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

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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

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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

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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)

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