Industry Training Demand Profile - Health

Industry Training Demand Profile

Health

Contents

Scope of Health Training Demand Profile

Part 1...... Industry background and directions

Part 2...... Skill shortages

Part 3...... Industry demand for training

Part 4...... Assessment of infrastructure needs

Part 5 Information on VET in schools, including Australian School-based Apprenticeships

Part 6 Industry’s top priorities for the public training system

Part 7...... Higher education

Scope of Health Training Demand Profile

This Training Demand Profile concerns the Tasmanian Health Industry, which covers the following sectors:

  • Hospitals
  • General Practice
  • Specialist medical services
  • Dental
  • Ambulance services
  • Community Health Centres

While core occupations within theHealth industry are the main focus of the training demand profile, skills other than core skills and qualifications are covered where relevant in the analysis, highlighting industry demand for a range of broad skill areas of significance.

Industry sectors and core occupations

The scope of the industry covered in this analysis includes the following sectors:

ANZSIC Classifications

O861Hospitals and Nursing Homes

O862Medical and Dental

O863 Other Business Services

Each of these classifications represents discrete industry sectors within specific VET requirements.

Training Package coverage

The Health industry is covered by the National Health Industry Training Package:

HLT07Health

Qualifications and courses within Training Package(s)

The Health industry is covered by a range of Nationally Recognised Qualifications, as set out below:

DIRECT CLIENT CARE WORK

Aboriginal and/or Torres Strait Islander Health Work

HLT21307 Certificate II in Aboriginal and/or Torres Strait Islander Primary Health Care

HLT33207 Certificate III in Aboriginal and/or Torres Strait Islander Primary Health Care

HLT43907 Certificate IV in Aboriginal and/or Torres Strait Islander Primary Health Care (Practice)

HLT44007 Certificate IV in Aboriginal and/or Torres Strait Islander Primary Health (Community Care)

HLT52107 Diploma of Aboriginal and/or Torres Strait Islander Primary Health Care (Practice)

HLT52207 Diploma of Aboriginal and/or Torres Strait Islander Primary Health (Community Care)

HLT61207 Advanced Diploma of Aboriginal and/or Torres Strait Islander Primary Health Care (Practice)

HLT61307 Advanced Diploma of Aboriginal and/or Torres Strait Islander Primary Health (Community Care)

Allied Health Assisting

HLT32407 Certificate III in Allied Health Assistance

HLT42507 Certificate IV in Allied Health Assistance

Ambulance

HLT21107 Certificate II in Emergency Medical Service First Response

HLT33107 Certificate III in Basic Health Care

HLT30207 Certificate III in Non-Emergency Client Transport

HLT31907 Certificate III in Ambulance Communications (Call-taking)

HLT41107 Certificate IV in Ambulance Communications

HLT41007 Certificate IV in Health Care (Ambulance)

HLT50407 Diploma of Paramedical Science (Ambulance)

HLT60307 Advanced Diploma of Paramedical Science (Ambulance)

Anaesthetic Technology

HLT42607 Certificate IV in Anaesthetic Technology

HLT50607 Diploma of Paramedical Science (Anaesthesia)

Audiometry

HLT41307 Certificate IV in Audiometric Assessment

HLT51307 Diploma of Hearing Device Prescription and Evaluation

Complementary and Alternative Health

HLT42707 Certificate IV in Aromatherapy

HLT51407 Diploma of Aromatherapy

HLT60907 Advanced Diploma of Aromatic Medicine

HLT41207 Certificate IV in Ayurvedic Lifestyle Consultation

HLT60707 Advanced Diploma of Ayurveda

HLT60607 Advanced Diploma of Homoeopathy

HLT42807 Certificate IV in Kinesiology

HLT51507 Diploma of Kinesiology

HLT40307 Certificate IV in Massage Therapy Practice

HLT50307 Diploma of Remedial Massage

HLT60507 Advanced Diploma of Naturopathy

HLT61007 Advanced Diploma of Nutritional Medicine

HLT51707 Diploma of Reflexology

HLT50207 Diploma of Shiatsu and Oriental Therapies

HLT50107 Diploma of Traditional Chinese Medicine Remedial Massage (An Mo Tui Na)

HLT60107 Advanced Diploma of Western Herbal Medicine

Dental Work

HLT31807 Certificate III in Dental Assisting

HLT43007 Certificate IV in Dental Assisting

HLT60407 Advanced Diploma of Dental Prosthetics

Enrolled Nursing

HLT43407 Certificate IV in Nursing (Enrolled/Division 2 nursing)

HLT51607 Diploma of Nursing (Enrolled/Division 2 nursing

HLT61107 Advanced Diploma of Nursing (Enrolled/Division 2 nursing)

Health Services Assistance

HLT32507 Certificate III in Health Services Assistance

HLT42007 Certificate IV in Operating Theatre Technical Support

Medical Assisting

HLT43107 Certificate IV in Defence Health Care

HLT43307 Certificate IV in Medical Practice Assisting

Neurophysiology Technology

HLT41707 Certificate IV in Neurophysiology Technology

HLT60807 Advanced Diploma of Neurophysiology Technology

Nutrition/Dietetic Assistance

HLT31507 Certificate III in Nutrition and Dietetic Assistance

Optical Dispensing

HLT43507 Certificate IV in Optical Dispensing

Pathology

HLT32607 Certificate III in Pathology

HLT41807 Certificate IV in Pathology

TECHNICAL SUPPORT WORK

Cardiac Technology

HLT42107Certificate IV in Cardiac Technology

Cast Technology

HLT41407 Certificate IV in Cast Technology

Dental Technology

HLT32707 Certificate III in Dental Laboratory Assisting

HLT50507 Diploma of Dental Technology

Hyperbaric Technology

HLT41507 Certificate IV in Hyperbaric Technology

HLT50707 Diploma of Hyperbaric Technology

Mortuary Assisting/Technology

HLT32007 Certificate III in Mortuary Theatre Practice

HLT41607 Certificate IV in Mortuary Theatre Practice

HLT51907 Diploma of Mortuary Theatre Practice

Optical Technology

HLT43707 Certificate IV in Optical Technology

Pharmacy Support

HLT31407Certificate III in Hospital/Health Services Pharmacy Support

HLT40507 Certificate IV in Hospital/Health Services Pharmacy Support

Prosthetic/Orthotic Technology

HLT32107 Certificate III in Prosthetic/Orthotic Technology

Rehabilitation and Assistive Technology

HLT43607 Certificate IV in Rehabilitation and Assistive Technology

Sleep Technology

HLT41907 Certificate IV in Sleep Technology

HLT50907 Diploma of Sleep Technology

Sterilisation Services

HLT31107Certificate III in Sterilisation Services

HLT43807Certificate IV in Sterilisation Services

ANCILLARY AND BUSINESS SERVICES WORK

Ancillary Services

HLT21207 Certificate II in Health Support Services

HLT32807 Certificate III in Health Support Services

General Business Operations

HLT32907 Certificate III in Health Administration

HLT43207 Certificate IV in Health Administration

HLT40407 Certificate IV in Health Supervision

HLT52007 Diploma of Practice Management

PUBLIC HEALTH WORK

Population Health

HLT20905 Certificate II in Population Health

HLT21005 Certificate II in Indigenous Environmental Health

HLT32205 Certificate III in Population Health

HLT32305 Certificate III in Indigenous Environmental Health

HLT42305 Certificate IV in Population Health

HLT42405 Certificate IV in Indigenous Environmental Health

HLT51005 Diploma of Population Health

HLT51105 Diploma of Indigenous Environmental Health

Part 1Industry background and directions

Industry trends

Tasmania’s health care system incorporates three large public hospitals (the Royal Hobart, Launceston General and North West Regional),a range of small rural hospitals, publicly-funded community-based health servicesand privatelyfundedcommunity-based health services including general and specialist medical, nursingand allied health care services and private hospitals.

A recent analysis as outlined in a Clinical issues paper prepared by the Department of Health and Human Services suggests that there are opportunities to improve the efficiency of Tasmania’s major public hospitals, reducing length of stay and reducing the incidence of avoidable admissions. This however, will require changes in hospital practices and in the way health servicesare designed and delivered. Providing more services in community settings will allow patients to be managed closer to their home or at home.[i]

The changing nature of the health workforce is one of the biggest challenges faced by healthcare systems in Australia and internationally.Although workforce numbers for most health professions have been growing faster thanpopulation growth in Australia, a number of other factors have created a workforce shortageacross many professions, particularly in outer metropolitan, rural and remote areas.

The Health Industry falls within the third major employment group in Tasmania.

Source: DEWR, 2001[ii]

The health workforce is ageing, average working hours are reducing and sub-specialisation of the workforce has increased. The health care system has become increasingly reliant on overseas trained health care professionals, particularly doctors. Nationally, overseas trained doctors make up 25% of the medical workforce, compared to 19% a decade ago.[iii]

While the Healthsector in Tasmania has not traditionally been a large consumer of vocational education and training, preferring generally to recruit graduates from the tertiary sector, there is a growing awareness of the benefits of VET qualifications in business application, particularly at the higher Australian Qualifications Framework levels (Certificate IV – Diploma levels).

New businesses

Hospitals in the past have been viewed as stand-alone institutions, but increasingly they are expected to work with other hospitals, other health care providers (e.g. general practitioners and other community-based providers) and the communities they serve to contribute to anintegrated health care system which is able to deliver better outcomes for patients.[iv]

The make-up of our community is changing. The public hospital system will need to take account of these changes and continue to provide services that meet the community’s needs.

As a consequence of increased life expectancy and (to a lesser extent) reduced fertility rates, the makeup of the population is changing.[v]In June 2006, Tasmania had the second highest proportion of any Australian state or territory of people aged 65 years or more.In addition, the Tasmanian community is ageing at a more rapid rate than other states and territories.

These changes have important implications for the health care system. Older people have a greater need for health services and their needs are more likely to be related to chronic diseases.[vi]The proportion of people with one or more chronic conditions rises rapidly with age.

Many new approaches to care have been implemented in different health care systems,for example:

  • ‘Hospital in the Home’ and ‘Hospital in the Nursing Home’ where people who otherwise would require hospital care receive treatment in their homes;
  • Post-Acute Care, where people who are discharged from hospital but require ongoing short term care receive that care in their homes;
  • Innovative care in hospital emergency departments, where assessment of patients with particular conditions is streamlined (for example, for patients presenting with chest pain) toensure that all patients are evaluated thoroughly and efficiently and only those who require hospital treatment are admitted;
  • Out-of-hospital preparation for surgery, so that patients can be admitted safely to hospital on the day of surgery rather than in advance;
  • Day-only surgery centres, where patients who do not require overnight admission can have their surgery performed safely and efficiently and where patients do not have to endurecancellations of surgery because of unexpected emergency cases; and
  • Chronic disease management, where patients are supported to understand their condition, manage it actively with professional support and seek assistance at an early stage if theirhealth deteriorates, before hospital admission is necessary[vii].

New technology

There has been an ‘explosion’ in technology in the health care system, changing outcomesfor patients, improving the longevity of the Australian community and driving organisational change in the health care system.

Examples of this technology include new medications, magnetic resonance imaging, angioplasties, hipreplacements and many other interventions. Advances in medical technology have madeit feasible and desirable to do more for each patient and to intervene with more patients.

Nationally, work is underway on the establishment of a shared Electronic Health Record. This will provide opportunities for improved communication between all health careproviders, particularly for patients with chronic and complex conditions.

Communications technology offers opportunities in some disciplines to extend thegeographic reach of specialist clinicians. There are significant opportunities to maximise theuse of technologies such as tele-health, which enables health care professionals in one area toconsult with other professionals or patients in another location, and the transfer of diagnosticinformation between hospitals. Videoconferencing allows the creation of ‘virtual teams’across sites, and can reduce the professional isolation of individual clinicians and small teams.

Increasing use of the internet and the uptake of broadband within the community means thatmore patients will have permanent network connections to their homes, facilitating the use ofoptions such as home monitoring.

New diagnostic and monitoring technologies and new pharmaceuticals are available thatimprove the quality of care for people with serious illnesses and disabilities. Tasmanians shouldbe able to access these new technologies within the State if they can be provided in a costeffective, high quality manner. Clinicians want to provide the most up-to-date care, and will beattracted to work in a system that provides good technological support. Much new technologyis expensive, however, and often there is only the capacity to provide it in a single location,which means that decisions have to be made about the most appropriate location and howaccess can be optimised for Tasmanians who live in more remote areas.[viii]

Strategic priorities/directions

Population growth and the ageing of the Tasmanian population are increasingdemand for health services. Better informed consumers are demanding highquality and up-to-date health care and a greater say in their treatment.The ageing of the population is also leading to an increased emphasis on themanagement and treatment of chronic diseases and an emphasis on healthyageing strategies.

Compared with the national average, Tasmania has:[ix]

  • A higher proportion of the population who report a long term health condition(79.0% compared with 76.7%);
  • A higher proportion of the population aged 18 years and above who smoke(25.4% compared with 23.2%);
  • A higher proportion of the population who are obese (17.1% compared with 16.6%);
  • A lower proportion of the population consuming the recommended vegetable intake;
  • A lower proportion of the population at risk of alcohol related harm; and
  • A vaccination rate above the national average.[x]

Various indicators highlight that:

  • The proportion of Tasmanians who report their health as very good or excellent is similar tothe national average;
  • Smoking-related mortality rates are significantly higher than the national average; and
  • A slightly lower proportion of Tasmanians report psychological distress, compared to thenational average.

In 2004-05, Tasmania had one of the highest rates of hospital separations due to diabetes at10.72 separations per 1,000 population,compared with the national average of 9.77 per 1,000 population.[xi]

More effort in areas such as health promotion, illness prevention and chronic diseasemanagement will be required to ensure the best possible health and wellbeing for Tasmania’sageing population.

Consumer preference for complementary and alternative health care will also affectthe demand for health services. This market is growing by about 30% a year in Australia.[xii]

Diminishing areas/skills

Within the Health industry, there will be a continual drive to update skill levels for new technologies and service delivery models.

Part 2Skill shortages

At a national level, the Australian Government Department of Employment and Workplace Relations produce an annual list of skill shortages across various Health Industry specialisations.[xiii] A range of skills shortages and recruitment difficulties are listed in the following specialisations for Tasmania:

Nursing

  • Accident/Emergency
  • Aged Care
  • Cardiothoracic
  • Community
  • Critical/Intensive Care
  • Neonatal Intensive Care
  • Neurological
  • Oncology
  • Operating Theatre
  • Paediatric
  • Palliative Care
  • Preoperative
  • Rehabilitation
  • Renal
  • Registered Midwife
  • Mental Health Nurse
  • Enrolled Nurse

Health Specialists

  • Dentist
  • Dental Specialist
  • Hospital Pharmacist
  • Retail Pharmacist
  • Occupational Therapist
  • Physiotherapist
  • Optometrist
  • Speech Pathologist
  • Podiatrist
  • Medical Diagnostic Radiographer
  • Sonographer

These findings are reinforced with the inclusion of the majority of these occupations on the Migration Occupations in Demand List, prepared by the Department of Immigration and Multicultural and Indigenous Affairs.[xiv]

Whilst pathways to the majority of the above professions are through tertiary institutions, supportive and assisting roles are covered in the National Health Training Package.

As the shortages in these professions are not likely to be satisfied, alternate models of service delivery are currently being developed that utilise the skills of vocationally trained staff in undertaking certain duties and functions under supervision, or where tertiary qualified staff obtain additional qualifications and accordingly undertake a broader task.

In addition tothe skills shortages listed above, job prospects for medical technical officers, complementary and alternate health, nurses aides and assistants are listed as either ‘good’ or ‘very good’in labour force trend data (the highest possible ratings) with projected strong employment growth, and also ‘moderate’ employment growth for nurses.[xv]

There is also general recognition within the Tasmanian Health system of the critical need to upskill existing support staff in their current positions and to provide a wide range of professionals with practical business and management skills.

Part 3Industry demand for training

1Tasmanian Health Industry

Characteristics of the existing workforce

The Healthand Community Services Industry employs approximately 1,077,000 persons, full time and part time nationally, which is around 10.5 per cent of the total workforce. In Tasmania the Health and Community Services accounts for 11.5 per cent of the total workforce.

Over the past five years, employment in the industry has increased at a rate of 3.5 per cent per annum. The median age for workers in this industry nationally is 43 years and earnings are around $800 per week (full-time and before tax)[xvi].

Employment arrangements

The majority of major occupations have a large component of part-time staff. For example, Enrolled Nursing, Nursing aides, and personal care assistants have 52 percent part time workforce and Registered nurses at 51 percent.[xvii]

Employer Size

The Department of Health and Human Services (DHHS) is the largest employer of Health Services staff in Tasmania operating over 350 sites including:

  • Three acute hospitals: The Royal Hobart, Launceston General and North WestRegionalHospitals;
  • Twenty rural health facilities (including district hospitals, multi-purpose services and other inpatient facilities);
  • Forty-six ambulance stations;
  • Twenty-one community health and multi-purpose centres;
  • Fifteen day centres for the frail, aged and people with a disability;
  • Eighty-two child health centres (at a combination of dedicated and co-located sites);
  • Two youth health centres;
  • Three parenting centres;
  • Thirty-two mental health facilities;
  • Seven housing service centres servicing over 12,500 social housing properties;
  • Thirty-three oral (dental) health facilities;
  • Thirty-two tele-health facilities;
  • One inpatient and five outreach clinics for alcohol and drug services; and
  • A number of services are also provided directly to clients in their homes.[xviii]

The balance of the workforce is mainly engaged within the private sectorand spread between private hospitals,medical, dental, communityand complementary health practices and centres.