December 2011 - Ministry of Health

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29 February 2012
Dear Colleague
Science and Technical Workforces
In August 2011, Health Workforce New Zealand (HWNZ) established a health
and education sector working group to consider how education, training and
workforce planning across the health-related science and technical workforces
might be better managed to meet growing demand for services, and to
provide a workforce that is equipped to adapt quickly to changes in technology
and models of care.
The Science and Technical Workforces Working Group (the Working Group)
was required to provide HWNZ with a report on the above matters by 31
December 2011.
The Working Group’s report is attached, along with some specific questions
generated by the Working group and its report. We would appreciate your
comments on the report and answers to the questions so that we can decide
on the next steps.
The closing date for comments is Monday 14 May 2012. Your comments
should be emailed to planning@healthworkforce.govt.nz. An analysis of the
feedback will be provided to the HWNZ Board and a decision will be made on
the next steps. Information about the next step will be sent to you. We expect
this to be in June or July 2012.
Yours sincerely
Brenda Wraight
Director
Health Workforce New Zealand
HEALTH SCIENCE AND TECHNICAL
WORKFORCES WORKING GROUP
REPORT TO THE HEALTH WORKFORCE NEW
ZEALAND BOARD
December 2011
Contents
1. Executive summary and recommendations
2. Background
2.1 Science and technical workforce
2.2 Health Workforce New Zealand’s view
2.3 The Science and Technical Workforces Working Group
3. Defining the science and technical workforces
4. Aims
5. A science and technical workforce model for New Zealand
5.1 A model for the science and technical workforce
5.2 Science and technical workforce planning
6. Recommendations
Appendix 1: Science and Technical Workforces Working Group Terms of
Reference
Appendix 2: Science and Technical Workforces Working Group members
Appendix 3: Health sector science and technical professions list
Appendix 4: Regional training hubs
Science & Technical Workforces Working Group Report (December 2011)
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1.
Executive summary and recommendations
The health-related science and technical professions comprise over 20
occupational groups of regulated and unregulated professions. Many of the
science and technical occupational groups are small, and many often work in
isolation.
New Zealand’s ability to meet future demand for science and technical
workforces is compromised by the size and the level of training required for
some professions and by the exclusion, in some cases, of the relevant
science and technical professions from the development of service delivery
plans.
Health Workforce New Zealand (HWNZ) established a small working group,
for around four months, to consider:

what we want our science and technical workforce to look like in the
future
how workforce planning might be improved across the science and
technical professions and in relation to workforce planning in other
health professions.

Collectively, the working group had a good understanding across a wide
range of health-related science and technical professions, their training and
service delivery needs.
In this report, the working group suggests the following overarching definition
of ‘science and technical’ professions in the health sector:
Professions
expertise to
treatment of
other health
care.
that primarily provide technical and scientific
support the diagnosis, monitoring, management and
health conditions independently or in conjunction with
professionals to ensure safe, effective, quality patient
This definition should not be viewed as the final definition, but rather as a
starting point.
New Zealand needs a health system and a health workforce that is:
i.
ii.
iii.
fit for purpose
able to adapt to changing technology and models of care
sustainable in the future.
Within this context, the working group believes that New Zealand needs a
health science and technical workforce where professionals work to the top of
their scope of practice, and where the training and workplace environment
supports science and technical professionals to do this.
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There are some basic principles that any model for developing and sustaining
New Zealand’s science and technical workforce in the future must
encompass.
These include balancing generalist and specialist training,
recognising the value of clinical experience and the impact of clinical training
on service delivery and trainers, recognising areas of commonality in training
programmes, and encouraging a focus on skill sets rather than professional
boundaries.
In relation to workforce planning, the working group believed that there would
be merit in a single co-ordinating entity.
Such an entity would ensure
consistency in the assumptions used for workforce forecasting across the
science and technical professions.
It would also ensure that workforce
planning for the science and technical workforce was not carried out in
isolation from other health workforce planning.
The working group suggested that the regional training hubs being
established throughout 2011 might be the best place to co-ordinate workforce
planning for the science and technical and other health workforces.
Recommendations
The working group recommends that the HWNZ Board circulate this report for
sector comment, particularly:
 Is there a need for better co-ordination of workforce planning for the
science and technical workforce?
 Provide an indication of whether the list of science and technical
professions is basically accurate.
 Where is there currently multi-disciplinary education and training
between different science and technical professions?
 Where should there be more multi-disciplinary education and training?
 Where should the balance lie between a generalist and a specialty
focus in education and training?
Depending on the results of that consultation, the working group recommends
a second working group be established to develop a more specific science
and technical workforces education and training framework that:
 begins to look at profession/service-specific details
 fosters an environment in which professionals work to the top of their
scope of practice
 develops mechanisms to ensure that service delivery models are
developed with input from all relevant workforces, including the science
and technical sector
 will provide national body endorsement of national standards of
practice (the working group acknowledges that much work will be
needed before national standards can be developed and endorsed).
This group will need to draw on profession-specific expertise.
Science & Technical Workforces Working Group Report (December 2011)
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2.
Background
2.1 Science and technical workforce
The health-related science and technical professions comprise over 20
occupational groups of regulated and unregulated professions. Estimates of
the proportion of the New Zealand health workforce involved in science and
technical professions vary, generally ranging between five and 15 percent.
Five key variables impact on the estimated figures:
i.
ii.
iii.
iv.
v.
Whether the calculation includes or excludes the private health
sector.
Whether the calculation includes or excludes administrative
employees in the health sector (e.g. District Health Board human
resource and finance, and Ministry of Health employees).
The lack of workforce data for some professions, particularly those
not regulated under the Health Practitioners Competence
Assurance Act 2003.
How ‘science and technical’ is defined.
The overlapping of roles into technical areas by other professions
(eg nursing scopes working into scientific and technical areas)
without reference to the relevant technical and scientific
professional body.
Many of the science and technical occupational groups are small.
For
example, there are fewer than 10 medical photographers working in New
Zealand. Science and technical professionals often work alone or in very
small groups and therefore have limited peer/professional support.
Because of their size and the level of training required, many of these
professions could be considered vulnerable, placing New Zealand at risk of
being unable to meet future demand for these professions.
Our ability to meet future demand in the health-related science and technical
sector is further compromised by the development of service delivery plans
often not involving the relevant science and technical workforces.
In 2007, District Health Boards New Zealand’s (DHBNZ’s) Allied and
Technical Workforce Strategy Group identified the key challenges for many of
the health-related science and technical workforces in New Zealand’s public
health sector. The key challenges were:
 workforce supply and demand
 underdeveloped career pathways
 lack of training opportunities.1
1
Future W orkforce The Technical Health Workforce Employed in DHBs DHBNZ New Zealand
July 2007
Science & Technical Workforces Working Group Report (December 2011)
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2.2 Health Workforce New Zealand’s view
District Health Boards Shared Services (formerly DHBNZ) advises that the
situation was still much the same for these professions in 2011.
While
individual DHBs may work to address local issues around their science and
technical workforces, Health Workforce New Zealand (HWNZ) holds the view
that there is little co-ordinated regional or national approach to future
workforce planning or training. HWNZ believes there is also little or no coordination of common training elements across the science and technical
professions in New Zealand.
In HWNZ’s view, supported by some individuals and groups within the health
sector, the status quo for the science and technical workforce does not
provide the best results for the New Zealand health system or the public.
Some within the sector have commented to HWNZ that, currently:
 individual practitioners and/or professions are often isolated and lack
peer support
 there is little co-ordination between training numbers and future
workforce planning
 there is potential for technology to make some professions obsolete or
to merge with or develop into another profession, and the workforce
concerned could be more easily redeployed if training were coordinated across the science and technical professions
 low critical mass of many of the science and technical professions
amplifies the impact of workforce shortages and vacancies, and the
capacity for career development and training provision in the profession
 there is little flexibility for career changes or working across two or
more professions without training for each profession separately
 some professions may be trained to a higher level than required in the
workplace while others (particularly overseas-trained practitioners) may
not be working to the top of their scope of practice for a variety of
reasons
 some professions are trained in-house with no nationally agreed
standard to ensure skills are adequate and transferable to other
DHBs/providers.
Due to the small workforces of many of the health-related science and
technical professions, a profession may quickly become vulnerable.
Key
variables that may result in a profession becoming vulnerable include the
availability of training courses or positions and new technology, particularly
‘unexpected’ technology.
For example, over the last 12-18 months three training providers have
discontinued or signalled an intention to discontinue distance learning
programmes:
 Massey University (New Zealand): medical laboratory science
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 Swinburne University (Australia): clinical perfusion
 Monash University (Australia): nuclear medicine technology.
Low workforce demand translates to low enrolment numbers for some science
and technical training programmes and programmes are not considered
commercially viable.
Where there are viable numbers to establish programmes, the larger technical
and scientific workforces have been able to get agreement to new
programmes, though often taking several years of approach.
Two new
programmes scheduled for their first intake of students in 2013 are:
 Otago Medical School Postgraduate Diploma in Echocardiography
 Otago Medical School Masters in Technology (Cardiac Devices).
2.3 The Science and Technical Workforces
Working Group
HWNZ decided to establish a working group, for around four months, to:
 consider the merits of a base qualification(s) and modular approach to
education and training for New Zealand’s science and technical
workforces
 develop a framework to demonstrate how a base qualification(s) and
modular approach might be structured
 consider how a single science and technical professional entity might
function in the New Zealand context, particularly in providing coordinated workforce planning.
A copy of the Science and Technical Workforces Working Group Terms of
Reference is attached as Appendix 1.
The working group members were selected with the intention of pulling
together a group that collectively had a good understanding across a wide
range of health-related science and technical professions, their training and
service delivery needs. A list of the Working Group members is attached as
Appendix 2.
3.
Defining the science and technical workforce
There are two levels to defining the health-related science and technical
professions:
i. Defining the ‘science and technical’ health sector as a whole.
ii. Determining which individual health professions belong within the
science and technical sector.
While the working group has attempted to address both these aspects, the
working group is very aware that the definitions in this report should not be
applied too rigidly. The overarching definition and decisions about which
professions are included will be further refined if work is done to look at the
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education and training curricula and the workplace skill sets required for
individual science and technical professions and service delivery areas.
The working group has, as a starting point, developed the following
overarching definition of ‘science and technical’ professions in the health
sector:
Professions
expertise to
treatment of
other health
care.
that primarily provide technical and scientific
support the diagnosis, monitoring, management and
health conditions independently or in conjunction with
professionals to ensure safe, effective, quality patient
A list of the science and technical professions (and their descriptions) the
working group considers are likely to fit within the science and technical health
sector is contained in Appendix 3. Again, this list should not be viewed as
complete, but rather as a starting point.
4.
Aims
New Zealand needs a health system and a health workforce that is:
i. fit for purpose
ii. able to adapt to changing technology and models of care
iii. sustainable in the future.
Within this context, the working group believes that New Zealand needs a
health science and technical workforce that:
 provides a clear national standard for the health-related science and
technical professions2
 allows easier movement between professions to respond to changing
demands without having to re-train from the beginning
 provides for easier movement from some science and technical
professions to emerging professions in the health sector
 finds a balance between a more ‘generalist’ approach (to enable a
technician to work across several service areas in smaller hospitals or
in primary care and community services) and the opportunity to
specialise
 develops the science and technical workforces in a way that supports
smooth adoption of innovation in technology and models of care
The inclusion of a ‘national standard’ here is not intended to take over the role of the
regulatory authorities in setting scopes of practice and qualifications in relation to professions
regulated under the Health Practitioners Competence Assurance Act 2003. Rather it is
intended as an overarching, non-profession specific standard on which professions can build
profession specific training programmes and standards.
2
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 provides co-ordination of workforce planning across the science and
technical workforces, and alignment with workforce planning in other
health workforces such as medical and nursing
 provides a more nationally consistent and co-ordinated science and
technical workforce, incorporating career structures that may make
these workforces more attractive career options
 reduces the impact of training providers discontinuing distance-learning
programmes or to help increase enrolment numbers, making distancelearning more viable in the long-term
 increases the capacity and capability for smaller hospitals, community
health care providers and private hospitals to participate in training,
leaving the larger, specialist hospitals to provide the higher level,
specialist training
 ensures that education and training programmes are consistent with
international education and training standards
 where appropriate, builds on the existing education and training
programmes that are currently accessed
 provides equal leverage to existing funding to access professional
development.
5.
A science and technical workforce for New Zealand
5.1 A model for the science and technical
workforce
The working group is clear that there are some basic principles that any model
for developing and sustaining New Zealand’s science and technical workforce
in the future must encompass. A model must:
 maintain a balance between providing generalist education and training
and the trainees’ desire to focus on a particular area
 include workplace clinical training (the ratio of academic to clinical
focus will vary between different professions)
 recognise that there is not a ‘one size fits all’ model, so the model must
allow for variations and exceptions
 provide a framework that individual professions can align their current
education and training programmes to, allowing them to identify gaps,
areas for improvement, and areas of commonality with other science
and technical professions (where education and training programmes
could be combined)
 encourage a focus on identifying and training required service skill sets
rather than on professional titles and boundaries
 recognise the impact of training on trainers and service provision
 recognise the value of and support the trainer.
5.2 Science and technical workforce planning
HWNZ asked the working group to consider whether or not there would be
merit in having a single entity to provide workforce planning across all the
science and technical professions working in the health sector.
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The working group held the view that there would be merit in a single coordinating entity. Such an entity would ensure consistency in the assumptions
used for workforce forecasting across the science and technical professions.
It would also ensure that workforce planning for the science and technical
workforce was not carried out in isolation from other health workforce
planning.
The working group suggested that the regional training hubs being
established throughout 2011 might be the best place to co-ordinate workforce
planning for the science and technical and other health workforces.
HWNZ has collaborated with District Health Boards (DHBs), education
providers and professional associations to establish four new regional training
hubs to support effective health professional training.
One of the key
responsibilities of the training hubs is to ensure workforce training aligns with
national service delivery needs and regional clinical service plans. The hubs
are expected to improve the quality and consistency of training programmes,
which should enable better use of available resources and reduce duplication.
Further information about the regional training hubs is provided in Appendix 4.
The initial focus of the regional training hubs is on pre-vocational medical
training, but the intention is for the training hubs to extend their role over time
to encompass a range of health professions. The science and technical
professions could be incorporated into the regional training hubs in the future.
This may provide greater opportunity for including the science and technical
workforce in service delivery planning and to improve equity of access to
existing funding for professional development across the health professions.
6.
Recommendations
The working group recommends that the HWNZ Board circulate this report for
sector comment, particularly on the following questions:
 Is there a need for better co-ordination of workforce planning for the
science and technical workforce?
 Provide an indication of whether the list of science and technical
professions is basically accurate.
 Where is there currently multi-disciplinary education and training
between different science and technical professions?
 Where should there be more multi-disciplinary education and training?
 Where should the balance lie between a generalist and a specialty
focus in education and training?
Depending on the results of that consultation, the working group recommends
a second working group be established to develop a more specific science
and technical workforces education and training framework that:
 begins to look at profession/service-specific details
Science & Technical Workforces Working Group Report (December 2011)
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 fosters an environment in which professionals work to the top of their
scope of practice
 develops mechanisms to ensure that service delivery models are
developed with input from all relevant workforces, including the science
and technical sector
 will provide national body endorsement of national standards of
practice (the working group acknowledges that much work will be
needed before national standards can be developed and endorsed).
This group will need to draw on profession-specific expertise.
Science & Technical Workforces Working Group Report (December 2011)
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Appendix 1
TERMS OF REFERENCE
HEALTH SCIENCE AND TECHNICAL WORKFORCES
WORKING GROUP
Introduction
There are over 20 health-related science and technical professions in New
Zealand’s health sector, comprising around five percent of our health
workforce. Many of the science and technical professions are small in
number and they often work in isolation from each other and from other health
workforces.
Health Workforce New Zealand (HWNZ) has formed the view that there is little
co-ordination between training, service delivery and future workforce planning
either within some individual science and technical professions or across
different but related professions. HWNZ holds the view that, in many cases,
there is little flexibility across the professions to, individually or collectively,
adapt quickly to meet the demands of often rapid changes in technology and
models of care that may require a new skill set or the redeployment of a
workforce made obsolete by changing technology or models of care.
HWNZ believes that New Zealand’s capacity and capability within the science
and technical workforce would be improved by a more co-ordinated approach
providing nationally consistent training standards across the health-related
science and technical professions, greater flexibility for career change, and
alignment of training and future workforce planning.
Developing and implementing a co-ordinated approach to training and future
workforce planning within the science and technical health sector would be a
long-term undertaking. The first step would be to convene a health and
education sector working group to identify the challenges and map out a
framework for education and training that will fit most of the science and
technical professions working in the health sector, with the aim of ensuring the
most effective workforce possible for New Zealand.
Role of the Working Group
The Health Science and Technical Workforces Working Group (the Working
Group) is established by HWNZ. The Working Group is charged with:

considering the merits of a base qualification(s) and modular approach
to education and training for New Zealand’s science and technical
workforces
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

developing a framework to demonstrate how a base qualification(s)
and modular approach might be structured
considering how a single science and technical professional entity
might function in the New Zealand context, particularly in providing coordinated workforce planning.
Accountability
The Working Group is accountable to and provides advice to HWNZ and the
HWNZ Board.
Deliverables
The Working Group will identify the health-related science and technical
professions working in New Zealand, in both the public and private health and
disability sectors. A preliminary list of professions is provided in Appendix 1.3
The Working Group will develop a workforce development / training model for
the health-related science and technical professions that:
 identifies one or more ‘base’ or ‘core’ level science and technical
qualifications
 builds specialty qualifications on to the base level qualifications.
The Working Group will identify any science and technical professions that are
unlikely to fit such a model.
The Working Group will assess how such a model might achieve the
objectives outlined below, and any other relevant objectives agreed by the
Working Group.
The Working Group will consider the merits of establishing a single
professional entity to:
 provide a support network across the health-related science and
technical professions
 take on the role of accrediting training programmes to ensure coordination, consistency and flexibility so that training programmes
adapt to fit changing workforce needs and models of care
 provide a central source of workforce information from its membership,
which could be used for national planning and evaluation.
The Working Group will provide to the HWNZ Board, within four months of the
Working Group’s appointment, a written final report that:
 proposes a workforce development / training model
3
The list of professions initially compiled as Appendix 1 to the Terms of Reference has been
superseded by the list of professions and their descriptions provided in Appendix 3 of this
report.
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 comments on how the proposed model might achieve the objectives
outlined in the section below
 gives the working group’s view on the merits of establishing a single
professional entity for the science and technical professions.
Objectives of the training model
The objectives of the training model are to:
 provide a clear national standard for the health-related science and
technical professions
 establish a ‘base level’ of generalist training across the professions or
groups of professions, allowing easier movement between professions
to respond to changing demands (without having to re-train from the
beginning)4
 provide easier movement across science and technical professions or
from some professions to emerging professions in the health sector
 increase the capacity and capability for smaller hospitals, community
health care providers and private hospitals to participate in training
(including the use of simulation training), leaving the larger, specialist
hospitals to provide higher level, specialist training
 provide a more ‘generalist’ approach that may enable a technician to
work across several service areas in smaller hospitals or primary care
and community services as some lower level hospital services are
moved into the community
 minimise the impact of training providers discontinuing distance
learning programmes or help increase enrolment numbers thus making
distance learning for other courses viable in the long term
 be consistent with moves to bring greater co-ordination and
consistency to education and training across medicine (prevocational
and vocational) and other health professions.
Composition of the Working Group
Collectively the Working Group will have the following expertise and attributes
 knowledge of and expertise in undergraduate health-related science
and technical profession education and training in New Zealand and
overseas
 knowledge of and expertise in postgraduate education and training
programmes in the health-related science and technical professions
 knowledge of New Zealand’s current health services delivery in both
hospital and community settings
 an understanding of the health service delivery needs in order to meet
future demands reflecting New Zealand’s ageing population and ethnic
mix
4
HWNZ recognises that there are likely to be some science and technical professions that will
not fit this type of approach. These exceptions should be identified by the W orking Group.
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 an ability to think creatively to provide solutions that are not constrained
by traditional health professional boundaries or current service delivery
models.
Terms and conditions of appointment
The Director of HWNZ (the Director) will appoint the members of the Working
Group.
Any member of the Working Group may at any time resign as a member by
advising the Director in writing.
The Director may discharge any member or appoint new members in
response to any changes to the key tasks that are being addressed or to
replace a member who is discharged or resigns.
The Director will Chair the Working Group. The Chair will preside at any
meeting of the Working Group at which they are present and will arrange for
their delegate or another Working Group member to Chair any meeting the
Chair is unable to attend.
Conflicts of interest
Members must perform their functions in good faith, honestly and impartially
and avoid situations that might compromise their integrity or otherwise lead to
conflicts of interest.
Members attend meetings and undertake Working Group activities as
independent persons responsible to the Working Group as a whole. Members
are not appointed as representatives of professional or educational
organisations and groups. The Working Group should not, therefore, assume
that a particular group's interests have been taken into account because a
member is associated with a particular profession, group or training provider.
When members believe they have a conflict of interest on a subject that will
prevent them from reaching an impartial decision or undertaking an activity
consistent with the Working Group’s functions, they must declare that conflict
of interest and withdraw themselves from the discussion and/or activity.
Servicing and funding the Working Group
HWNZ will provide administrative, policy and analytical support to the Working
Group.
HWNZ will fund travel and associated costs for three face-to-face Working
Group meetings over the four month period of the Working Group’s
appointment. HWNZ will also fund costs associated with additional Working
Group meetings held via teleconference or video conference within the
appointed four months.
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Appendix 2
Science and Technical Workforces Working Group
Members
Brenda Wraight (Chair)
Director, Health Workforce New Zealand
Alasdair McIntosh
Pharmacy Industry Training Organisation
Angela Morgan
Cardiac physiology
Howell Round
Medical physics
Julia Metcalfe
Medical radiation technology and sonography
Mike Powell
Anaesthetic technology
Phillip Barnes
Medical laboratory science
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Appendix 3
Science and technical professions descriptions
Profession
Definition/description
Anaesthetic technicians
Usually work under direct supervision of registered anaesthetists in both public & private settings. They assist
anaesthetists, prepare operating theatres and clinics for anaesthetic procedures. This includes, but is not limited
to, the insertion of indwelling canulas such as intravenous lines, insertion of nasal temperature probes into nasal
cavities, use of a haemocue for blood sampling to establish biomedical profiles, insertion of intra-oral devices to
maintain airway flow, responsibility for operation of anaesthetic machines that maintain airway flow during
anaesthesia.
Audiologist
Study, identify, measure & treat hearing disorders, provide hearing aids & other listening devices to assist those
with hearing loss. May include workplace & classroom assessments of sound levels.
Audiometrists
Performs hearing evaluation on adults and hearing aid fitting services
Biomedical engineers &
An interdisciplinary field in which the principles, laws, and techniques of engineering, physics, chemistry, and other
biomedical electronic technicians physical sciences are applied to facilitate progress in medicine, biology, and other life sciences. Biomedical
engineering encompasses both engineering science and applied engineering in order to define and solve problems
in medical research and clinical medicine for the improvement of health care. Biomedical engineers must have
training in anatomy, physiology, and medicine, as well as in engineering
Cardiac Sonographers
Sonographers that specialise in the anatomy and function of the heart. Use equipment to examine and evaluate
the heart's chamber size, muscle and valve function, blood flow & arrangement of the parts. Cardiac sonographers
do not generally make diagnoses, they report findings to a cardiologist for analysis/diagnosis.
Clinical Dental Technicians
Provide prosthetics appliances to patients and provide technical support to other clinical and Lab staff
Clinical perfusionists
Members of the open heart surgery team, mainly responsible for the heart-lung machine. Uses a number of
technical, mechanical & electronic devices to ensure oxygen reaches the patient's body through the blood, even
when the heart and lungs are not functioning, and controlling the machinery that temporarily takes over a patient's
respiratory and/or circulation of blood during open heart surgery.
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Clinical physiologists:
 Cardiac
 Respiratory
 Sleep
Three scopes of practice: Cardiac, Respiratory and Sleep. Responsible for diagnostic testing, descriptive analysis
of results and interpretation of diagnostic tests. Responsible for invasive and non-invasive procedures, for
assessing treatment options and providing assessment and management of long term treatment where
technological devices are the chosen therapy for a medical condition; i.e.: pacemakers, implantable cardiac
defibrillators, continuous positive airway pressure support, non-invasive ventilation.
Cytogeneticists
Detects and analyses hereditary diseases and abnormalities, through studying chromosomes obtained from
samples of blood, bone marrow, body fluid, amniotic fluid or foetal tissue.
Dental hygienists
Treat gum disease and help people maintain good oral health. Tasks may include assessing and provisionally
diagnosing gum disease, test saliva for tooth decay, take and develop x-rays if registered to do so, whiten teeth,
make mouthguards for sports and stents for bleaching teeth, maintain orthodontic appliances for patients.
Dental Technicians
Provide lab support to clinical dental technicians
Dental therapists
Provide children and adolescents with routine dental care and refer patients for more specialist dental care. Tasks
may include restoring teeth, providing preventive treatment, extracting first teeth with local anaesthetic, taking xrays of the mouth, providing education and promotion in the community and to individuals.
Gastroenterology scientists &
technicians
Use technical mechanical and electronic instruments to measure various parameters within the digestive tract
Genetic associates
Work with individuals, couples and families to provide risk assessment, genetic information and support.
Associates work closely with consultants from other specialties and genetic testing laboratories.
Magnetic resonance imaging
technologists
Use MRI scanners, radio frequency waves and magnetic fields to diagnose possible injury or disease.
Medical laboratory scientists &
technicians
Scientists who work with pathologists and carry out laboratory tests on blood, tissue and other samples taken from
patients. Tasks may include using and maintaining specialised laboratory equipment, evaluating results,
communicating results to hospital. Technicians help scientists and pathologists with tests and other duties in a
diagnostic medical laboratory.
Medical photographers
Produce accurate and objective images that record injuries, diseases, the progress of medical procedures /
operations. Images can be used for measurement and analysis, to accompany medical / scientific reports, articles
and research papers.
Medical physicists
Professionals with education and specialist training in the concepts and techniques of applying physics in medicine.
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Medical physicists working in the clinical environment are health professionals, with education and specialist
training in the concepts and techniques of applying physics in medicine, competent to practice independently in
one or more of the subfields (specialties) of medical physics.
Medical radiation technologists
Produce diagnostic radiographs or carry out diagnostic procedures either independently or in collaboration with a
radiologist or other medical practitioner. They evaluate the diagnostic quality of the images and take corrective
measures as required. The practice of Diagnostic Imaging General Technologists involves the use of ionising
radiation which may include CT, mammography, lithotripsy and angiography. Responsibilities may also include
Intravenous luer placement, and other duties as requested within workplace guidelines by an attending radiologist,
medical practitioner or employer. Diagnostic Imaging General Technologists must demonstrate competencies in
patient care, patient positioning, use of imaging technology, radiation safety, clinical responsibility, organisation for
the examination, and quality assurance.
Neurophysiology scientists &
technicians
Responsible for diagnostic testing on central and peripheral nervous system, descriptive analysis of results and
clinical reporting . Intra-operative monitoring of spinal cord functioning in orthopaedics and Neurosurgery and
Neurosurgery
Nuclear medicine technologist
Use radiopharmaceuticals in the diagnosis and treatment of disease. The practice involves the manufacture,
administration, imaging and quantification of diagnostic radiopharmaceuticals to demonstrate organ and molecular
function as well as the delivery of therapeutic radiopharmaceuticals to treat a number of pathologies. Involved in
the operation of gamma and PET imaging systems with or without sealed sources of radioactive materials or X-ray
tubes for attenuation correction, anatomical fusion, transmission imaging or diagnostic CT ( when appropriately
trained). Competencies include but are not limited to patient care, patient positioning, preparation and
administration of radiopharmaceuticals, radionuclide safety, radiation safety, clinical responsibility, organization for
the examination, in vitro diagnostic testing , radionuclide therapy and quality assurance.
Orthotists & prosthetists
Orthotists makes braces or devices, like special footwear, to aid or correct skeletal injuries or problems. Prothetists
make artificial limbs.
Pharmacy technicians
Assist pharmacists with the dispensing of prescription medicines. This may include all parts of the dispensing
process but is always done under the direct personal supervision of a pharmacist.
Radiation therapists
Primarily concerned with the planning and implementation of radiation treatment and issues of care and wellbeing
of people diagnosed with cancer and other conditions undergoing radiation therapy. They plan and apply ionising
radiation to patients in accordance with the prescription of an Oncologist. Radiation Therapists provide specific
care to patients prior, during and after treatment, educating patients in regard to procedures as well as how to deal
with radiation reactions. Radiation Therapists must demonstrate competence in patient care, treatment design and
delivery and radiation safety, clinical responsibility, organisation of the treatment, and quality assurance.
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Renal dialysis technicians
Operate dialysis equipment that remove extra fluid, salt and other waste from the blodd while maintaining levels of
certain other chemicals. They prepare patients for dialysis, monitor the patient and the dialysis machine, and keep
the machine in good working order.
Sonographers
Operate ultrasonic imaging devices to produce diagnostic images, scans, videos, or 3D volumes of anatomy and
diagnostic data. Sonographers view, analyse and modify the scan to optimise the information in the image. Must
be registered with the medical Radiation Technologists Board and have passed an examination that is approved by
the Medical Radiation Technologists Board or awarded and exemption to practise by the board
Sterile service technicians
Performs and has operational responsibility for technical procedures related to the preparation of sterile
instruments, supplies and equipment for use in medical and surgical procedures: maintains environment integrity
and equipment of sterile supply services. Operates sterilisers and all processing equipment. Performs technical
and mechanical work in the inspection, decontamination, servicing and equipment. Ensures instruments and
equipment are operating properly prior to issuing. Provides instrument picking and case cart packing to support the
efficient and timely provision of instruments and sets to theatres, ICU's and ED's.
Vision Hearing technicians
Provide screening according to the National Vision Hearing Screening Protocols (those employed/contrated by
DHBs).
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Appendix 4
Regional training hubs
(Source: http://www.healthworkforce.govt.nz/our-work/regional-training-hubs)
Health Workforce New Zealand (HWNZ) has collaborated with District Health Boards
(DHBs), education providers and professional associations to establish four new
regional training hubs (hubs) to support effective health professional training.
The four hubs, each covering a population of approximately one million people, cover
the 20 DHB regions:
 Northern (Waitemata, Auckland, Counties Manukau and Northland DHBs)
 Midland (Waikato, Taranaki, Lakes, Bay of Plenty and Tairawhiti DHBs)
 Central (Midcentral, Whanganui, Hawkes Bay, Wairarapa, Capital and Coast,
and Hutt Valley DHBs)
 South Island (Southern, Canterbury, South Canterbury, West Coast and Nelson
Marlborough DHBs).
Initial project plans and governance structures were developed in the first half of 2011
and it is expected that all four hubs will be fully operational by the end of December
2011. Each hub has actively involved clinicians in the development process.
Role of the hubs
Key responsibilities of the training hubs include:
 Standardising training/education programmes using educational principles and
assessments in collaboration with the various colleges, educational providers,
professional associations, DHBs, PHOs, private sector and HWNZ
 Co-ordinating clinical placements to support specialist training programmes
 Supporting trainees to develop and implement career plans and provision of
mentoring services
 Providing peer reviewing learning opportunities
 Sourcing traditional and non traditional accredited student placements
 Ensuring workforce training aligns with national service delivery needs and
regional clinical service plans
 Administering workforce initiatives, e.g. voluntary bonding, leadership
development, Advanced Trainee Fellowship Scheme and support for HWNZ
innovations such as the Physician Assistant role.
 Implementing and overseeing a national skills and simulation based education
strategy.
The hubs are expected to improve the quality and consistency of training programmes
which should enable better use of available resources and reduce duplication.
Through regional collaboration and co-ordination they can offer more varied and flexible
support for trainees and improve the skill level of trainers and mentors. This new
approach should ensure a more effective and efficient way of supporting health
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professionals on their educational journey and closer alignment between clinical training
and service delivery needs.
Status of the hubs
The integration and coordination of pre-vocational medical training is a priority for the
four hubs but all will have responsibility for all clinical training. The Midland, Central and
Southern hubs are taking the opportunity to use a multi-disciplinary approach from
inception, while the Northern hub has broadened its scope to also include allied health
and nursing.
The Northern and Midland hubs are undertaking specific project work for medicine, with
PGY1 and PGY2 standardisation, and project work for the nursing and midwifery and
allied and technical workforces.
The Central and Southern hubs have drafted project plans and are discussing them with
local stakeholders ahead of sign-off by their DHB Chief Executives in their regions. This
is expected to be finalised by mid-November 2011.
All hubs are in the process of developing career planning processes which will become
a HWNZ expectation for all trainees that it funds from 1 January 2011 onwards.
Oversight of the hubs
Each hub has its own local governance arrangements, integrated into regional decisionmaking systems and ensuring involvement of relevant stakeholders.
HWNZ will:
 provide strategic direction and maintain a monitoring and oversight role
 work closely with the hubs individually and collectively through the establishment
phase
 provide ongoing guidance and support for clinical and academic matters relating
to the implementation of regional training plans.
HWNZ has worked with the National Health Board to develop a reporting framework
aligned to existing processes through which the hubs will report progress from 1 July
2012 on a number of specific workforce priorities such as career planning and
implementation for PGY1 and PGY2. HWNZ will seek input from the hubs in
determining the hubs’ other priorities for the immediate, medium and longer term.
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