How To Develop A National Workforce Development Plan

Transcription

1 environmental scan 2014 agenda for CHANGE Community Services & Health Industry Skills Council

2 AGENDA FOR CHANGE The Community Services and Health Industry Skills Council has prepared this Environmental Scan to highlight industry intelligence about existing and emerging trends in the community services and health industry, especially with regard to workforce development. As the Industry Skills Council for this industry, our role is to lead, advise and assist on workforce development and develop the national work-based qualifications that are integral to ensure quality care and support for all Australians. This Environmental Scan has been produced with the assistance of funding provided by the Commonwealth Government through the Department of Industry.

3 Introduction Community Services and Health Industry Skills Council provides the direction for workforce development for Australia s Community Services and Health industry. We drive this development by:»» providing advice and intelligence»» developing skills»» supporting growth»» working in collaboration. Advice We ensure that industry information and other research we gather is shared with governments and government agencies, employers, unions, trainers, workers and potential workers so that decisions affecting our industries support the development and growth of our workforce and reflect client needs. Skills We have developed 160 qualifications, 1,198 competencies and 80 skill sets that form the national Vocational Education and Training (VET) standards for community services and health. These standards support a broad range of job roles carried out by 800,000 plus workers in Australia, and form the Community Services Training Package and the Health Training Package. Our training packages are used to ensure consistency and quality in training, and support workforce develop. Workforce Growth And Development We influence workforce development using a fourlevel strategy:»» national/industry: developing information and workforce predictions on policy and reform implications»» state/sector/region: developing models to operate in specific locations that connect agencies working in the same sector to strengthen the service outcomes»» enterprise: showcasing and supporting best-practice models for service delivery through workforce planning and training including growing foundation skills»» individual: helping existing and potential workers access career advice and pathway information. Collaboration We maintain a two-way relationship with government advisory bodies, unions, peak bodies, associations, state and territory advisory boards and training providers to bridge the information gap on issues and activities impacting our workforce. CS&HISC is one of 11 nationally recognised industry skills councils funded by the Australian Government. It is a not-for-profit company limited by guarantee and governed by an independent and industry-led Board of Directors. Environmental scan

4 AGENDA FOR CHANGE CONTENTS 2 02 Environmental scan 2014 LIST OF TABLES Table 1: Ten fastest growing health and community service specific occupations (by change in 000s, ) 09 Table 2: Language spoken at home by ANZSIC industry subdivision 20 Table 3: Potential new and emerging roles identified by the Community Services and Health industry 37 LIST OF FIGURES Figure 1: Projected employment growth by industry, Nov 2012-Nov Figure 2: Projected growth ( 000s) in selected health and community service specific occupational groups, Nov 2012-Nov Figure 3: Community Services and Health Training Package enrolments ( 000s), Figure 4: Health enrolments ( 000s) in Higher Education and VET sectors, Figure 5: Course enrolments in Victoria, Community Services and Health Training Packages, by level of qualification 27 Figure 6a: Community Services Training Package enrolments by students age, Figure 6b: Health Training Package enrolments by students age, Figure 7: Community Services and Health Training Package enrolments (2012) and resident population by area of remoteness (ARIA+) 29

5 KEY INSIGHTS 04 Agenda for Change Latest Intelligence 06 Overview 08 Strong and Growing Demand 09 Implications for Industry 12 The Policy Environment 12 Changes to VET Funding 13 Recruiting, Retaining and Distributing Staff 14 Data to Drive Accountability and Transparency 15 Key Points Identified Workforce Development Needs 16 Overview 18 Key Skills for a Changing Industry 18 Skilling Across Aligned Sectors 20 Workforce Strategies: Growth and Retention 20 Focus on CALD Workers 20 Attracting Younger Workers 21 Retention of More Mature Workers 21 Workforce Development to Improve Access Current Impact of Training Packages 22 Overview 24 Training Package Uptake 24 Impact of VET Reforms 26 Student Profile 26 Qualifications and Vocational Outcomes 30 Industry Views on Current Training 30 Broader Impact of Training Packages Future Directions of Training Packages 32 Overview 34 New and Emerging Roles 35 Improved Pathways 36 Streamed Qualifications 37 Speed to Market 38 End Notes 39 References 40 Appendices 42 Abbreviations 102 Environmental scan

6 AGENDA FOR CHANGE KEY INSIGHTS The Community Services and Health industry continues to be Australia s largest and fastest growing employer. In the context of this growth there are a number of challenges that industry and governments will have to work together to address. Environmental scan 2014 Industry stakeholders have told us that care and support services are facing the following challenges: a. Strong and changing service demand: Population ageing is increasing service demand and the adoption of consumerdirected funding models will transform the way services are delivered. b. Uncertainty in the policy environment: The scope and scale of changes in service demand are rapidly shifting. The workforce implications of key service reforms such as the National Disability Insurance Scheme (NDIS) have yet to be fully understood or realised. Also, developments in the Vocational Education and Training (VET) sector have implications for our capacity to train the future workforce required to meet increased service demand. c. Need for better data: Difficulties accessing relevant and high-quality training and workforce data makes workforce planning for the Community Services and Health industry challenging, particularly with changing service demand and a shifting policy landscape. d. Gaps in supply: With increased demand for workers current workforce shortages will increase without effective and coordinated strategies to supply sufficient and appropriately skilled workers. e. Difficulty recruiting and retaining staff: In addition to gaps in supply, the low wages and poorer employment conditions for some roles are known to create real barriers to recruitment and retention. Other reported barriers to recruitment and retention include: low awareness of opportunities; an ageing workforce; an unwillingness to work in certain geographical areas; and for some roles, negative perceptions about the work. f. Threats to training capacity: The future capacity to train the required number of appropriately skilled workers may be inhibited by: difficulties obtaining appropriate work placements for VET students; conflicting training priorities between the state and national levels; and a growing disconnect between the VET and higher education (HE) systems. The Community Services and Health industry must deal with these ongoing challenges in the context of finite public resources. While this is challenging, the current uncertainties create opportunities to redefine the shape of our industry to better plan for a more sustainable future. 04

7 KEY INSIGHTS A new national health and community services workforce development plan will improve our focus on meeting the needs of those requiring care and support. Agenda for Change Addressing the challenges identified by industry will require a national health and community services workforce development plan. A national workforce development plan will assist the health, community services and education sectors to become more focused on meeting the needs of those requiring care and support. 2. Develop skills for changing service needs: Changes in service delivery must be supported by appropriate training and workforce development. Consumerdirected funding; clients with multiple needs; client-centred care and support; and providing services in a person s home all demand a broad skills base. industry needs a data system that supports inter-agency data sharing with industry and has clear accountabilities for collecting and reporting relevant data. New data and better use of existing data are needed to ensure that current and future workforce development activities can be better evaluated. The latest intelligence points to an agenda for change for our industry and tells us that this new workforce development plan must address the following: 1. Sustainability through improved workforce planning: Australia needs a sustainable approach to workforce development that addresses workforce supply to avoid future shortages. This will require a whole of workforce approach to workforce planning; greater inter-agency collaboration; and industry engagement in the development and implementation of policy that acknowledges the fundamental issues affecting the health and community services workforce. It is therefore more important than ever that qualifications and training deliver the full range of skills required for care and support roles, including new and emerging roles. 3. Promote strong partnerships between training providers and workplaces: Training and service providers share the responsibility for ensuring that training produces graduates with the appropriate skills for the job. Strong partnerships between training and service providers are essential and therefore any challenges to these partnerships should be addressed. 4. Ensure transparency and accountability: The systems and processes for workforce planning should be transparent, with clear lines of accountability supported by effective industry engagement. In particular, our 5. Support enhanced workforce productivity: Expansion of services in an increasingly constrained fiscal environment requires a much greater emphasis on workforce productivity. Service providers will need to be supported to innovate and evaluate new ways of working in a more productive way. 6. Support recruitment and retention: Recruitment and retention strategies are needed to address concerns about pay and conditions. Service providers also need support to identify and recruit for the personal attributes as well as the taught knowledge and skills required for work in the health and community services. 05 Environmental scan 2014

8 AGENDA FOR CHANGE 01. latest intelligence Latest intelligence confirms a continued increase in demand for health and community services. It also suggests a shifting policy landscape is contributing to uncertainty around the workforce required to meet future demand.

9 80 Australia s Our 2.6 projected GROWTH IN POPULATION million AGED 65 informal carers AND OVER have their own training needs industry continues to be Australia s fastest growing employer

10 01. latest intelligence With further increases in employment growth projected, the need for workforce sustainability will require continued attention to innovation and improvements in productivity. Overview Industry intelligence and the latest workforce data show that increased service demand has been accompanied by an increase in the size of the workforce. In the context of this growth, health and community service providers continue to report difficulties recruiting and retaining sufficient numbers of appropriately skilled staff. Workforce projections suggest that our workforce will continue to grow. However, there is a lack of clarity around the scope and scale of changes in service demand and of the consequent implications for education, training and workforce development. This is, in part, because the workforce implications of key service reforms such as the National Disability Insurance Scheme (NDIS) have yet to be fully understood or realised. Adding to this uncertainty are changes in VET funding at the state/ territory level. These changes are contributing to concerns about Australia s future capacity to train the number and quality of workers required. The industry is still under pressure to deliver services to an ageing and expanding population in a tight fiscal climate. Reconciling these competing pressures can only be achieved through an increase in productivity. Service providers will need to be supported to innovate and evaluate new ways of working in a more productive way. Environmental scan 2014 Workforce planning for the care and support industry lacks strategic engagement and coordination across governments and industry. It has traditionally focused on the degree qualified professions, despite growth in the numbers of VET qualified workers. To avoid future shortages, Australia needs a health and community services workforce plan that considers the development of the whole workforce, is supported by high quality data and involves effective inter-agency collaboration and industry engagement. Greater stability with a clear vision for overall policy settings will be necessary to achieve a sustainable workforce development strategy so that Australia s community services and health workforce can deliver on its potential. 08

11 01. latest intelligence Strong and Growing Demand Increases in demand for care and support services are being driven both by demographic factors and service reform. Increasing demand for support services as a result of population ageing has been identified as a significant force currently reshaping the Australian Community Services and Health industry (AIHW 2013). Both internationally and in Australia, health and community services have been moving consistently towards homebased and individualised models of support across the industry, particularly in disability, aged care and mental health. The move to individualised, consumer-directed funding models will continue to impact on the nature of care and support services being delivered and associated numbers of workers required. For example, full national rollout of the NDIS is expected to require the disability workforce to double in size (Treasury 2013, p17). At the same time, the age structure of the paid care and support workforce means many workers are expected to retire in the next decade (NDS Victoria 2013). Table 1: Ten fastest growing health and community service specific occupations (by change in 000, ) Occupation (ANZSCO 6 digit level) Growth (000s) Percentage growth Aged or Disabled Carer 77, , % Child Care Worker 59,472 80, % Other Registered Nurses 45,115 61, % (not further defined) Teachers Aide 34,314 48, % Occupational Health 6,842 15, % and Safety Adviser Registered Nurse (Critical 9,915 16, % Care and Emergency) Community Worker 17,875 24, % Personal Care Assistant 21,957 28, % Welfare Worker 11,267 17, % Registered Nurse (Perioperative) 10,010 15, % Environmental scan 2014 Source: ABS Census of Population and Housing, 2006 and 2011 customised data request for CS&HISC using the most detailed ANZSCO occupational classification (six-digit level). Please refer to end note i. 09

12 01. latest intelligence 10 Environmental scan 2014 The population aged 65 and over is projected to increase from 3.2 million in 2012 to between 5.7 million and 5.8 million in 2031 (ABS 2012). This will place pressure on aged care services as well as a wide range of acute and sub-acute health services (Department of Health, Victoria: submission to EScan 2014). This demographic shift means that increasing service demand in the care and support industry is expected to endure despite the state of the economy, and is likely to have a greater impact than economic or cyclical factors. The increased demand for services has been accompanied by increases in the numbers of workers. Table 1 presents 2006 and 2011 Census data that confirm the strong growth in a number of occupations, most notably Aged or Disabled Carers (aged care workers and disability support workers), an expansion that has been supported by strong growth in demand for both aged care and disability services. Similarly, in response to increased demand for child care services there has been a substantial increase in the number of child care workers. Despite these increases however, current workforce shortages have been reported in a number of areas including aged care and child care (DEEWR 2013a). Alongside the paid carer workforce, there are also substantial numbers of unpaid or informal carers. The National Carer Strategy recognised that the 2.6 million unpaid or informal carers in Australia have their own training needs (Department of Families, Housing, Community Services and Indigenous Affairs 2011). However, changing family structures may mean a declining proportion of Australians requiring care will be able to rely on informal carers in the future (Productivity Commission 2011a, p56). Any decline in the number of informal carers will need to be addressed by additional paid workers or incentives (financial or training) to support informal carers. Government projections show that Health Care and Social Assistance will continue to be the fastest growing industry in actual terms between November 2012 and November 2017 (Figure 1). Figure 2 shows the 10 occupational groups, specific to health and community services, that are predicted to have the highest actual growth between November 2012 and November 2017 (Department of Employment, 2013). These latest projections place greater emphasis on the future role of VET-trained occupations than previously projected; for example, the number of Aged and Disabled Carers is expected to increase by around 31,300 (or 27.7%). This is greater than the increase projected previously (see occupational projections to November 2016, DEEWR, 2012) and is the largest projected increase of all health and community service specific occupations. There is now only a modest increase (an additional 10,200 or 4.2%) of Registered Nurses projected from 2012 to 2017.

13 01. latest intelligence Figure 1: Projected employment growth by industry, Nov 2012 Nov 2017 Health Care and Social Assistance Retail Trade Construction Accommodation and Food Services Education and Training Professional, Scientific and Technical Services Public Administration and Safety Transport, Postal and Warehousing Other Services Administrative and Support Services Arts and Recreation Services Financial and Insurance Services Wholesale Trade Manufacturing Mining Rental, Hiring and Real Estate Services Information Media and Telecommunications Electricity, Gas, Water and Waste Services Agriculture, Forestry and Fishing Projected change in employment ( 000) Source: Industry Projections to November 2017, Department of Employment (2013) Figure 2: Projected growth ( 000) in selected health and community service specific occupational groups, Nov 2012 Nov 2017 Projected change ('000s), Nov Nov Aged and Disabled Carers 15.5 Child Carers Generalist Medical Practitioners Welfare Support Workers Medical Technicians Source: Occupational Projections to November 2017, Department of Employment (2013) Registered Nurses Social Workers Dental Assistants Psychologists Counsellors 11 Environmental scan 2014

14 01. latest intelligence 12 Environmental scan 2014 Implications for Industry Increases in government expenditure are being driven by population ageing, and are expected to continue partly as a consequence of new technologies and the demand for higher quality services (Productivity Commission, 2013). Australia will need a larger workforce to support the NDIS and to accommodate a $6.9 billion growth in demand for mental health services (Productivity Commission, 2011b). With further increases in employment growth projected, the need for workforce sustainability will require continued attention to innovation and improvements in productivity. There is a compelling need for more sustainable and productive approaches to delivering services, especially in areas such as aged care, disability and mental health. Innovation in service delivery must be supported by workforce development that focuses on equipping staff with the skills, knowledge and experience required for the jobs to be performed in the future. These innovations are likely to lead to changes to individual roles; and working conditions will need to support the recruitment and retention of sufficient workers with the required skills. Currently there is a great deal of emphasis within the care and support industry on measuring resource inputs but relatively little on the actual outcomes. However, it is difficult to draw conclusions about productivity when performance metrics are not clearly articulated. Measuring productivity in the Community Services and Health industry appears to have been put in the too hard basket. The Community Services and Health Industry Skills Council (CS&HISC) believes it is time to make a start on generating productivity metrics. Growth in the demand for appropriately skilled workers requires an increase in the numbers of future workers being trained. This will increase the pressure on service providers to deliver work placements for VET and university students. Issues relating to the sustainable provision of work placements are increasingly being considered (Perlin 2011; Scott and Oliver 2013; Stewart and Owens 2013) and require further attention in the VET sector. Organisations will require a high level of leadership and management skill to ensure that industry successfully makes the transition to new policy and funding parameters. Service providers also have the challenge of implementing new ways of working while ensuring that working conditions attract more and diverse workers. In light of recent changes to the nature of the Aged Care Workforce Compact (Crowe 2013), concerns about workforce shortages being exacerbated by low wages are particularly pertinent. The Policy Environment There is a high degree of uncertainty in the current policy environment that health and community services workforce operates within. The full implications of key current health and community service policies are not yet known, resulting in uncertainty about about the workforce required.

15 01. latest intelligence Under a full National Disability Insurance Scheme, the disability workforce figures are expected to double, however what that workforce [will] look like is difficult to gauge (Community Services Directorate, ACT: submission to EScan 2014). In addition, the new federal government is yet to announce its program of reform for community services, health and tertiary education and the National Commission of Audit recommendations may lead to changes that will also take time to be fully realised. Some of this uncertainty relates to concerns about possible reductions in funding. However, the latest available data on government and private expenditure (up to the fiscal year for community services and for health) show that expenditure continues to increase, both in real terms and as a proportion of the national revenue base (see Appendices C1 and C2). The increase in government expenditure has occurred across all reported community services and health sectors, with the exception of spending on private hospitals (Productivity Commission 2014). A slowing of federal government expenditure is expected for the period ahead. The most significant policy developments include the implementation of aged care reforms and the roll-out of the NDIS (please refer to end note ii). These reforms focus on increased consumer choice and control and require the industry to build workforce capacity and skills. For example, it is anticipated that full roll-out of the NDIS will require the formal disability workforce to double in size (Treasury 2013, p17). There are concerns that this service expansion and reform will exacerbate existing workforce shortages and that the higher wages paid in the disability sector will divert staff away from aged care. In addition, feedback from the NDIS demonstration sites indicates that the average cost of the NDIS per person is 15 per cent higher than what was originally budgeted (Wilson 2014). This level of overspend is unsustainable if replicated in the national roll out. Changes in regulation are also impacting on the care and support workforce. It is anticipated that the national regulation of Aboriginal and Torres Strait Islander health practitioners will improve the recognition and effectiveness of this role across Australia. In child care, reforms under the National Quality Framework (NQF) are already impacting the child care and early childhood development workforce. For example, new quality standards mean that from 2014 every long day care, family day care, preschool, and outside school hours service is expected to maintain a specific ratio of Certificate III, Diploma and Degree qualified staff based on the number of children and their ages. This requirement is driving the need to train and recruit new workers as well as up-skill existing workers. The overwhelming industry-held view is that the changing policy environment will alter the scope and shape of the care and support workforce, with some pointing to an increased role for VET-qualified workers. Growing a sustainable workforce will require a greater mix of skills for new and emerging roles and an increased utilisation of VETqualified workers (Department of Health, Victoria: submission to EScan 2014). Health and community service providers are looking to policy makers for guidance on how to respond to the implementation of consumer-directed models of funding. Changes to VET Funding Industry also expressed concern that the VET system may not be able to supply the number of appropriately skilled workers required to respond to changes in service demand and delivery. Reforms in VET funding are being implemented across a number of jurisdictions and aim to focus the provision of VET subsidies on areas of greatest public benefit and industry need. However, where these reforms result in an increase in fees, there is concern that even with fee support any increase in fees adds to the risk that certain groups will perceive training to be unaffordable; a perception that could lead to a reduction of enrolments. The longer term implications of this could be significant, with a decrease in overall student numbers that may impact national efforts to supply the future required workforce. This is a particular concern for qualifications leading to occupations for which there is strong demand and for Diploma and Advanced Diploma qualifications, which support the development of much needed leadership and management capability. 13 Environmental scan 2014

16 01. latest intelligence 14 Environmental scan 2014 Assessing the impact of the current changes in funding is complicated as each state and territory has its own list of priorities with different methodologies for determining which qualifications are to be considered a priority. While some differences between jurisdictions are to be expected, there needs to be national oversight of state training priorities and incentives to support the development of Australia s future health and community services workforce. The impact of previous changes to VET funding on enrolments is discussed in section three of this report. Recruiting, Retaining and Distributing Staff Difficulties recruiting and retaining staff continue to be reported across our industry. Some difficulties are national and relate to demographic changes, increased service demand and changes in national policy and regulation. For example:»» in child care, current and persistent shortages of appropriately qualified child centre managers and child care workers have been reported (deewr 2013a)»» in aged care, the most recent census and survey of the aged care sector showed difficulties recruiting and retaining staff (Aged Care Workforce final report, king et al 2012). More recent evidence indicates that while vacancies are relatively easy to fill it is harder to recruit for roles providing in home care, and providers across the sector continue to report difficulties retaining staff (DEEWR 2013b). The Aged Care Workforce final report also highlighted the need to define the social and emotional skills associated with direct care work, in order to support the recruitment of workers with the attributes required for direct care work (King et al 2012). There are indications that poor distribution of the workforce continues to create shortages in certain regions. Stakeholders reported difficulties recruiting suitably qualified workers in aged care, child care and other areas including clinical coding, allied health assistance and child protection. Reported difficulties also related to the need for workers with the skills required to respond to changes to service delivery. For example, the need for:»» support workers in aged care and disability with the skills to respond to co-morbidity»» qualified and experienced managers and leaders»» experienced mental health workers to manage and co-ordinate peer workers. Stakeholders also felt that some recruitment difficulties related to barriers in the system, such as misdistribution or inefficient training pathways, which restrict supply of workers into particular roles or to rural and remote areas. Examples highlighted by stakeholder submissions include:»» difficulty in regional areas recruiting Certificate iii and Diploma qualified child care workers to meet the national quality standards»» incentives are encouraging private sector medical practices to recruit Aboriginal and Torres Strait Islander health workers, driving increasing demand for a limited supply.

17 01. latest intelligence In the view of many stakeholders, low pay remains an important barrier to improving workforce retention. As a result of a decision by the Fair Work Commission in 2012, around 150,000 workers in social, disability and community services are due to receive pay increases of between 23 and 45 per cent. However, to address the barrier of low pay fully, other initiatives may be required. Appendix C4 provides details of the workforce shortages, skill gaps and system constraints identified by stakeholders. Data to Drive Accountability and Transparency Difficulties accessing relevant and high quality training and workforce data, in a time of change and uncertainty, makes health and community services workforce planning challenging (Goodger 2013). There are a number of agencies collecting data without transparent protocols for how that data is being shared and being made available to industry in a digestible format. While national registers of health professionals exist and new registers are being developed, data collection on the care and support workforce needs to more inclusive of the broad range of care and support occupations, including those roles that are VET qualified. The current Australian and New Zealand Standard Classification of Occupations (ANZSCO) system limits industry s ability to classify and count the numbers of workers in certain roles, (please refer to end note iii). Where data is not available it is difficult to plan effectively, and ultimately reduces the likelihood of a coherent workforce development strategy for the Community Services and Health industry. Stakeholders have highlighted the need for better data to assist in the development of the required workforce. There is no agreed assessment for future demand, and no place to create this agreement. The sector needs to undertake better and more detailed demand estimation, service modelling and transition planning in order to meet future needs (EScan 2014 interview, peak body, Mental Health sector). Effective and sustainable workforce planning demands a data system where accountabilities for collecting and reporting relevant data are clear and inter-agency data sharing is supported. New data and better use of existing data is needed to ensure that current and future workforce development activities can be better evaluated, both regionally and nationally. Key Points»» There is strong and growing demand for health and community services. Occupations such as child care workers and support workers in aged care, disability support and home and community care have experienced strong growth and numbers are projected to continue to increase over the next five years.»» There is considerable uncertainty in the policy environment. What is certain is that the industry will be subject to greater funding pressure. Workforce innovations will be essential to meeting future demands for services.»» Planning for the future and responding to changes in the policy settings for health, community services and VET is made more difficult by the lack of reliable, comparable and transparent training and workforce data. 15 Environmental scan 2014

18 AGENDA FOR CHANGE 02. IDENTIFIED WORKFORCE DEVELOPMENT NEEDS Strategies to attract new workers, develop skills and retain existing workers will need to respond to increased demand for services, a shifting policy context and the changing needs of clients and workers.

19 Australians % IN workers of direct-care speak English workers in Aged as a second Care were born language overseas in remote areas have poorer access to health practitioners

20 02. IDENTIFIED WORKFORCE DEVELOPMENT NEEDS Strong leadership and management skills will be necessary to manage the organisational, cultural and financial implications of consumer-directed services. 18 Environmental scan 2014 Overview Changes in service demand and delivery must be supported by appropriate training and workforce development. As was the case in EScan 2013 there is a need to develop skills for consumer-directed care, enhance leadership and management capability and to support skilling across sectors. Current policy is advocating a move to individualised (consumer-directed) funding models for care and support services. Strong leadership and management skills will be necessary to manage the organisational, cultural and financial implications of consumer-directed services. Also the move to more consumer-directed, home and community delivered services is likely to lead to an increased demand for workers with a broader base of skills and the further blurring of boundaries between traditional sectors, (please refer to end note iv). To meet increased service demand the industry will need to continue to develop and implement strategies that attract new workers and retain existing workers. To meet the demand for health and community services in rural and remote areas innovative use of new and existing roles will be required. Key Skills for a Changing Industry New service delivery models being introduced throughout health and community services require a change in skill-mix and mindset. In disability, transition to a new market model of individualised funding, and the expected increase in homebased services will require changes in the skills sets and the approaches of both workers and organisations (NDS Victoria 2013, p4). The entire disability support workforce will need to effectively promote client choice and control (Cortis et al 2013). More broadly, it is expected that consumer-directed funding models will require workers to have increased personal accountability and decisionmaking responsibilities, and the ability to collaborate with workers in other services. In addition, workers will need to provide care and support within client-centred approach to service delivery and an understanding of the practice implications of a human rights based framework.

21 02. IDENTIFIED WORKFORCE DEVELOPMENT NEEDS Staff need to become more flexible and, more broadly, better trained. They need to define their roles as client-centric rather than servicecentric. They need to be encouraged and supported to move out of their silos into ways of working which transcend traditional paradigms in favour of addressing client disadvantage in a holistic manner (Department of Human Services, Victoria: submission to EScan 2014). As the move towards consumer-directed models of care gathers pace, industry will need strong support to develop comprehensive workforce development plans that achieve Australian Government policy objectives. While industry remains largely supportive of the move to consumer-directed models, some stakeholders raised concerns about the resources service providers will need to investigate and strategically consider the workforce and business planning implications of these changes. As market pressures increase, many small providers will need to be supported to develop workforce plans, and larger providers should be supported to evaluate the effectiveness of their plans. High levels of leadership and entrepreneurial skills are required to shift organisations and workers to new service delivery models. Stakeholder feedback singled out the improvement of the management and leadership skills of middle level managers as being particularly crucial. Improving management and leadership competencies is [a priority], particularly in relation to developing middle managers [ability to]: lead practice supervision and support; effectively manage risk; encourage service cultures that support person-centred practice; and drive the implementation of new workforce practice and innovation (NSW Health: submission to EScan 2014). Under the Aged Care Workforce Innovation Project funded by the Department of Industry, CS&HISC is engaged in two initiatives that encourage an industry led approach to improving leadership and business management capacity in the aged care sector. More information about the Aged Care Workforce Innovation Network (WIN) and Aged Care Leadership development project is available on our website: 19 Environmental scan 2014

22 02. IDENTIFIED WORKFORCE DEVELOPMENT NEEDS As the client-base becomes increasingly diverse, industry stakeholders also noted the need for culturally sensitive services. This involves employers providing working environments that are culturally safe for workers and clients, as well as workforce development that equips workers with the required skills and cultural competencies. Skilling Across Aligned Sectors With the introduction of individualised funding models, it is expected that service complexity will increase. Consumers may, for example, need to access disability, aged care and housing services simultaneously. This means that the industry will need to develop and maintain a workforce that is able to operate across a range of service contexts. An increase in at-home care will involve the management of chronic and complex conditions in the home and in the community. This will require more generalist roles with the ability to determine when and how to enlist specialist assistance. These workers will require a broad base of skills, drawing knowledge from different disciplines and across sectors in order to better support clients. Workers of the future will need to be able to apply their knowledge over a broad range of areas and have the skills required to improve the functioning of multi-disciplinary teams. This is likely to be a particular requirement in rural and remote areas. Organisations will need to operate in ways which use specialist and generalist workers effectively and recognise the complimentary roles of both within a team. With ever-increasing demands for health care it is essential to make the best use of every health practitioner available. This means that all health professionals should be working within their competencies to their full scope of practice (National Rural Health Alliance: submission to EScan 2014). Workers skills and qualifications should be matched to the job they are required to do. As such, new revised qualifications will need to reflect the broader range of knowledge and skills required of roles redesigned in response to changes in service and funding models. In addition, there is a need for new qualifications that better support flexible career and training pathways. The development of streamed qualifications that recognise the common skills for care and support work would assist horizontal mobility across sectoral boundaries, contribute to more flexible organisations and provide greater employability for workers. This will require articulation of the core skills for care and support roles and will facilitate a more sustainable and flexible workforce. Workforce Strategies: Growth and Retention Industry stakeholders highlighted a number of current strategies to support the supply of the future health and community services workforce. These most commonly involved active recruitment of migrant and younger workers, and retention of more mature workers. Focus on CALD Workers Industry intelligence indicates an increasing number of workers in the care and support industry are from Cultural and Linguistically Diverse (CALD) backgrounds. ABS data from the 2011 Census indicate that around one in five workers in the Health Care and Social Assistance industry speak Table 2: Language spoken at home by ANZSIC industry subdivision 20 Environmental scan 2014 Total workers N ( 000) English N ( 000) Language spoken at home Language other than English N ( 000) Language other than English % Social Assistance Services Residential Care Services Hospitals Medical and other Healthcare services Total Health Care and Social Assistance Source: ABS 2011 Census of Population and Housing Note: Australian and New Zealand Industrial Classification (ANZSIC) is used by the ABS to classify an individual s industry of employment.

23 02. IDENTIFIED WORKFORCE DEVELOPMENT NEEDS a language other than English at home, with the largest proportion of non-english speakers working in the residential care services sector (Table 2). Data reported in the 2012 Aged Care Workforce Census suggests an even higher proportion of Personal Care Assistants and Community Care Workers working in aged care speak a language other than English. It identified that in 2012 the proportion of the direct care workforce born overseas was 28% in community outlets and had increased from 25% in 2003 to 35% in residential care facilities (King et al 2012). This diversity was seen as largely positive for the industry. However, cultural and linguistic diversity has significant implications for training and workforce development. Overseas workers need to be provided with additional support to develop the cultural competency, English language literacy and related communication skills they need to do an effective job. CS&HISC is engaged in a range of activities aimed at supporting the development of Foundation Skills across the workforce. Beyond training and support provided in Australia, broader strategies that embrace the internationalisation of skills agenda have yet to be fully explored by the care and support industry. However, offshore VET delivery in the fields of health and human welfare studies and services experienced rapid growth over the period (NCVER 2013a). Attracting Younger Workers The community services and health workforce in particular, is ageing. Stakeholders raised the following strategies to increase attraction of younger workers to the industry:»» encouraging organisations to undertake succession planning so that younger workers can identify a clear career path»» marketing to overcome the non-glamorous image of the sector»» stronger articulation arrangements between vet and universities. Retention of More Mature Workers Strategies to retain mature workers involve a better understanding of the requirements of older workers, particularly around job design, working hours and ongoing training. Stakeholders reported that the introduction of new minimum qualification requirements, in family day care for example, have added to the challenge of retaining mature workers as some are reluctant to embark on a new qualification. Workforce Development to Improve Access The challenges faced by health professionals and health services in remote communities continue to be significant. For example, Australians living in remote areas have significantly less access (between 45% and 67%) to medical practitioners, putting pressure on all health workers (HWA 2013a). A major concern is the limited choice and control consumers in these areas experience due to the difficulty recruiting and retaining staff. Addressing these concerns requires practitioners in remote areas to have a more flexible and collaborative approach to service delivery. Practitioners and health systems will need to be more flexible, less siloed and to recognise the roles and contributions of the client/patient themselves and the people in the patient s life (National Rural Health Alliance: submission to EScan 2014). Difficulties accessing care are exacerbated by the fact that health outcomes for people living outside metropolitan areas continue to be worse than for their city counterparts, particularly for Aboriginal and Torres Strait Islander people. Reducing the gap in life expectancy between Indigenous and non-indigenous Australians continues to be a challenge for the care and support industry. Improving Indigenous representation in the health and community services workforce and improving the cultural awareness of all workers are key to addressing this on-going challenge and responding to the National Indigenous Reform Agreement, Closing the Gap (COAG 2012). The proportion of Indigenous students enrolled on different Training Packages is described in section three and in Appendix D2. The Growing our Future report (HWA 2011) identified strategies to strengthen and develop the Aboriginal and Torres Strait Islander Health Worker workforce to better respond to the needs of the Aboriginal and Torres Strait Islander population. Since the report:»» Aboriginal and Torres Strait Islander Health Practitioner role is a recognised health profession and is subject to registration»» CS&HISC has completed the review and update of the Aboriginal and Torres Strait Islander Health Workers qualifications in the HLT Health Training Package»» HWA has initiated a number of projects to support some of the 27 recommendations identified in the Growing our Future report. 21 Environmental scan 2014

24 AGENDA FOR CHANGE 03. CURRENT IMPACT OF TRAINING PACKAGES Environmental scan 2014 Recent data shows that publicly funded enrolments in the Community Services and Health Training Packages have increased and that service providers are generally satisfied with the quality and relevance of formal vocational training.

25 In 2012 our enrolments increased by increase in number of Indigenous students since 2008 Two thirds of our students are aged 25 and over 23 Environmental scan 2014

26 03. current impact of training packages Stakeholders voiced concerns about the potential disruptive effect of current VET funding reforms and their potential impact on future training capacity and enrolments. 24 Environmental scan 2014 Overview Publicly funded enrolments in the Community Services (CHC) and Health (HLT) Training Packages increased in 2012 relative to Older students form a growing component of community services and health enrolments. Indigenous students are also a prominent group of community services and health enrolments, including a substantial number enrolled in higher level VET courses. It should be noted that VET enrolment figures are available only up to 2012, figures on course completions are subject to an even longer lag, and all figures only relate to publicly funded enrolments. Stakeholders voiced concerns about the potential disruptive effect of current VET funding reforms and their potential impact on future training capacity and enrolments. Recent survey data indicate that health and community service employers are generally satisfied with the quality and relevance of formal vocational training. However, concerns remain about the variability in quality of training and the supply of VET work placements. Training Package Uptake As predicted in EScan 2013, publicly funded enrolments in the Community Services Training Package continue to grow, with 230,477 enrolments in 2012, an increase of 29,444 enrolments (14.5%) since Part of this growth is being driven by increased demand for care and support workers in Aged Care and Children s Services. The 67,654 publicly funded enrolments in the Health Training Package in 2012 represent a marginal increase (844 or 1.3%) in enrolments since However, this follows the slight decline in enrolments between 2010 and Therefore this continues the pattern of no notable growth in Health enrolments since EScan 2013 highlighted a steady increase in the number of university enrolments in Health courses from 2007 in contrast with enrolments in the Health Training Package, which have plateaued since Last year it was suggested that this might point to students who may have previously undertaken a qualification in the VET sector choosing to enrol in a university course instead.

27 03. current impact of training packages While it is clear that the increase in university Health courses has continued into 2012 (Figure 4), it is likely that a number of factors are contributing to this trend. For example, recent changes in the regulatory requirements for health professionals and the introduction of uncapped places in higher education in Further research is required to fully explore any trends in the uptake of training and to consider whether the training being undertaken is the right match for the productive future workforce required. Figure 3: Community Services and Health Training Package enrolments ( 000), Enrolments ('000) CHC Community Services Source: NCVER VOCSTATS Students and Courses, accessed December HLT Health Environmental scan 2014