August 2014 Commonwealth of Australia 2014



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Appendix D – Existing workforce position


Understanding the existing workforce position, that is, if the workforce is currently in balance (with workforce supply matching demand for services) or not, is important, as understanding this position greatly affects the interpretation of the workforce projection results. Projections are based on observed historical trends, and interpretation of the projection results requires consideration to the factors that may impact future workforce supply or demand. Ideally, quantitative evidence should be used to determine whether a workforce is in balance or not at a particular point in time. In the absence of suitable data, an assessment by key stakeholders of their view of the existing workforce position of the oral health workforces was used. This was developed during the consultation process for this project, where HWA spoke with the profession and jurisdictions.

Existing workforce position assessment scale


Stakeholders used the following scale to assess the existing workforce position of each oral health profession. In most cases, these assessments were made at the macro (whole workforce) level, not at a sector or regional level. Factors such as budget will have a major impact on whether a specialty assessed as green (no current perceived shortage) at the macro level actually translates into ready access to that specialty in the public sector.

Colour code

Description

White

Current perceived excess supply – that is, current aggregate workforce exceeds existing expressed service demand, including across geographic areas

Green

No current perceived shortage / workforce in balance – that is, sufficient workforce for existing expressed service demand, no distributional issues, minimal number of vacancies, no difficulty filling positions, and short waiting times.

Orange

Some level of expressed demand exceeding available workforce – either through maldistribution or insufficient workforce numbers, some vacancies exist, with difficulty in filling positions

Red

Perceived current shortage – that is, expressed service demand in excess of existing workforce, ongoing vacancies exist (across geographic areas), difficult/unable to fill positions, and extended waiting times

Other measures available to examine existing workforce position


Other partial measures that can be used to provide an indication of the existing workforce position of a particular workforce are waiting times and vacancy rates.

Waiting times


Waiting times for services are a commonly reported healthcare performance indicator, however this is a measure of access to oral health services, not specifically a measure of workforce imbalance. For this reason, waiting times could only be used as a partial measure to demonstrate existing workforce position. Factors aside from workforce availability that influence waiting times include:

  • There is no agreed definition on what is a reasonable waiting time

  • The length of time someone has to wait for treatment influences the likelihood they join a waiting list

  • The demand for emergency treatment.

Overarching all of the above factors is the influence of budget. Budget constraints influence supply by limiting the availability of staff and impacting on the scheduling and allocation of treatment facilities, which impacts waiting times.

In addition, waiting times often relate to services provided in the public sector only, and does not account for demand or waiting times for services provided by private sector practitioners. Information on waiting time for appointments can be partial indicator for private practitioners, with a longer waiting time for an appointment possibly indicating a workforce imbalance, however similar cautions apply in directly equating a waiting time for appointments to a workforce shortage.

For oral health services, waiting time data is reported by some jurisdictions. However this is not nationally consistent. The AIHW has developed a public dental waiting time national minimum dataset, with formal reporting due to begin in July 2014 for the 2013-14 year, which will provide nationally consistent information on public dental waiting times. Even so, this covers the public sector only, which represents only a small proportion of oral health service provision. Therefore waiting times are not currently a good indicator for measuring the overall oral health workforce position.

Vacancy rates


Vacancy rates and duration of vacancies are often used to assess potential workforce imbalances. Vacancies can imply there is an insufficient sized workforce as there are not enough people to fill positions available However, there are a range of cautions to note with using vacancy rates as a measure of workforce shortage:

  • Vacancies occur as a part of normal operations due to turnover and lags in filling positions

  • There is no single level of vacancy rate considered to reflect a workforce shortage

  • Vacancies can occur for reasons other than shortage. For example, the vacancy could be in an unattractive location, an employer may choose not to fill a vacancy for reasons such as budget constraints, or applicants for a position may not have sufficient experience or skills the employer is looking for.

  • Vacancy rates may also understate workforce shortage, for example positions may not be advertised if they are not expected to be filled.

The sector in which this measure is being applied to also determines its usefulness. In the public health sector, positions are salaried so vacancy rates can be an appropriate indicator. However, in the private sector, services are often delivered by private practitioners, so there may be minimal identified vacancies.

For oral health, private practitioners in Australia provide most dental services, so vacancy rates are also not currently a good indicator for measuring the overall oral health workforce position.


Glossary


Clinician – A person who spends the majority of their time working in the area of clinical practice, that is, the diagnosis, care and treatment (including recommended preventative action) of patients or clients. Clinical practice may involve direct client contact or may be practiced indirectly through individual case material (for example, a dental technician).

Comparison scenario – A scenario where current trends are assumed to continue into the future. This is compared with a range of alternative scenarios.

Employed – a practitioner who reported working in their profession in the week before the survey. In this report, data on employed practitioners include those who:

  • Worked for a total of one hour or more in the week before the survey in a job or business (including own business) for pay, commission, payment in kind or profit.

  • Usually worked, but were on leave for less than three months, on strike or locked out, or rostered off.

Full-time equivalent (FTE) – The model calculates FTE on a per role basis based on the initial headcount in these workforces, multiplied by their reported hours worked. This is then divided by a standardized assumption about what constitutes a single FTE across the workforces modelled (38 hours per week) to generate the FTE quantity.

International dental graduate (IDG) – Dentists whose basic dental qualifications were acquired in a country other than Australia

International students – Private or sponsored students in an Australian university who are not Australian citizens or permanent residents.

Registered workforce – Those dental professions which are regulated under the National Registration and Accreditation Scheme – dentists, dental specialists, oral health therapists, dental hygienists, and dental therapists.

References


1 National Advisory Committee on Oral Health 2004. Healthy Mouths Healthy Lives: Australia’s National Oral Health Plan 2004-2013. South Australian Department of Health: Adelaide.

2 Dental Board of Australia 2013. Draft Scope of Practice Registration Standard and Guidelines [PDF, 175 KB]. Viewed 24 December 2013.

3 Dental Board of Australia 2013. Approved Programs of Study. Viewed 18 December 2013.

4 Australian Dental Council 2013. Overseas Trained Dental Practitioners. Viewed 19 December 2013.

5 Dental Board of Australia 2013. Specialist Registration. Viewed 19 December 2013

6 Dental Board of Australia 2013. Approved Programs of Study. Viewed 18 December 2013.

7 Dental Board of Australia 2013. Overseas Qualified Practitioners: Specialist Dentists. Viewed 19 December 2013

8 Dental Board of Australia 2013. Specialist Registration. Viewed 19 December 2013

9 Dental Board of Australia 2013. Approved Programs of Study. Viewed 18 December 2013.

10 Dental Board of Australia 2013. Overseas Qualified Practitioners: Specialist Dentists. Viewed 19 December 2013

11 Dental Board of Australia 2013. Specialist Registration. Viewed 19 December 2013

12 Royal Australasian College of Dental Surgeons. Special Stream of Oral and Maxillofacial Surgery – FRACDS (OMS). Viewed 19 December 2013.

13 Royal Australasian College of Dental Surgeons 2013. Handbook for Accredited Education and Training in Oral and Maxillofacial Surgery [PDF, 2.2 MB]. Viewed 20 December 2013.

14 Dental Board of Australia 2013. Specialist Registration. Viewed 19 December 2013

15 Dental Board of Australia 2013. Overseas Qualified Practitioners: Specialist Dentists. Viewed 19 December 2013

16 Dental Board of Australia 2013. Specialist Registration. Viewed 19 December 2013

17 Dental Board of Australia 2013. Approved Programs of Study. Viewed 18 December 2013.

18 Dental Board of Australia 2013. Overseas Qualified Practitioners: Specialist Dentists. Viewed 19 December 2013

19 Dental Board of Australia 2013. Specialist Registration. Viewed 19 December 2013

20 Dental Board of Australia 2013. Approved Programs of Study. Viewed 18 December 2013.

21 Royal College of Pathologists of Australasia 2013. Oral and Maxillofacial Pathology Trainee Handbook [PDF, 1.2 MB]. Viewed 20 December 2013.

22 Dental Board of Australia 2013. Overseas Qualified Practitioners: Specialist Dentists. Viewed 19 December 2013

23 Dental Board of Australia 2013. Specialist Registration. Viewed 19 December 2013

24 Dental Board of Australia 2013. Overseas Qualified Practitioners: Specialist Dentists. Viewed 19 December 2013

25 Dental Board of Australia 2013. Specialist Registration. Viewed 19 December 2013

26 Dental Board of Australia 2013. Approved Programs of Study. Viewed 18 December 2013.

27 Dental Board of Australia 2013. Overseas Qualified Practitioners: Specialist Dentists. Viewed 19 December 2013

28 Dental Board of Australia 2013. Specialist Registration. Viewed 19 December 2013

29 Dental Board of Australia 2013. Approved Programs of Study. Viewed 18 December 2013.

30 Dental Board of Australia 2013. Overseas Qualified Practitioners: Specialist Dentists. Viewed 19 December 2013

31 Dental Board of Australia 2013. Specialist Registration. Viewed 19 December 2013

32 Dental Board of Australia 2013. Approved Programs of Study. Viewed 18 December 2013.

33 Dental Board of Australia 2013. Overseas Qualified Practitioners: Specialist Dentists. Viewed 19 December 2013

34 Dental Board of Australia 2013. Specialist Registration. Viewed 19 December 2013

35 Dental Board of Australia 2013. Approved Programs of Study. Viewed 18 December 2013.

36 Dental Board of Australia 2013. Overseas Qualified Practitioners: Specialist Dentists. Viewed 19 December 2013

37 Dental Board of Australia 2013. Specialist Registration. Viewed 19 December 2013

38 Dental Board of Australia 2013. Overseas Qualified Practitioners: Specialist Dentists. Viewed 19 December 2013

39 Dental Board of Australia 2013. Specialist Registration. Viewed 19 December 2013

40 Dental Board of Australia 2013. Approved Programs of Study. Viewed 18 December 2013.

41 Dental Board of Australia 2013. Overseas Qualified Practitioners: Specialist Dentists. Viewed 19 December 2013

42 Dental Board of Australia 2013. Specialist Registration. Viewed 19 December 2013

43 Royal College of Pathologists of Australasia 2013. Trainee Handbook 2014 [PDF, 1.1 MB]. Viewed 19 December 2013.

44 Dental Board of Australia 2013. Overseas Qualified Practitioners: Specialist Dentists. Viewed 19 December 2013

45 Dental Board of Australia 2013. Unpublished.

46 Dental Board of Australia 2013. Approved Programs of Study. Viewed 18 December 2013.

47 Dental Board of Australia 2013. Unpublished.

48 Dental Board of Australia 2013. Approved Programs of Study. Viewed 18 December 2013

49 Dental Board of Australia 2013. Unpublished.

50 Dental Board of Australia 2013. Approved Programs of Study. Viewed 18 December 2013

51 Australian Bureau of Statistics 2009. Australian and New Zealand Standard Classification of Occupations: Unit Group 4232 Dental Assistants. Viewed 20 December 2013

52 Job Guide 2013. Dental Assistant. Viewed 24 December 2013.

53 Training.gov.au 2012. Qualification details: Certificate IV in Dental Assisting. Viewed 24 December 2013.

54 Australian Bureau of Statistics 2009. Australian and New Zealand Standard Classification of Occupations: Unit Group 4112 Dental Hygienists, Technicians and Therapists. Viewed 20 December 2013

55 Job Guide 2013. Dental Technician. Viewed 24 December 2013.

56 Health Workforce Australia 2012. Health Workforce 2025 - Doctors, Nurses and Midwives – Volume 1. Adelaide: HWA.

57 Health Workforce Australia 2012. Health Workforce 2025 – Doctors, Nurses and Midwives – Volume 2. Adelaide: HWA.

58 Health Workforce Australia 2012. Health Workforce 2025 - Medical Specialties – Volume 3. Adelaide: HWA.
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