6. Strategies and actions for implementation
Strategies and actions for implementation
How will the Workforce Plan establish, sustain, and grow the workforce?
The following four workforce focus areas align to the Advancing health service delivery through workforce: A strategy for Queensland 2017-2026 and actions of the Workforce Plan.
Keeping Connected
Strengthening
Designing
Enabling
Workforce Plan Strategies and Actions.
Across each of these focus areas, strategies and actions were identified that are key to the short and long-term success of our specialist palliative care workforce and the clinical services that will be delivered to health consumers, their families and carers.
The strategies were developed with the understanding that a capable, well-organised and engaged specialist palliative care workforce underpins the delivery of safe, high-quality palliative and end-of-life care services.
Queensland Health Specialist Palliative Care Workforce Plan: Strategies and actions
The following four columns are titled as follows:
Designing the workforce
Enabling the workforce
Strengthening the workforce
Keeping connected
Designing the workforce
* Research and implement sustainable workforce models using a staged approach to respond to Queenslanders’ needs.
* Shape workforce models for improved equity of access to care for rural, regional and First Nations peoples.
* Design integrated workforce models to support consumers choosing care closer to home.
1.1 Expand positions across medical, nursing, allied health, Aboriginal and Torres Strait Islander health, and administration workforces to strengthen a multidisciplinary team approach.
1.2 Establish a baseline core specialist palliative care workforce in priority areas of need.
1.3 Build a sustainable local specialist palliative care workforce to meet community needs and preferences.
1.4 Grow and foster the specialist palliative care workforce in line with projected future population needs.
1.5 Establish Aboriginal and Torres Strait Islander workforce positions to deliver and support culturally safe and appropriate care.
1.6 Establish positions to support bereavement care for consumers, families and carers.
1.7. Build Hospital and Health Service community-based palliative care workforce models for local communities.
1.8. Implement workforce models that integrate virtual health care solutions where appropriate.
1.9 Design and mobilise workforce models to enable out-of-hours specialist palliative care delivery.
1.10 Enhance workforce capacity and capability to support transition from paediatric to adult palliative care services.
Enabling the workforce
* Enable the workforce to deliver care effectively through access to appropriate technology, equipment and resources.
* Support the specialist palliative care workforce to provide quality care to consumers, families and carers.
* Enhance workforce wellbeing and inclusive and culturally safe workplaces.
2.1 Continue funding the Queensland Palliative Medicine Advanced Training Pathway.
2.2 Continue to partner with relevant entities to enhance access to technology, telehealth, broadband and WiFi for improved connectivity and virtual healthcare across regional, rural and remote locations.
2.3 Work with local health services and palliative care equipment providers to enable prompt access to the equipment needs of consumers regardless of location.
2.4 Increase the administration workforce to appropriately support specialist palliative care services.
2.5 Inform quality improvement of care models, processes, practices and pathways to ensure cultural safety and the elimination of racism.
2.6 Consider assistant roles to support specialist clinicians to maximise scope of practice.
2.7 Enable access to programs that support staff safety and wellbeing including debriefing support and reflective practice.
2.8 Ensure appropriate clinical governance arrangements are in place to support the workforce to provide safe and quality specialist palliative care across the State.
2.9 Support clinicians to undertake practice-based research and translate to practice.
Strengthening the workforce
* Strengthen workforce capacity and capability to deliver quality care through education, training and development.
* Develop initiatives to support attraction and retention, particularly in regional, rural, and remote Queensland.
3.1 Increase the number of funded training positions for advanced trainees in palliative medicine.
3.2 Promote the inclusion of palliative care in pre-entry and entry level health education programs.
3.3 Optimise access to student clinical placements across professions and disciplines.
3.4 Implement local approaches to grow staff into design positions through upskilling and ‘Grow-Your-Own’ career pathways.
3.5 Support access to incentivised immersive experiences in specialist palliative care for new and emerging workforces.
3.6 Incentivise post graduate qualifications for specialist palliative care workforces.
3.7 Enhance access to programs for the Aboriginal and Torres Strait Islander health workforce to build palliative care skills and capability.
3.8 Develop succession plans with particular focus on ‘critical roles’ to support service continuity.
3.9 Provide mentoring opportunities for emerging and future specialist palliative care leaders.
3.10 Establish and connect educator roles in hub locations (SPaRTa and CHQ) to support education, training and development for specialist palliative care workforces in regional, rural, remote services.
Keeping connected
* Strengthen partnerships across sectors and services to maximise:
- opportunities for a connected and agile workforce
- the reach of specialist palliative care services
- consumer experience for consumers, families and carers.
4.1 Work with consumers, families and carers, the local community and other providers for an integrated community-based workforce approach.
4.2 Enhance partnerships between SPaRTa, PallConsult, and CHQ with local regional and rural teams.
4.3 Strengthen links between acute, primary, and aged care sectors to enable streamlined and connected quality care.
4.4 Continue to encourage workforce participation in specialist palliative care communities of practice, the Queensland Palliative Care Clinical Network, and/or other relevant professional networks.
4.5 Continue to share information on best practice to enable quality improvement.
4.6 Grow innovative partnership workforce models that improve the coordination of palliative care, and the navigation of options and pathways for consumers, carers and families.
4.7 Work with service provider partners to expand specialist palliative care knowledge across the lifespan for local workforces and community.
Investing in the future specialist palliative care workforce
With a system perspective established, detailed consultation and collaboration with individual Hospital and Health Services occurred to focus on how local requirements could best be met, while driving system-level improvements in accordance with the Strategy's principles and goals and the Workforce Plan strategies and actions.
Specialist palliative care workforce expansion
Under the Workforce Plan, our frontline specialist palliative care workforce will increase by 87.0%, and uplift from 265.61 FTE in September 2021 to a total of 496.80 FTE in June 2026.
More specifically:
* Medical practitioners will increase by 88.99% (59.00 FTE)
* Nurses, including registered nurses, clinical nurses, clinical nurse consultants and nurse practitioners, will increase by 54.42% (76.21 FTE)
* Allied health professionals will increase by 173.75% (57.58 FTE)
* Aboriginal and Torres Strait Islander health workforces will increase by 1605% (16.05 FTE)
* Administration officers will increase by 88.90% (22.35 FTE)
These increases are reflected in the following graph. FTE per profession as at September 2021 and June 2026 (projected).
The allocation of investment will support a staged build of the specialist palliative care workforce to enable growth in the greatest areas of need first.
Investment will be prioritised to establish a core baseline specialist palliative care workforce profile where this is not currently available, then build a sustainable workforce profile to enable service stabilisation, and subsequently grow the workforce to respond to future population growth within each Hospital and Health Service.
Please refer to the following graphs. Queensland Health specialist palliative care FTE per 100,000 population 2021 and 2026 (projected)
Please note these graphs all show two different columns, each representing 2021 and 2026 respectively across the various areas.
These planned workforce enhancements will support greater equity of access to specialist palliative care services by achieving a more comparable number of FTE per 100,000 population across each of the major and regional specialist palliative care Hospital and Health Services by 2026. Establishment of a core baseline workforce for rural and remote Hospital and Health Services results in comparatively higher workforce to population ratios, regardless of the projected future resident population for these Hospital and Health Services.
Specialist palliative care FTE supporting statewide programs such as Children's Health Queensland, PallConsult and MASS-PCEP are not included in Hospital and Health services population graphs, as they deliver services to all Queensland Hospital and Health Services.
Similarly, SPaRTa FTE operating from hubs based at Gold Coast, Sunshine Coast, Townsville and Cairns and Hinterland Hospital and Health Services are not included in Hospital and Health Services population graphs, as they deliver services primarily to rural, remote and regional communities.
Please refer to the following map, which represents the projected Queensland Health specialist palliative care workforce growth by 2026. Total Hospital and Health Services FTE by 2026 and percentage growth between 2021 and 2026
You will see that each area is represented by its FTE and percentage growth. The standalone box represents the area in South East Queensland on the greater area map.
Investment in capability development
The achievement of the future specialist palliative care workforce required to meet the needs of Queenslanders is contingent on the availability of appropriately qualified and skilled workforces across professions.
Building and strengthening the capability of our specialist palliative care workforce and supporting the development of students and clinicians seeking a career in specialist palliative care is essential to achieving the workforce of the future.
Separate to investment in additional frontline positions for Hospital and Health Services, investment will be made in specific capability development initiatives from within the committed $102 million from 2022-23.
Informed by consultation with clinicians and service providers, these investments include:
* The creation of additional opportunities for immersive experiences in specialist palliative care service delivery through the development of a multidisciplinary immersion program, and funding access to the Program of Experience in the Palliative Approach (PEPA) and Indigenous PEPA (iPEPA). (Actions 3.5 and 3.7)
* A review of existing nursing Transition to Practice Programs to build on palliative care knowledge and practice to ensure foundation capability within the Queensland Health nursing workforce. (Action 3.2)
* Incentives to support the completion of post graduate qualifications relevant to specialist palliative care, such as Graduate Certificates in Palliative Care and related areas such as lymphoedema management, and Master of Nursing programs leading to Nurse Practitioner qualifications. (Action 3.6)
* Incentives to support completion of post graduate qualifications in bereavement care, such as Graduate Certificates in Bereavement Counselling and Intervention, or Counselling, or Trauma Responsive Practice, and in Master of Counselling leading to certification as a bereavement counsellor. (Action 3.6)
* Funding for short-term leadership mentoring for nursing and allied health practitioners moving into leadership roles within specialist palliative care services. (Action 3.9)
* Continued funding for the Queensland Palliative Medicine Advanced Training Pathway to coordinate a statewide training program to develop a skilled palliative medicine physician workforce. (Action 2.1)
* Establishment of an additional 4.0 FTE temporary medical registrar positions in regional locations from early 2022 for a period of two years prior to the implementation of new permanent training positions from 2023-24. (Action 3.1)
* Establishment of an additional 2.0 FTE educator positions in each of the four SPaRTa service hubs to deliver education, training, and supervision support for nursing, allied health practitioners and Aboriginal and Torres Strait Islander health workforces. (Action 3.10)