An evaluation of New Zealand’s iterative Workforce Service Reviews: a new way of thinking about health workforce planning

Abstract

Evidence now exists at a point in time about what makes the WSR processes work. Implications for HWNZ are presented using a capacity-building framework to inform future decision making regarding WSRs. WHAT IS KNOWN ABOUT THE TOPIC? More appropriate workforce planning is required to meet the challenges facing the health workforce, from both the demand and the workforce side. To ensure New Zealand's healthcare workforce was fit for purpose, HWNZ initiated an iterative WSR process in topic specific areas. The WSRs process was designed to develop a vision of the relevant health service and workforce for 2020, and models of care that were patient-centred and team-based. WHAT DOES THIS PAPER ADD? The paper provides evidence that the WSR process was a successful means for bringing together professionals from across the health disciplines and building sector capacity to develop new ways of thinking about service and workforce planning. The paper presents key enablers of, and barriers to, the WSR iterative process. WHAT ARE THE IMPLICATIONS FOR PRACTITIONERS? The evaluation revealed that a multitude of factors can influence the capacity of the WSR process at the individual (workforce skills and abilities), organisational (leadership and interactions) and systems (infrastructure) levels. Implications for HWNZ on ways to build the capacity of the WSRs according to three capacity-building dimensions are presented to inform future decision making.

Matching the production of doctors with national needs

“…The second cause of disappointment is the approach to planning. With the possible exception of the New Zealand service forecast approach, there are no approaches that use design thinking or are based on an understanding of the various users’ requirements…”

“…Conventional modelling is an often very sophisticated supply‐side calculation, which is based on historical workforce dynamics and which applies in contexts in which demand is a population and demographic projection of ‘desirable’ provider‐to‐population ratios . This inappropriately assumes both a consistency of specific models of health care and that planning can be useful if it is undertaken for professional groups in isolation .…”

“… Despite the unpredictability of specific models of health care, most health workers are neither easily retrainable nor redeployable …”

“…44,45 This is referred to as the 'health care paradox' and it defeats most health care planning. 44,[46][47][48][49]…”

“…The second cause of disappointment is the approach to planning. With the possible exception of the New Zealand service forecast approach, 46,47,49 there are no approaches that use design thinking or are based on an understanding of the various users' requirements. 50 Conventional modelling is an often very sophisticated supply-side calculation, which is based on historical workforce dynamics and which applies in contexts in which demand is a population and demographic projection of 'desirable' provider-topopulation ratios.…”