Artículos de revistas
URI permanente para esta colecciónhttps://hdl.handle.net/20.500.12640/4067
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Ítem Acceso Abierto Are sustainable health workforces possible?: issues and a possible remedy(MDPI, 2023-02-15) Rees, Gareth H.; James, Rosemary; Samadashvili, Levan; Scotter, CrisThe 2020–2022 period of the global COVID-19 pandemic exposed the fact that many countries health systems had inadequate health workforce availability. This is despite sustainable health workforces being critical to health service and healthcare delivery, an acknowledgement that drove the significant investment and focus on health workforce development over the previous two decades. As such, this review article discusses health workforce governance and planning, notes its weaknesses, and identifies some of the barriers to the implementation of health workforce policy making and planning and the achievement of sustainable health workforces. Important is the recognition that health workforce planning is long-term in nature, while health workforce decision-making processes are dominated by political processes that have much shorter time frames. The article concludes by offering the approach of backcasting to overcome this dichotomy.Ítem Acceso Abierto Rethinking workforce planning for integrated care: using scenario analysis to facilitate policy development(BioMed Central, 2020-05-15) Rees, Gareth H.; Crampton, Peter; Gauld, Robin; MacDonell, StephenBackground: A goal of health workforce planning is to have the most appropriate workforce available to meet prevailing needs. However, this is a difficult task when considering integrated care, as future workforces may require different numbers, roles and skill mixes than those at present. With this uncertainty and large variations in what constitutes integrated care, current health workforce policy and planning processes are poorly placed to respond. In order to address this issue, we present a scenario-based workforce planning approach. Methods: We propose a novel mixed methods design, incorporating content analysis, scenario methods and scenario analysis through the use of a policy Delphi. The design prescribes that data be gathered from workforce documents and studies that are used to develop scenarios, which are then assessed by a panel of suitably qualified people. Assessment consists of evaluating scenario desirability, feasibility and validity and includes a process for indicating policy development opportunities. Results: We confirmed our method using data from New Zealand’s Older Persons Health sector and its workforce. Three scenarios resulted, one that reflects a normative direction and two alternatives that reflect key sector workforce drivers and trends. One of these, based on alternative assumptions, was found to be more desirable by the policy Delphi panel. The panel also found a number of favourable policy proposals. Conclusions: The method shows that through applying techniques that have been developed to accommodate uncertainty, health workforce planning can benefit when confronting issues associated with integrated care. The method contributes to overcoming significant weaknesses of present health workforce planning approaches by identifying a wider range of plausible futures and thematic kernels for policy development. The use of scenarios provides a means to contemplate future situations and provides opportunities for policy rehearsal and reflection.Ítem Acceso Abierto The implications of COVID-19 for health workforce planning and policy: the case of Peru(Wiley, 2021-02-19) Rees, Gareth H.; Peralta Quispe, Felipe; Scotter, CrisLike many countries Peru is confronting uncertainties due to the COVID-19 pandemic and its consequences. This is having impacts not only on health systems but also on the planning and preparation of its workforces. In this case article we summarise the progress Peru has been making to improve its workforce capacity and planning and review how Peru has coped with the stresses put on its health system arising from the pandemic. By recounting the responses that the Ministry of Health made through mobilising existing capabilities, additional workers and collaboration with health science faculties and health professional colleges, the article identifies that a longer-term planning perspective based on skills that services require is something that Peru may consider to compliment the health workforce investments that are already being made. As such, this case provides an example for workforce planners and policy makers to contemplate when considering health workforce planning in post-COVID uncertainty.Ítem Acceso Abierto The evolution of New Zealand's health workforce policy and planning system: a study of workforce governance and health reform(BioMed Central, 2019-07-05) Rees, Gareth H.Introduction: While considerable attention has been given to improving health workforce planning practice, few articles focus on the relationship between health workforce governance and health reform. By outlining a sequence of health reforms, we reveal how New Zealand’s health workforce governance and practices came under pressure, leading to a rethink and the introduction of innovative approaches and initiatives. Case description: New Zealand’s health system was quite stable up to the late 1980s, after which 30 years of structural and system reform was undertaken. This had the effect of replacing the centralised medically led health workforce policy and planning system with a market-driven and short-run employer-led planning approach. The increasing pressures and inconsistencies this approach produced ultimately led to the re-centralisation of some governance functions and brought with it a new vision of how to better prepare for future health needs. While significant gain has been made implementing this new vision, issues remain for achieving more effective innovation diffusion and improved integrated care orientations. Discussion and evaluation: The case reveals that there was a failure to consider the health workforce in almost all of the reforms. Health and workforce policy became increasingly disconnected at the central and regional levels, leading to fragmentation, duplication and widening gaps. New Zealand’s more recent workforce policy and planning approach has adopted new tools and techniques to overcome these weaknesses that have implications for the workforce and service delivery, workforce governance and planning methodologies. However, further strengthening of workforce governance is required to embed the changes in policy and planning and to improve organisational capabilities to diffuse innovation and respond to evolving roles and team-based models of care. Conclusion: The case reveals that disconnecting the workforce from reform policy leads to a range of debilitating effects. By addressing how it approaches workforce planning and policy, New Zealand is now better placed to plan for a future of integrated and team-based health care. The case provides cues for other countries considering reform agendas, the most important being to include and consider the health workforce in health reform processes.
