Role of Australian Primary Healthcare Organisations (PHCOs) in Primary Healthcare (PHC) Workforce Planning: Lessons from Abroad

By Naccarella, Lucio; Buchan, James et al. | Australian Health Review, August 2011 | Go to article overview

Role of Australian Primary Healthcare Organisations (PHCOs) in Primary Healthcare (PHC) Workforce Planning: Lessons from Abroad


Naccarella, Lucio, Buchan, James, Newton, Bill, Brooks, Peter, Australian Health Review


Background

The Australian Commonwealth Government has emphasised the need to strengthen the primary healthcare (PHC) system by releasing its first National PHC Strategy1. It has also committed to addressing workforce pressures, by funding Health Workforce Australia - 'Australia's first health workforce planning agency to better plan for our future health workforce needs'.2

The Australian Government will also establish a national network of PHC organisations (PHCOs) referred to as 'Medicare Locals3 to improve access to care, to enhance local service coordination, population health planning and service integration. Peak bodies, such as the Australian General Practice Network (AGPN) advocate a core function of PHCOs, being workforce planning, development and support. Core activities identified include: staff development; clinical and managerial leadership development; workforce recruitment, development and support; professional and practice support services; interdisciplinary education and training; and change management services.4

Australian policymakers and peak bodies are promoting the role of PHCOs as inclusive of workforce planning. This development should be informed by international evidence of successes and failures, particularly in regard to development and implementation of national workforce policies.

PHCOs are recognised as providing a link between the micro level (where clinical care is delivered by providers), and the macro (systems) level (where policy, funding and infrastructure activity occurs).5,6 PHCOs are not new, but their form and functions vary.7-10 In New Zealand (NZ), as part of its 2001 PHC Strategy, primary health organisations (PHOs), a form of PHCO, were funded to provide: workforce shortage forecasting and policy development; recruitment; continuing education, mentoring programs, assistance with practice systems and efficiency; development of new or extending old roles; supporting students and clinical placements; and encouraging multidisciplinary teamwork and skill-mix.11 In the UK, since 2002 Primary Care Trusts (PCTs), another form of PHCO, have focussed on workforce development opportunities, including expanding the roles of existing PHC workers, creating new roles and encouraging workforce skill-mix.12,13

In Australia PHC workforce reforms are being implemented by Divisions of General Practice, (additionally in New South Wales by Area Health Services, and in Victoria by Primary Care Partnerships) (Health Workforce Australia, see http://www.hwa. gov.au/, accessed September 2010).14-17 In the context of workforce, these have focussed on: workforce shortage forecasting; recruiting to general practice; providing continuing education; mentoring programs; assisting with practice systems; supporting the development of new roles; supporting clinical placements; and supporting multidisciplinary teamwork and skill-mix at the practice level.16,17 This paper reviews international experience in order to inform Australian PHC workforce policy on the role of PHCOs/Medicare Locals in PHC Workforce Planning.

Method

A qualitative research approach underpinned the study, and was overseen by an international advisory group. Forty-three key informants (21 = UK; 22 = NZ) from policy (i.e. advisors), research (i.e. academics) and practice (i.e. PHCO funders, directors and evaluators) arenas were identified via the advisory group. Twenty-nine (67%) informants agreed to participate in a semistructured interview, which were audio-taped with consent and transcribed verbatim by an independent transcriber. Thematic analysis was used to identify and code themes and to iteratively build a systematic interpretation of data.

Table 1 provides a profile of key informants. Informants were asked:

1. What types of PHCOs do you think about in relation to PHC workforce planning, development and support?

2. What roles and responsibilities do PHCOs currently have in PHC workforce planning, development and support? …

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