Community Provider Workshops Summary of Feedback

1. Community Provider Workshops Summary of Feedback Prepared for a Joint Meeting of DSAC and CPHAC 19 May 2009

2. “Big Picture” Issues Service Delivery Issues Funding & Contracting Business Issues Sector Issues General Workforce Issues Professional Rural Workforce Maori Workforce Unregulated workforce Volunteers Other rural issues Existing strategies Proposed strategies Next steps Overview

3. Purpose of the Workshops “Build the Strategic Capability of our Workforce”. A workshop to be organised for CPHAC & DSAC to meet interested parties to explore means of working together to develop confidence in achieving a sustainable, renewable and integrated community healthcare workforce with the purpose of: • Advising the Board • Informing the next District Annual Plan

4. Workshop Discussion Questions • What are our local workforce issues, strategies and priorities? • What is our local workforce development activity? • From the feedback consider the identified priorities what are the most pressing for your group and why? • How can we in the community work together on this and what can we commit to doing now and in the future?

5. “Big Picture” Issues • Recruitment • Retention • Government Policy; immigration etc • Remuneration (inadequate, inequitable) • Funding & Contracting • Sense of sector disconnection locally, regionally, with each other, with the DHBs

6. Funding & Contracting • Term of contract may limit longer term NGO HR planning • Inflexibility; lack of trust; unclear direction • Funding models need to differentiate between rural and urban; one size doesn’t fit all • Pay discrepancies between DHB and NGO

7. Issues affecting Business • Costs of recruitment, competition for scarce staff • Multiple small overlapping providers • Multiplicity of backroom functions • High cost of business compliance requirements

8. General Workforce issues • Younger people’s expectations, commitment • No sector wide proactive planning for workforce • Ageing workforce; more injuries, more part-time; not available to mentor • Distance and time for education opportunities • Continued professional development outside of work time • Ability to back fill to release staff

9. Professional Workforce • Difficult getting clinical academic staff for training providers • Insufficient graduate placements available (nurses, allied health) • Scopes of practice e.g. (Nurses working below skill level because of a lack of Nurse Aides) • Locums expensive, transient, competitive market

10. Professional Workforce • Lack of professional development, support and supervision. Professional isolation. • Orientation to NZ way of life • Barriers to overseas professionals and people re-entering workforce (registration, HPCA Act) • Career pathways • End of career issues; GPs can’t sell their practices; • Ageing Workforce

11. Unregulated Workforce • Travel costs for low paid workers, particularly in rural areas • Inability to recognise training through higher wages • Casualised hours • High turnover

12. Volunteers • Overly relied on • Diminishing resource

13. Rural Sector • Rural voice not being heard • Lifestyle no longer offsets lower salaries • Reduced service delivery due to travel time • One size does not fit all • Rural training difficult; cost & lack of backfill • High consumer expectations of health and disability workers (always available) • Trend to increasing specialisation difficult to transfer to rural setting • After hours requirements (never off duty) = Burnout

14. Existing Community Strategies • Some provider networks exist (e.g. rural hospitals, aged care facilities, mental health providers etc) • Support for families of new rural clinicians • Relationships with training providers e.g. SIT, Otago Poly, University of Otago • Some activity around exploring new ways of working

15. Strategies Proposed from Workshop Recruitment/Retention • Promotion of our region as employment destination of choice • Promotion of health as an attractive career option • Settlement support • Recruitment and retention collect data / monitor • Retention > Training of staff > Models of practice – job satisfaction Workforce Information • Collect valid and comparable workforce data

16. Strategies Proposed continued Professional development • Training & Scholarships • Use of networks to communicate opportunities • Increased intakes to training • Career pathway development • Support for new graduates (NETP) • Workforce Education • Facilitate placement of ALL graduates • Reducing inequalities > All organisations – organisation staff development

17. Strategies Proposed continued Networks and Relationships • Mental Health network • Strong relationships • Network with other agencies (Social, housing, etc) • Sharing of resources e.g. competency, education, backfill for staff release, illness • Build on current frameworks – not everyone is a health worker – use teachers, police etc • DHB needs to take a wide view > Include the community perspective / input

18. Strategies Proposed continued Service Delivery • Changing models of care • Investigating different model of care • Community ownership of infrastructure Priority Workforces • Maori workforce development > collect data (MPDF) > recruitment and retention – monitor / support • Maori workforce is not strong enough to support Maori participation • Disability workforce participation

19. Next Steps • CPHAC & DSAC Discussion • Verification from invited participants