Service Planning for New Workforce Models Shelley Horne Director Clinical Service Reform, SA Health April 2011.

Service Planning for New Workforce Models

Shelley Horne Director Clinical Service Reform, SA HealthApril 2011

SA’s Health Care Plan

Reforms aimed at:

> Rebalancing the system components

> Matching services to local population needs

> Designing models of care informed by evidence

> Achieving these outcomes within the constraints posed by future workforce availability

Statewide Service Plans

> Some fundamentals> An iterative process> Layers of detail> First layer of recommendations

• Confirm system wide model of care• To inform development of Master Plans• Detail in relation to early priorities

Content

> System level vision of Model of Care including:• expected changes in trends in clinical practice

• Critical relationships

• Any changes required to improve quality and safety

• Information technology that may assist

> System level identification of workforce issues requiring focus & description of future plans

> Teaching and research issues

Regional Service Construct

Integrated service delivery models including:> Prevention, screening, early intervention, primary

health care services, community based specialist services, inpatient based specialist services, ongoing services and support

> Agreed clinical protocols and patient pathways to ensure seamless transition.

> Facility and Communication mechanisms to support• Major hospital

• General hospitals

• GP Plus Health Care Centres

• GP Plus Health Networks

Service plans and reform focus areas

> Plans from Clinical Networks:• Cancer, maternal and neonatal, cardiology, mental

health, renal, rehabilitation, orthopaedic, child health, stroke, palliative care, older people health services

> Plans from focussed groups of clinicians• Medical imaging, Paediatric Services, Allergy/

Immunology

> Plans for specific populations• Aboriginal health Care Plan, Veteran’s Health Care

Plan

> Service Redesign • Outpatient services, acute medical units, direct

admission arrangements,

Related Planning

> Model of Care for the System – models of care developed by Statewide service plans and Clinical networks reflect this whole of system view

> Application of Model of Care to facility design> Workforce arrangements reflect the needs of the

model of care and models of care reflect known workforce availability

> Teaching and research> Clinical Network outputs> Other Statewide Service plan outputs

Model of care - overview

Reflects:> Future patient profile> Future patient needs> Arrangements that best suit optimum pathways> Groupings of patients with like needs> Contemporary clinical practice> Advances in functional design for optimal healing> Advances in technology

Enhanced roles within new service models

> Significant growth in Nurse Practitioner and enhanced nursing roles across:• ED, Palliative Care, Geriatric, Cancer,

Midwifery, Mental Health, Chronic disease management

Exploring potential for other roles in community settings:• minor injury illness, allergy,

> Exploring enhanced AHP, medical assistant roles.

An example

> The Cancer Clinical Practice Nursing Director (CNAHS) will:

> Provide advanced clinical nursing care to oncology patients/clients.

> Provide corporate professional advanced clinical nursing advice, mentoring and leadership to cancer nurse practitioners and nurse practitioner candidates.

> Provide strategic and operational leadership in the development of the cancer nursing clinical services across the CNAHS consistent with the principals and priorities of the SA Health Care Plan, Statewide Cancer Clinical Network and Statewide Cancer Control Plan.

Food for thought

> Workforce planning incorporating new/ enhanced roles.• How can planners understand the impact of

new/ enhanced roles on existing roles?• How will the staffing profile required for service

delivery be determined?• Balancing subspecialisation with generic

requirements

A possible process

> Start with patient/population needs. > Establish model of care > Match needs with skills & expertise.> Match skills/expertise with available

optimised disciplinary roles.> Renegotiate roles.> Refine workforce projections.

A palliative care example

Psychosocial Biomedical

A palliative care examplePsychosocial Biomedical

Medical Work

Nursing Work

Social Work

Spiritual Care Work

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Palliative Medicine

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Palliative Medicine

Nurse Consultant

A palliative example Psychosocial Biomedical

Palliative Medicine

Nurse Consultant

Social Worker

A palliative care examplePsychosocial Biomedical

Palliative Medicine

Nurse Consultant

Social Worker

Bereavement Councillor

A palliative care examplePsychosocial Biomedical

Palliative Medicine

Nurse Consultant

Social Worker

Pastoral Carer

Bereavement Councillor

A palliative care example

Palliative Medicine

Nurse Consultant

Social Worker

Pastoral Carer

Bereavement Councillor

A palliative care example

Palliative Medicine

Nurse Consultant

Social Worker

Pastoral Carer

Welfare Officer

Bereavement Councillor

A palliative care example

Palliative Medicine

Nurse Consultant

Social Worker

Pastoral Carer

Welfare Officer

Bereavement Councillor

A palliative care example

Palliative Medicine

Nurse Consultant

Social Worker

Pastoral Carer

Clin Psychol

Welfare Officer

Bereavement Councillor

A palliative care example

Palliative Medicine

Nurse Consultant

Social Worker

Pastoral Carer

Clin Psychol

Welfare Officer

Bereavement Councillor

A palliative care example

Palliative Medicine

Nurse Consultant

Social Worker

Pastoral Carer

Clin Psychol

Welfare Officer

Psych

Bereavement Councillor

A palliative care example

Palliative Medicine

Nurse Consultant

Social Worker

Pastoral Carer

Clin Psychol

Welfare Officer

Psych

Bereavement Councillor

A palliative care example

Palliative Medicine

Nurse Consultant

Social Worker

Pastoral Carer

Clin Psychol

Welfare Officer

Psych

Bereavement Councillor

A palliative care example

Palliative Medicine

Nurse Consultant

Social Worker

Pastoral Carer

Clin Psychol

Welfare Officer

Psych

Pharm

Bereavement Councillor

A palliative care example

Palliative Medicine

Nurse Consultant

Social Worker

Pastoral Carer

Clin Psychol

Welfare Officer

GPSI

Psych

Pharm

Bereavement Councillor

A palliative care example

Palliative Medicine

Nurse Consultant

Social Worker

Pastoral Carer

Clin Psychol

Welfare Officer

GPSI

Psych

NP

Pharm

Bereavement Councillor

A palliative care example

Palliative Medicine

Nurse Consultant

Social Worker

Pastoral Carer

Clin Psychol

Welfare Officer

Community Network Faciliator

GPSI

Psych

NP

Pharm

Bereavement Councillor

A palliative care example

Palliative Medicine

Nurse Consultant

Social Worker

Pastoral Carer

Clin Psychol

Welfare Officer

Community Network Faciliator

AIN/PCW

GPSI

Psych

NP

Pharm

Bereavement Councillor

A palliative care example

Palliative Medicine

Nurse Consultant

Social Worker

Pastoral Carer

Clin Psychol

Welfare Officer

AIN/PCW

The Therapists

GPSI

Psych

NP

Pharm

Bereavement Councillor

A palliative care example

Palliative Medicine

Nurse Consultant

Social Worker

Pastoral Carer

Clin Psychol

Welfare Officer

Community Network Faciliator

AIN/PCW

The Therapists

GPSI

Psych

NP

Pharm

Bereavement Councillor