A health workforce career framework

• Abstract
• Purpose of health policy or idea
• Characteristics of this policy
• Political and economic background
• Purpose and process analysis
• Expected outcome
• References

Abstract

A Career Framework is being developed to provide for the consistent development of a flexible health workforce. The framework, which covers both clinical and non-clinical workforces, will identify career pathways for different occupations while recognising overlapping scopes of practice and competencies. It will be used to support individuals and organisations in the development of career pathways, and to support health workforce development and planning.

Purpose of health policy or idea

The aim of the Career Framework is to clarify how people might move through various career paths within the health sector and hence to help profile the sector as an attractive career option. The Framework will be used to:

• support individuals and organisations in the development of careers and career pathways
• inform and support health workforce development and planning.

The Framework does not supercede existing discipline-specific competencies and professional pathways. Rather the intention is to incorporate these into the framework over time, and to accommodate the more generic competencies (such as mental health and public health) that exist within the sector.

Very broadly, the Framework identifies eight points in a career pathway from beginner to expert. The aim is to assist workers to identify how they can transition from one point to another, and the points at which there are opportunities to move within and across occupational groups and scopes of practice. 

The Framework is one of a number of linked components of workforce planning. Other components include workforce policy development, legislation and regulation of health professionals, recruitment and retention, and workforce information.

Main points

Main objectives

1. To clairfy career pathways for health sector personnel
2. To help profile the health sector as an attractive career option

Groups affected

The health workforce, Health care providers

Degree of Innovation	traditional		innovative
Degree of Controversy	consensual		highly controversial
Structural or Systemic Impact	marginal		fundamental
Public Visibility	very low		very high
Transferability	strongly system-dependent		system-neutral

Political and economic background

New Zealand, like many other countries, is facing some major challenges in respect of its health workforce. These include the aging of the workforce, poor retention and high turnover, global migration, changing population health needs and expectations (including increasing complexity and quite rapid changes in the population's ethnic mix), and changes in the way that services are provided and organised.

Workforce development activities in New Zealand are diverse and involve many different organisations. Between 2001 and 2006, the Health Workforce Advisory Committee was charged with the tasks of strategic planning for the development for the health workforce and advising the Minister of Health on national goals and critical issues (see HPM Survey 1(2003)). More recently, the Ministry of Health and the District Health Boards have taken leadership roles in developing and coordinating the many types and levels of workforce development plans and strategies.

Purpose and process analysis

Current Process Stages

	Idea	Pilot	Policy Paper	Legislation	Implementation	Evaluation	Change
Implemented in this survey?

Origins of health policy idea

In 2006, the Health Workforce Advisory Committee proposed the development of a health workforce career framework, especially to give structure to that part of the health workforce that is unregulated. At the same time, the Ministry of Health and District Health Boards were discussing the possibility of developing a career framework that covers the whole of the health and disability (i.e. social care) sectors.

The Framework was subsequently developed following extensive consultation with the sector, including workshops, a consultation document, written submissions and public meetings. Key actors have included the Ministry of Health, District Health Boards, professional organisations, trade unions, non-government organisations and regulatory bodies.

Initiators of idea/main actors

• Government

• Providers

Approach of idea

The approach of the idea is described as:
new:

Stakeholder positions

Most stakeholders are supportive of the idea of a Career Framework. However one key question is whether a universal career framework should apply to workers in both the health and disability sectors. Some people in the disability sector did not favour the inclusion of their workforce in the same framework as the health sector workforce. The framework is therefore currently being developed for the health sector only. The Ministry of Health is, however, still committed to the principle of a universal framework. The intention is to continue consulting with the disability sector to develop an integrated framework over time.  

Actors and positions

Government
Ministry of Health	very supportive		strongly opposed
Providers
District Health Boards	very supportive		strongly opposed
Other health providers	very supportive		strongly opposed
Providers of disability support services	very supportive		strongly opposed

Actors and influence

Government
Ministry of Health	very strong		none
Providers
District Health Boards	very strong		none
Other health providers	very strong		none
Providers of disability support services	very strong		none

Positions and Influences at a glance

Adoption and implementation

The publication of this high-level framework is just the first step towards the ongoing development of a detailed health workforce career framework. The Ministry of Health will work with other stakeholders to further develop the framework itself and an overall strategy for implementation. An action plan for the first two years will be announced in June 2008.

Monitoring and evaluation

A programme of evaluation will be developed to ensure that implementation of the Career Famework is in line with its guiding principles, and that the Framework fulfills required outcomes.

Expected outcome

The Ministry of Health is of the view that the rewards of implementing the Career Framework alongside other key workforce initiatives will be significant in terms of a flexible and sustainable health workforce because it will offer a range of attractive,varied and challenging career options. However the development of a universal Career Framework is an ambitious project, given the numerous stakeholders involved. At present this development is only in its very early stages. Successful development and implementation will depend crucially on close collaboration with a wide range of people and agencies, and the degree of buy-in by the many stakeholders.

Impact of this policy

Quality of Health Care Services	marginal		fundamental
Level of Equity	system less equitable		system more equitable
Cost Efficiency	very low		very high

It is likely to be some years before the framework is fully developed and implemented, and for any benefits of its implementation to have an impact on the health sector. In the longer term, if successful, improved retention of workers should improve both quality of care and cost efficiency of services.

References

Sources of Information

• Ministry of Health. A Career Framework for the Health Workforce in New Zealand. Wellington: Ministry of Health, 2007. www.moh.govt.nz/moh.nsf/indexmh/career-framework-oct07?Open
• Ministry of Health. Health Workforce Development: An Overview. Wellington: Ministry of Health, 2006. www.moh.govt.nz/moh.nsf/pagesmh/3390?Open

Reform formerly reported in

Health Human Resources Development Process Stages: Policy Paper

Author/s and/or contributors to this survey

Toni Ashton, CHSRP

Suggested citation for this online article

Toni Ashton, CHSRP. "A health workforce career framework". Health Policy Monitor, April 2008. Available at http://www.hpm.org/survey/nz/a11/4