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PREPARED BY
Health Workforce New ZealandAddressing Workforce Challenges
Dr Ruth Anderson
Acting Director
Health Workforce New Zealand
WORKFORCE CAPACITY • Capacity is limiting factor for National Bowel Screening
programme
• Gastroenterologists (3 lists per week)- undertake approx. 60% of colonoscopies- registrar training duration average of 6 years- lead providers of colonoscopies in urban areas
• General Surgeons (1 list per week)- undertake approx. 40% of colonoscopies- registrar training duration average 5 years- lead providers of colonoscopies in rural and regional areas- increased pressure for surgical interventions
• Pathologists and Allied Health Science and Technical Workforces– expected shortages in face of increased demand 2
CURRENT STATUS GASTROENTEROLOGISTS: Numbers
3
2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 20260
10
20
30
40
50
60
70
80
90
56 5759
5962.161306764231
65.072614905798167.761747994621
70.249923695325672.5545339270689
74.690331482035476.6702231862161
78.505876830850680.208154007933981.787380435716683.2534845372168
Gastroenterologists in DHBs
Gastroenterologists in DHBs Projected number of Gastroenterologists in DHBs
CURRENT STATUSGASTROENTEROLOGISTS: Age Group
4
30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80-84 85+0
2
4
6
8
10
12
14
16
Number of Gastroenterologists in DHBs as at 30 Mar 2015by age group
CURRENT STATUSINTERNAL MEDICINE (inc Gastro): Exit Rate
5
30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80-84 85+0.0%
5.0%
10.0%
15.0%
20.0%
25.0%23.5%
9.7%
3.4% 3.0%2.1% 2.1% 2.7%
6.5%
11.2%
15.5%
21.1%22.2%
Average Exit Rate by age group for Internal Medicine Specialists in New Zealand
2010-2014
CURRENT STATUSGENERAL SURGEONS: Numbers
6
CURRENT STATUSGENERAL SURGEONS: Age Group
7
30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80-840
10
20
30
40
50
60
Number of General Surgeons with APC as at 30 Mar 2015by age group
CURRENT STATUSGENERAL SURGEONS: Exit Rate
8
30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-790.0%
5.0%
10.0%
15.0%
20.0%
25.0%
30.0%
27.3%
22.1%
3.0%2.4% 2.3%
1.1%
5.4%
10.2%
15.7%
18.2%
Average Exit Rate by age group for General Surgeons in New Zealand2010-2014
GASTROENTEROLOGY AND GENERAL SURGICAL REGISTRAR TRAINING
GASTROENTEROLOGY
• Currently training 4-5 Gastroenterology registrars per annum
• Expected to increase to 6 Gastroenterology registrars per annum by 2016
• Attrition rate 23.5% for specialists 30-34 years, 9.7 % at 35-39 years
GENERAL SURGERY
• Currently training 20 General Surgery registrars per annum
• No projected increase in registrar numbers
• Attrition rate 27.3% for specialists 35-39 years, 22.1% at 35-39 years
9
CURRENT STATUSPATHOLOGISTS: Numbers
10
2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 20260
50
100
150
200
250
300
350
228 234248
256266
274
280.808509366326286.877186089723291.862123238315295.94367507218298.835128210688300.891932082899302.886983197697304.50753778596305.770790202196306.773352119496307.5818851634
Pathologists with APC as at 30 March 2015
Pathologists with APC Projected number of Pathologists with APC
CURRENT STATUSPATHOLOGIST: Age Group
11
30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-790
10
20
30
40
50
60
5
21
44
38 39
5148
21
3 4
Number of Pathologists with APC as at 30 Mar 2015by age group
CURRENT FUNDING SUPPORT FOR TRAINING
• Health Workforce allocates $120 million for medical vocational training (Total Budget $178 million)
• DHBs provide salary component
• HWNZ Funding per annum for training only:• Gastroenterology $42,518 per registrar• General Surgery $57,994 per registrar
12
HEALTH WORKFORCE NEW ZEALAND’S ROLE• To continue to work closely with stakeholders (training
organisations (including colleges) employers, unions, associations, etc.) to provide coordinated:o workforce development interventions, and forward
planningo proactive resolution of workforce challenges and
issues
• Fund postgraduate professional health training and lead development of ‘extension of scope’ professional opportunities
• Assess strategic workforce needs, suitability for future purpose, and lead future planning
• Enhance, support and mandate regional initiatives
• Advise Minister, DG, DHBs and the wider sector on workforce
13
ACTION REQUIRED FOR NATIONAL BOWEL
SCREENING PROGRAMMEA commitment on part of all stakeholders to:
• Increase number of Gastroenterology and General Surgical Registrars
• Reduce new specialist attrition rates, particularly in 30-34 year age group
• Increase capacity in Pathologist, and Allied Health Science and Technical workforces
• Provide support for training by other health practitioners e.g., nurse endoscopists (potential to contribute 10-15% of colonoscopy demand)
14
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