Fitting health care workers to patient needs – lessons from Australia
Authors: Karen Steadman
25 July 2013
Looking at some of the recommendations from the Kings Fund on the NHS and Social Care workforce, I’m reminded of similar discussions going on in Australia in recent years about the rural and remote health workforce, where there is considerably difficultly responding to the health care needs of Australia’s widely dispersed population. Though Australia’s geography present a very different scenario from what we see in the UK, some of the ideas being investigated there are just as pertinent in our context – the focus must be on building a health workforce and designing roles specifically to fit patient needs.
Standing out in particular are the need for more integrative teams, and for changes to the job design- through the expansion of the existing scope of practice of some health workers and the development of new assistant roles. Some observations from my Australian experience are below:
As highlighted in the Kings Fund report, there is a need to develop teams, not just individual professional groups. In order to develop integrative teams that understand each others roles and can work together in an effective, cooperative, and co-dependent way, team members must know what it is their colleagues do, and that they all share the same values. This is about more than just knowing what each others role is – its about sharing a common language, its about understanding, and its about having a mutual respect for each others work. In order for this to occur, team members don’t need to just work with each other, but they need to learn with each other from an early stage – to develop their own working models of their profession within the context of other professions practice. Inter-professional teams, require inter-professional education.
Obviously different professions will have different clinical education, but we must remember that being an excellent clinician is not just about the clinical skills. There are a number of professional attributes which cross the boundaries of a given specialism, that can and should be learnt together across the professions – these include communication, clinical leadership, cultural awareness and respect, person-centred care and ethics. By learning these together, whatever the discipline, health students will have the opportunity care professionals will have the to ’learn with, from and about each other to improve collaboration and the quality of care’(Centre for the Advancement of Interprofessional Education).
The need to ‘Align the workforce to work, not the other way round’ is also a vital point. Bounded professional groupings and inflexible ‘scope of practice’ can be a barrier to providing effective care in a modern multi-disciplinary setting. We only need to look at the success of models of expanded practice here and overseas, such as Nurse Practitioners (winning their hard fought battle for prescribing rights) and new assistant roles, such as Physician Assistants, reducing the burden on more specialist clinicians, to see the value of developing new roles to fill profession gaps.
It will not be an easy job, but the health care workforce needs to be realigned to reflect the needs of the health service and the needs of patients – for too long we have tried (and failed) to squeeze profession shaped workers into need shaped holes.
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