Balancing supply and demand in our health system
Written by Tom Varghese
The Allied Health Science and Technical workforce encompasses over 40 professions and more than 40,000 individual professionals. It represents the second largest health workforce in New Zealand.
The allied workforce collectively supports patients across all age ranges and demographics and are critical to maintaining the quality of life for NZ’s ageing and chronically ill population. Allied health professionals provide services and engage in activities that may include prevention, assessment, diagnosis, treatment, rehabilitation, and promotion of health and wellbeing amongst others. The collective profession is crucial to supporting people living in the community and have a strong focus on bringing services closer to home. One of the action points in the 2016 Roadmap of actions report was to put in place workforce development initiatives and identify ways to best use the skills and expertise of the allied health workforce. 5 years on, are we better off? We have an allied health workforce who are skilled and qualified to carry out a lot of the tasks outlined in the strategy but arguably have not been utilised to their full potential.
The Health and Disability System Review suggested that “priority should be placed on gathering data in areas where less is known (e.g. allied health). Steps are being taken, but it will take some time before this is sufficiently robust to use for long-term planning and modelling”. The Health and Disability System review and imminent system transition process provide a unique opportunity to design health services that make better use of allied health professions to achieve the quadruple health objectives for sustainability in the sector.
The system is under pressure due to both supply and demand factors. Only by enabling other practitioners to share some of the growing burdens of work will the sector shift without significant efficiency-equity trade-offs. Current services have a long way to go to provide some version of the Patient-Centred Medical Home (PCMH) model, a population needs-based interdisciplinary team model of care. PCMH models are ideal for areas of high deprivation, where multi-morbidity and high prevalence of risk factors are observed and provide a context in which allied health professionals can add significant value to tier 1 services.
Alongside the PCMH model, new payment models have emerged that are better aligned to the model of care that a PCMH is designed to deliver. Currently, the only way patients can access publicly funded allied health practitioners is through a GP referral. However, there is an argument that GPs often lack the knowledge of allied health practitioner’s skillsets to know what kind of allied health professional is the right one.
Extending the scope of practice and creating skill flexibility among allied health professionals will go a long way in supporting a shift to using the right skills to provide the right care at the right time and in the right place.
