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The purpose of the forum was to road-test our understanding of the key challenges for the community services and health workforce, industry priorities for workforce development and the industry’s perspective on how these challenges and workforce development priorities should be addressed. The broad themes of the forum were:
» the key challenges for the community services and health workforce
» industry priorities for workforce development
» the industry’s perspective on how these challenges and workforce development priorities should be addressed.
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Organisation role submissionsWritten Interview Forum Survey Total
Health and/ or Community Service
Provider (Employer) 1 5 1 152 159
Professional Association / Union 2 2 2 10 16
Registered Training Organisation (RTO) 0 1 1 219 221
Government Department 18 1 0 60 79 Peak Body 8 5 6 29 47 Regulatory Body 1 1 1 0 3 Other 1 1 2 37 41 No response/ unknown 0 0 0 3 3 Total 31 16 13 510 569
B2: Stakeholder engagement participants by geographical coverage of their organisation
Geographical area submissionsWritten Interview Forum Survey Total
National 7 12 12 140 171
Australian Capital Territory 2 0 0 29 31
New South Wales 4 3 2 114 123
Northern Territory 1 0 0 23 24 Queensland 2 0 1 83 86 South Australia 5 1 0 56 62 Tasmania 0 0 0 27 27 Victoria 5 0 1 90 96 Western Australia 5 0 0 60 64 No response/ unknown 0 0 0 5 5
B3: Stakeholder engagement participants by sectoral coverage of their organisation
Sector submissionsWritten Interview Forum Survey Total
Aboriginal and Torres Strait Islander
Health 1 1 1 8 11
Aged care 3 1 1 83 87
Child, youth and family services 2 1 2 77 82
Disability 1 2 2 62 67
Mental health 0 2 1 19 22
Other (Single Sector) 2 6 1 54 63
Multiple Sectors 20 1 5 183 209
No response/ Not applicable 2 2 0 24 28
Total 31 16 13 510 569
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C1: Change in real government expenditure, selected community service areas, 2008-09 to 2012-13
Service area
% increase in expenditure from previous year1
Expenditure 2012-13 $m 2008-09 2009-10 2010-11 2011-12 2012-13
Aged care services2 5.1 6.4 6.0 3.7 4.3
Disability services3 6.8 6.7 3.4 7.4 3.7
Child protection and out of home care4 12.7 9.5 5.4 6.0 0.3
Children's services5,6,7 33.8 1.7 9.4 10.2 10.5
Homelessness services8 – – 17.4 -28.3 2.5
Source: Productivity Commission, 2014 (Report on Government Services) Notes:
1. Time series financial data are adjusted to 2012-13 dollars using the General Government Final Consumption Expenditure (GGFCE) chain price deflator (2012-13 = 100). The GGFCE replaces the Gross Domestic Product implicit price deflator used in previous editions.
2. Total expenditure on aged care services (2012-13 dollars), from Table 13A.6
3. Total expenditure on services (including actual payroll tax for NSW (for 2004-05–2007-08), Victoria (in part, for 2004-05–2007-08), SA (2006-07(in part)–2008-09), Tasmania and the NT) (2012-13 dollars), from Table 14A.5
4. State and Territory Government real recurrent expenditure on child protection and out-of-home care services (including intensive family support services), (2012-13 dollars), from Table 15A.1
5. Total government real expenditure on children’s services (2012-13 dollars), from Table 3A.3 6. The large increase in 2008-09 mainly reflects changes to the childcare rebate
7. Also includes one-off, non-capital payments to peak agencies who support child care and preschool service providers. 8. Total net real recurrent State and Territory Government expenditure on social housing (2012-13 dollars), from Table 17A.2
C2: Change in real government and non-government recurrent health expenditure, 2007-08 to 2011-2012
Type of expenditure Service area
% increase in expenditure from previous year1
Expenditure 2011-12 $m 2007-08 2008-09 2009-10 2010-11 2011-12 Government recurrent health expenditure1 Public hospitals2 6.8 4.6 4.6 5.5 5.3 38,483 Private hospitals 8.3 2.4 9.5 4.8 -1.5 3,958 Medical services 8.4 4.4 4.9 4.5 4.0 18,617 Dental services 16.7 30.1 14.3 11.7 7.0 2,305 Other health practitioners3 26.1 9.2 10.5 3.5 2.9 1,555 Medications 8.6 9.8 7.6 3.2 2.8 8,980 Other health3 11.4 9.2 1.8 -2.8 10.5 17,928 Non-government recurrent health expenditure4 Public hospitals 8.1 17.1 2.3 14.1 6.0 3,552 Private hospitals 2.9 23.3 3.0 6.2 7.3 7,517 Medical services 7.9 5.0 4.0 5.0 5.4 5,283 Dental services -0.4 3.6 9.0 -2.1 5.4 6,031 Other health practitioners3 -4.6 -7.7 4.2 7.6 3.8 2,916 Medications 8.1 12.5 6.1 24.5 1.5 9,860 Other health3 4.1 4.5 4.2 5.2 3.4 5,401
Source: Productivity Commission, 2014 (Report on Government Services) Notes:
1. Government recurrent health expenditure, by area of expenditure (2011-12 dollars), from Table EA.2
2. Public hospital services (2003-04 to 2011-12) excludes any dental services, community health services, patient transport services, public health and health research undertaken by the hospital. Can include services provided off the hospital site such as hospital in the home, dialysis or other services.
3. Other health comprises patient transport services, community health, public health, aids and appliances, other non-institutional health (nec.), administration and research.
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Type of expenditure Occupation Occupational datafrom Census Occupational projections from Dep. Employment
Aug 2006 ‘000 Aug 2011 ‘000 % change 2006- 2011 Nov 2012 ‘000 Nov 2017 ‘000 % change 2012- 2017
1341 Child Care Centre Managers 8.2 10.6 29.3 11.6 13.2 13.3
1342 Health and Welfare Services Managers 13.4 15.9 18.6 18.9 19.7 4.2 2242 Archivists, Curators and Records Managers 5.9 8.6 47.3 6.9 8.3 19.8 2411 Early Childhood (Pre-primary School) Teachers 15.3 18.3 20.0 23.7 26.5 11.7
2511 Dietitians 4.1 4.8 16.1 4.9 6.0 21.8
2512 Medical Imaging Professionals 12.2 17.4 43.0 14.5 17.4 20.0
2513 Occupational & Environmental Health Professionals 15.4 18.8 22.4 27.3 28.7 5.5
2514 Optometrists and Orthoptists 3.6 4.3 20.1 4.6 4.8 4.3
2515 Pharmacists 14.8 16.1 8.8 24.1 25.2 4.7
2519 Other Health Diagnostic & Promotion Professionals 5.2 6.3 22.5 7.2 8.0 11.8
2521 Chiropractors and Osteopaths 2.7 3.8 38.1 3.0 3.4 13.1
2522 Complementary Health Therapists 6.8 10.1 48.5 8.1 9.4 17.2
2523 Dental Practitioners 10.1 13.2 30.5 12.3 14.8 20.0
2524 Occupational Therapists 9.1 11.0 21.2 12.8 13.9 8.3
2525 Physiotherapists 12.3 15.9 29.7 14.9 18.0 20.4
2526 Podiatrists 3.3 4.3 32.1 3.9 3.8 -2.3
2527 Speech Professionals and Audiologists 4.5 5.6 25.4 7.1 7.8 9.7
2531 Generalist Medical Practitioners 40.3 50.2 24.6 53.2 63.8 20.0
2532 Anaesthetists 3.6 3.8 5.6 3.6 3.9 8.8
2533 Internal Medicine Specialists 5.0 6.8 37.3 7.5 7.9 6.1
2534 Psychiatrists 2.6 3.7 43.1 2.9 2.7 -5.7
2535 Surgeons 5.3 5.9 12.1 8.0 8.2 2.2
2539 Other Medical Practitioners 8.1 9.5 17.5 11.9 13.0 9.4
2541 Midwives 12.4 16.9 36.0 17.2 18.3 6.5
2542 Nurse Educators and Researchers 3.9 4.9 26.2 4.9 5.7 16.6
2543 Nurse Managers 10.8 18.9 74.6 13.2 14.9 12.4 2544 Registered Nurses 172.6 206.9 19.9 241.3 251.5 4.2 2721 Counsellors 13.9 19.6 41.0 17.1 20.5 20.0 2722 Ministers of Religion 12.8 15.0 16.7 17.7 18.5 4.5 2723 Psychologists 14.5 17.9 23.5 20.0 23.9 20.0 2725 Social Workers 18.6 22.1 18.8 25.8 31.0 20.0
2726 Welfare, Recreation and Community Arts Workers 14.7 16.4 11.6 21.9 24.8 13.1
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3999 Workers 10.9 12.6 15.9 16.6 16.6 -0.24112 Dental Hygienists, Technicians and Therapists 6.6 7.9 18.8 7.2 8.3 15.6
4113 Diversional Therapists 3.8 5.3 40.5 5.3 5.4 3.1
4115 Indigenous Health Workers 2.2 2.6 18.6 1.2 1.4 19.6
4116 Massage Therapists 11.4 15.0 32.0 14.1 17.0 20.0
4117 Welfare Support Workers 35.5 43.4 22.5 48.9 54.8 11.9
4211 Child Carers 77.4 108.2 39.8 119.5 135.0 13.0
4221 Education Aides 58.2 70.5 21.2 85.5 86.6 1.3
4231 Aged and Disabled Carers 85.3 107.9 26.6 113.0 144.3 27.7
4232 Dental Assistants 15.3 19.9 30.0 21.4 25.7 20.0
4233 Nursing Support and Personal Care Workers 41.8 53.4 27.8 78.2 81.4 4.1
4234 Special Care Workers 2.4 2.8 18.5 2.0 2.6 29.5
4515 Personal Care Consultants 4.1 4.3 4.4 5.1 5.7 12.1
4518 Other Personal Service Workers 6.8 9.2 35.3 11.3 12.6 11.9
5122 Practice Managers 12.2 14.1 15.3 14.9 17.1 14.8
5999 Other Clerical & Administrative Workers 13.4 18.6 38.5 18.0 19.5 8.4
6214 Pharmacy Sales Assistants 27.5 31.2 13.6 30.9 32.8 6.4
7119 Other Machine Operators 9.1 11.9 31.2 11.7 13.8 17.9
Sources:ABS Census of Population and Housing, 2006 and 2011; Department of Employment, Occupational projections: http://lmip.gov.au/default.aspx?LMIP/EmploymentProjections
Notes: Occupations selected include those that are specific to the Community Services and Health industry and/or which are identified in training.gov.au as aligned to a qualification in the Community Services or Health training packages (see Table E1). Due to
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The tables below describe role shortages, skill deficits, and system barriers to workforce development; as identified by stakeholders during the consultation process. Where appropriate comments are referenced to specific written submissions and (de-identified) interviews, which are listed after these tables.
Role shortages
Sector Occupation(s) Role shortage/new demand Reason
All sectors All roles Indigenous workers across the Community Services and Health industry1, 2, 3, 4, 5, 6
Participation of indigenous people in in the health and community services workforce is low, particularly when compared with the number of representations of indigenous people to health and community services. A more representative workforce would support the development of culturally safe and appropriate services. Community
Services Support workers providing care and support in the community and in homes
New advanced direct care
role5, 7, i that is skilled across
nursing and allied health to provide care and support in residential care, rehabilitation and community settings.8
Increased demand, complex care needs and move towards increasing consumer-directed funding models workers are changing what is required of direct care and support staff working in the home and community. This may lead to the development of roles requiring higher level/ advanced capabilities as well as a broader base of knowledge and skills. Community
services Financial counsellors Specialist financial counsellors to work with at risk clients through the courts.9
Role is currently being covered by general financial counsellors, however can be difficult to release them from their main role to do this work. Community
Services Client support workers in Victoria Specific new roles are being created including practice consultant (senior), team leader (middle manager) and key worker (managed support/ guided support).10
Implementation of Services Connect in Victoria is leading to the creation of new roles. Services connect provides a model to integrate and improve the way that human services work together and shift the focus of service delivery to be built around people and their needs. Community
Services Social work assistants Roles supporting social workers are emerging in South Australia4 and Queensland8 and para- professional social work roles are being explored in the ACT.11
Need for better defined para-professional roles. New multidisciplinary teams will support productivity improvements in social services. Disability All workers including
financial workers On-going increases in demand for disability workers12 new financial intermediaries in the disability sector10 and growth in contract purchasing and management positions.13
NDIS will require new role of financial intermediary to provide advice to clients and bundle purchases.
Children’s and
Youth Services Child care centre managers and workers4, 5, 7 Aboriginal and Torres Strait Islander early childhood professionals14
Insufficient supply of workers that have required skills and experience across childcare.
Increased demand for childcare services and new minimum education requirements/ staff ratios set by National Quality Standards for Early Childhood Education and Care.
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Role shortagesSector Occupation(s) Role shortage/new demand Reason
Children’s and
Youth Services Child care centre managers and workers4, 5, 7 Aboriginal and Torres Strait Islander early childhood professionals14
Insufficient supply of workers that have required skills and experience across childcare.
Increased demand for childcare services and new minimum education requirements/ staff ratios set by National Quality Standards for Early Childhood Education and Care.
Children’s and
Youth Services Child protection caseworkers Continuing demand for child protection caseworkers11 especially in rural and remote areas, out of home care workers.15
High demand, government direction and policy reform. Lack of higher education graduates willing to enter the care and protection workforce. Children’s and
Youth Services Youth workers Growing need for workers with expertise in juvenile justice, youth work as well as policing and night patrol2
Identified need in Northern Territory.
Children’s and
Youth Services Child safety officers Aboriginal child safety officers and practice leader roles13 Growing demand and need for cultural awareness. Children’s and
Youth Services Mental health workers in children’s & youth services
Aboriginal child and adolescent mental health workers16
Growing demand and need for cultural awareness. Children’s and
Youth Services Residential care workers Need for variegated and specialist residential care workers4
To attend to the various needs of clients. Health and Community Services Personal care assistants, allied health assistants, disability support workers5, 17
Lack of supply of suitably skilled and experienced workers in direct care and support roles across health and community services.
Increased demand for workers and workers with the skills to respond to range of client needs.
Education and
training Trainers and assessors Trainers and assessors to supervise work placements in health.1
Increased demand and competition for skilled educators to supervise clinical and work placements across undergraduate, postgraduate and VET.
Health Enrolled nurses and
Registered nurses Enrolled nurses across sectors and registered nurses in aged care1 registered nurses5
Increased demand driven by an ageing population.
Health Allied Health Assistant (AHA), Clinical Support Officer (CSO) and Assistant in Nursing (AIN)
In NSW ‘health assisting roles’ are becoming increasingly necessary in supporting and promoting care in the community1
Increase in older population and related trend towards more chronic and disease and co-morbidities.
Health Allied health
assistants A new assistant or technician role to support the medical physicist role in cancer and diagnostic services, to undertake among other tasks quality assurance of equipment.8
Identified need. More productive use of skilled health workforce.
Health Allied health
assistants An assistant audiology role is emerging8
Identified need. More productive use of skilled health workforce.
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Role shortagesSector Occupation(s) Role shortage/new demand Reason
Health Allied health
assistants Shortage of allied health assistants in prosthetics and orthotics, audiology, psychology, music therapy and within paediatric services6
Increased demand for services and emerging need for these roles. The introduction of the NDIS is likely to increase demand for prosthetics, orthotics and other allied health services. Health Allied health
professionals and allied health assistants (AHA’s)
Shortage of allied health professionals in rural and remote areas 8, 18, ii
Increased demand for the breadth of allied health professional skills. Difficulty attracting and retaining qualified staff in remote areas, with added pressure of ageing workforce. Health Health technicians Current shortage workers in
prosthetics, orthotics, sonography rehabilitation engineering and medical physics.5, 8
Increased demand.
Health Health technicians New audiology assistant role being recruited for in Queensland.8
Identified need.
Health Clinical coders Clinical coders at entry-level, mid-level and supervisory level), clinical coding auditor/educators, health Information Managers (HIMs), and clinical costing officers1, 6
Hospital Activity Based Funding (ABF) implemented in July 2012, as part of the national health reform, has resulted in an increased demand for high quality data and for improved health information management. Shift away from previous reliance on HE qualified health information managers. Health Dental professionals Rural and remote shortages
of dental professionals5 and oral health workers17
Poor distribution of workers.
Health Nurses, Aboriginal and Torres Strait Islander health practitioners and other roles
Specialist renal health workers19 Identified (national) need.
Mental health Mental health
support workers Relatively low enrolments in Certificate IV in Mental Health.16
Projected increase in demand for mental health services may not be met by current levels of supply.
Population health Aboriginal and Torres Strait Islander health workers
Shortage of Aboriginal and Torres Strait Islander health workers8, 11, 19
Indigenous health workers are in short supply, while indigenous representations to health services are high. Private medical practices are employing Aboriginal and Torres Strait Islander health workers in their practices through the payment of incentives – this is driving increased demand for a limited supply.
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Skill deficitsSector Occupation(s) Skill Gap Reason
All sectors All roles Skills to support consumer directed funding models and client centred care and support. Staff and managers will need a broader range of skills, including: communication (active listening, written) conflict management, negotiating, budgeting, planning and marketing20, iii
Introduction of NDIS and move towards consumer-directed funding models.
All sectors All roles Skills to support interdisciplinary practice5, 12 including generic knowledge and skills that can apply across sectors.21
A shift towards interdisciplinary practice will improve access to services that meet multiple client needs and goals (particularly in regional, rural and remote areas).i In health there has been an increasing trend towards specialisation, yet patients are increasingly presenting with multiple and complex co- morbidities, increasing the need for generalist workers with a broad range of skills. All sectors All direct care and
support roles Health literacyii understanding of health promotion and disease prevention17
Interdisciplinary practice in care and support requires all workers to have some understanding of health, health promotion and disease prevention.
All sectors Management and
leadership roles Training in management of volunteer7 Increasing number of volunteers, need to manage risks within organisations
All sectors All roles Skills to support the effective use
of new technologies and IT1, 7, 16 The increasing pace of technological development. In health recent developments include: online health support using Skype, online prevention tools and at-home care assisted technology. The implementation of the National Broadband Network will create growth in the use of technology in the health industry. The personally controlled Electronic Health Record
(currently on trial) will require an increase in computer knowledge and skills for existing workers and those entering the sector. All sectors (within
and beyond health and community services)
All roles Disability awareness training for workers outside of the disability sector.20
Under NDIS services across a range of sectors e.g. recreation and leisure will need to be disability aware and accessible to people living with a disability. Community
services All roles Cultural awareness training across all community services8, 16, 22, v and specifically in disability, mental health and youth work.5, 7, 12, 23
People from CALD backgrounds are increasingly represented in the workforce of the health industry as well as among the consumers. Community
services Management and leadership roles Management skills including finance, governance, risk management, grant writing and HR management.21
More competitive tendering and the need for organisations to consider social enterprise for core income mean managers need additional business skills.
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Skill deficitsSector Occupation(s) Skill Gap Reason
Community
Services Management and leadership roles Competencies in organisational management and practice for community services. These include: change management, sustainable workforce development, effective negotiation, implementing practice standards, and reflective practice.4, 6, 21
There is a need for managers that have the required capabilities to lead services through the changes and growth affecting the industry.
Community
Services Direct care and support roles in the home and community
Occupational health and safety in a home and community care context.10, vi
Workers undertaking in-home services will need to be skilled on OH&S.
Community
Services Direct care and support roles in the home and community
Management of complex and chronic conditions for community care workers.1, 4, 18
Increased focus on community based programs/intervention focused on preventative health care to better manage those with chronic illness living at home. Community
Services Financial counsellors Developments in rapidly changing policy and service areas, for example: new technologies and immigration policy.9
Financial counsellors are increasingly working with CALD communities – this work brings with it related knowledge requirements, for example of Visas and immigration. Developments in technology impacts on knowledge required to support people, for example in problem gambling. Community
Services Service coordinators Specific knowledge of chronic diseases12 Care Coordination Funding Scheme, requires specific training in chronic diseases. Disability Disability support
workers Disability support working with clients with psycho-social disabilities need higher level mental health understanding and capabilities.vii
NDIS also covers consumers with high-levels of psycho-social disability. Certificates III and IV in disability are not sufficiently mindful of psycho-social rehabilitation skills. Education and
training Trainers and educators in health and community services
Trainers and assessors competent in training and assessing cultural competency, English language, literacy and numeracy. This can be provided through Certificate IV in Training and Assessment and Certificate IV in Language, Literacy and Numeracy Assessment and Training.21
Increased demand to deliver life skills and language, literacy and numeracy programs for disadvantaged people require staff and volunteer tutors with the appropriate skills.
Health Management and
leadership roles Need for enhanced management and leadership skills, particularly: risk management, encouraging service cultures that support client-centred and family- inclusive practice, implementing new and innovative workforce models and approaches to practice.1, 6
There is a need for managers that have the required capabilities to lead services through the changes and growth affecting the industry.
Health Allied health professionals and assistants
Staff need appropriate skill mix to support patients with head and neck cancer and lymphoedema, throughout the care pathway.8
Effective management of these issues requires specific skills and knowledge.
Health Allied health
professionals Development of skill sets to support the administration of medicines by allied health professionals.8
Identified need for broader range of professionals to administer medicines.
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Skill deficitsSector Occupation(s) Skill Gap Reason
Health Allied health assistants/ health technician – audiology
Need to include audiometry competencies as electives in Certificate IV in Allied Health Assistance – to support new and emerging audiology assistant role.8
To support new and emerging audiology assistant role.
Health Health technicians –
medical imaging Medical imaging technicians need additional competencies, supported by the training package, including positioning patients and radiation safety.8
Identified need.
Health All roles Awareness concerning the
knowledge base of Aboriginal and Torres Strait Islander health practitioner. All health workers need to improve their understanding of the role of the Aboriginal and Torres Strait Islander health practitioner and what he/she is trained to do.19
Improved understanding and recognition of the role of the Aboriginal and Torres Strait Islander health practitioner will support effective multidisciplinary health care teams. This is particularly timely given the recent creation of a national register of practitioners. Health All roles Health issues in indigenous
communities.1
Establishment of indigenous specific health units in NSW. Health Enrolled nurses Required competencies for
enrolled nurses should be reviewed in line with industry guidelines.6
New competency requirements from ANMAC.
Mental health All roles Trauma informed care and