots/astronauts
• Health-mechanical era
Growth areas
• Knowledge workers– cyber security
– supply chain
– marketing analytics
– big data analysts
– Business
– Engineering
• Health- biotechnical era
Source: The Advisory Board Company – Research Briefing – Five Disruptive Forces Affecting Health Care, Washington USA 2014http://www.qmed.com/news/oxford-study-47-us-jobs-could-be-done-machines Feb 2015
The Big Workforce Issues
• Jobs and opportunities are changing fast
• Workforce is getting older
• Growth & complexity in workplace
• Generational change, work-life balance
• Regulation & scrutiny
• Public expectations
• Increasing reliance on overseas recruitment
• Regional & rural areas issues magnified
Albury Wodonga Health
• 2nd largest employer• Regional health service but min 4 hours away from metro • Rely on community and care interdependencies• Slow & low turnover• Paradox of loyal and nomadic worker• No one size employment model• Attraction, recruitment and retention of health
professionals relates to economic vibrancy of area• Specialisation, volume and cost• Local higher education linchpin • Local education options increases chances of growing your
own
Regional Higher Education Pathways
• Nursing
• Paramedical
• Physiotherapy
• Speech
• Social work
• Occupational therapy
• Psychology
• Accounting
• Business
• Human resource management
• Marketing
The disconnected numbers
• Regional areas increasing health self sufficiency
• Higher education demand is generic
• Workforce requirements are specific
• Oversupply of graduates not resulting in filling gaps in regional and rural /remote areas
• Early adoption greater chance of retention & return
• Social behaviours influence mobility
• Immigration as a consequence
Big picture
• Health service and higher education supply chain planning not connected for a globalized world
• Workforce planning not projected and connected to changing service requirements
• Knowledge workers growing in demand but health services don’t own universities
• Barriers due to tradition and state and federal funding models – “Educated without unemployment” – “Jobs without applicants”
• Disruptive change required but unintended consequences of one size fits all