Engagement Workshops
‘Health and Disability
Kaiawhina, Care and Support
Workforce Plan’
A 20 Year Horizon and 5 Year
Action Plan
“Starting Points”
A Definition
The non-regulated workforce refers to
those occupational groups not
covered by the Health Practitioners
Competence Assurance Act 2003
( Health Workforce NZ (2011), Aged
Care Workforce Service Forecast.
Wellington)
NZNO Submission to the Human Rights Council
– Universal Periodic Review New Zealand, 2013
“there has been significant growth in the employment
of a non-regulated workforce with … no single
definition of the non-regulated health workforce, or
any agency responsible for collecting workforce data. …
including no discussion around how non-regulated
health care workers will contribute to the collaborative
team to improve health outcomes”
Demand for a workforce plan
Recent publications that have highlighted the
need for a non-regulated workforce development
plan include:
‘Rising to the Challenge’, the Mental Health and Addiction
Service Development Plan 2012 – 2017
Disability Workforce Action Plan 2013 – 2016
Ministry of Health Statement of Intent 2012/13 - 2014/15
MSD, The New Zealand Carer’s Strategy, 2008
HWNZ, Aged Care Workforce Service Forecast, 2011
Key findings from the Thornton Aged
Residential Care Service Review, 2010
• by 2026, residential aged care workforce
demand will increase between 50% and 75%
(FTE)
• there is little data to inform us about the
current workforce in aged care
• few opportunities exist for national
benchmarking
‘Rising to the Challenge’, the Mental Health and
Addiction Service Development Plan 2012-2017
There will be significant growth and change in mental
health and addiction services with the on-going shift to
community based services and the growth in NGO
provision of both support and clinical services.
This direction includes non-regulated workers fulfilling
a wide range of roles.
The disability workforce action 2013/16 plan
‘The disability workforce action 2013/16 plan aims
to have a workforce that adds value to the lives of
people with disabilities. To achieve this vision over
the next three years, the plan pursues to increase
the skills of the disability workforce, increase the
skills of people with disabilities, improve the
learning options of carers and family/ whanau who
support people with disabilities, improve
information about the disability workforce and
improve integration of disability workforce
development’
DHB Regional & District Plans
DHBs are increasingly cognisant of the need to
give focus to the role of the non-regulated
worker in the health and disability workforce.
The following extracts are from a sample of DHB
and Regional Service Plans for 2013-2014 which
make reference to the development of the nonregulated workforce.
Northern Regional Service Plan
‘…to build and align the capability of the
workforce to deliver new models of care
….particularly to support integrated care and a
greater level of community-based service. There
are opportunities to better utilise the nonregulated workforce….. We also need to be at
the forefront of evaluating and implementing
new roles in key areas.’
Counties Manukau DHB
‘when compared to the population we serve, there
is much we must do to address the significant
under-representation of the Māori and Pacific
workforce in clinical staff groups. At the same time,
emphasis on our non-regulated and non-clinical
workforce would greatly increase the proportion of
Māori and Pacific people on our staff while clinical
staff may take longer’
Page 75
Central Regional Service Plan
Consolidation of training resources to ensure
economies of scale and sharing good practice
3. Conduct a stocktake of education and training
available to staff in the Central region for both
regulated and non-regulated workforces
7. Develop a regional plan to build workforce
capability for mental health and addiction services
including the non-regulated workforce
Page 75-78
South Canterbury DHB
‘We have embarked on plans to develop the nonregulated workforce and have undertaken a
stocktake of qualifications/training of health care
assistants/associates and orderlies to ascertain the
individual and organisational needs for the future
and to facilitate the creation of a potential career
path for these workers’
Page 60
Developing Models of Care and Support
A shift from:
• institutions to integrated services and community
based support
• a service delivery focus to a ‘person-centred’ approach
• the involvement of family/whānau in service planning.
Changes have resulted in workers:
• increasingly expected to engage in a greater level of
complexity in their work.
• requiring a flexible set of skills and competency
Models of Care and Support include:
• recovery, resilience, strengths based
• restorative, rehabilitation/habilitation
• individualised funding, local area coordination,
enabling good lives
• whānau ora, peer support
• health promotion, strengthening communities
Advancing the role of the non-regulated workforce
as contributing and valued team members within
integrated service delivery
Career Pathways
Caring Counts (2012) found that of the approximate
48,000 aged care workers:
• 61% of the community support workers have no formal
qualifications
• 46% have no qualifications.
This report strongly recommends investment in training
that will meet the skill sets required for the non-regulated
workforce to respond to new models of care
Nelson Marlborough District Health Board,
Census of Care and Support Workers, 2008
Data gathered found that of the non-regulated workforce the
following % had no qualification:
• Mental Health – 45% no qualifications (note: this group
had the greatest number of workers qualified to Level 4 and
above)
• Disability -73% no qualifications
• Home Support - 66% no qualifications
If this DHB information is indicative of a national picture the
need for both training and career pathways is great.
2013 NZQA Mandatory review of Qualifications
Levels 2-6
• The NZQA qualification review of health, disability,
social service and whānau ora involved extensive
consultation to inform the framework development of
qualifications with educational and employment
pathways, including from unregulated to regulated
roles.
• The changing models of care require new roles and
new functions to be captured and supported in the
review.
• The new qualifications are being future proofed to
enable flexibility and reflect changing models and
Government strategies and targets
Health Workforce NZ’s Annual Plan Outcomes
The unregulated workforce contributes directly to the
following 2012/2013 HWNZ outcomes
• A flexible workforce, to respond to the shift to primary and
community models of care, and the integration between
institutional and community settings
• A financially viable and sustainable workforce, through
freeing up of expensive clinician time and developing the
unregulated workforce
• A workforce that better reflects the demography of the
population being cared for
• An expanded health workforce through the development of
new roles and expansion of existing roles
Process
HWNZ and Careerforce
Boards agree to develop
a 5 year workforce plan
and 20 year vision
Gathering background
info. Initial project
discussions with HWNZ,
MOH and national
stakeholders
Regional meetings to
inform the 20 year view
and 5 year key work
themes
Feedback and further
refinement. 5 year plan
actions confirmed and
plan underway
Vision, 20 year picture
and draft 5 year actions
presented at May
Conference
Key themes are
expanded into a draft 5
year action plan –
continuous opportunity
to feed in on line
References
• Disability Workforce Action Plan, 2013 – 2016
• Gough, J. and Associates, Census of Care and Support Workers, Nelson
Marlborough DHB (2008)
• Health Workforce NZ (2011), Aged Care Workforce Service Forecast. Wgtn
• Human Rights Commission (2012) Caring Counts, the Report of the inquiry
into the Aged Care Workforce, Wellington
• NZNO (2013), Submission to the 18th Session of the Human Rights Council
– Universal Periodic Review New Zealand
• Ministry of Health, The Mental Health and Addiction Service Development
Plan 2012-2017 ‘Rising to the Challenge’
• Ministry of Health Statement of Intent, 2012/13 - 2014/15
• MSD, The New Zealand Carer’s Strategy, 2008
• Thornton, G. (2010), Aged Residential Care Service Review, NZ
• Timmins, N. and Ham, C. (2013) The quest for integrated health and social
care- A case study in Canterbury New Zealand, The King’s Fund, UK
Further Reference Material
If you know of any other information/publications that would
add depth and richness to this work, please could you send it to:
action@careerforce.org.nz