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This report provides an overview of the medical laboratory science workforce in Victoria in 2017. It is based on survey responses from 523 individual medical laboratory scientists (approximately 50 per cent of estimated number of medical laboratory scientists in Victoria), three focus groups involving 13 participants, and surveys from 160 employers and managers of organisations that provide pathology services in Victoria.

The medical laboratory science workforce in Victoria is older and female-dominated. Respondents predominately worked in either the public sector (66 per cent) (State, Commonwealth and jointly funded) or with large multi-sited private laboratories (24 per cent); a small number worked for small specialised laboratories and not-for-profit laboratories. The majority were employed in hospital-based laboratories (81 per cent). The majority of respondents (72 per cent) worked in one of the five core areas of laboratory science: haematology, transfusion science, microbiology, anatomical pathology and clinical biochemistry, or in a multidisciplinary core laboratory. Advanced roles were carried out by 54 per cent with the most common roles being in blood banking, identifying new developments, the clinical scientist role and molecular genetics interpretation. The majority of respondents were permanent employees, worked for one employer and in a laboratory that provided 24 hour/seven day a week services. Formal multi-disciplinary team structures were common and very few respondents were sole practitioners.

Participants in this research reported a low level of job satisfaction with only slightly more than half reporting somewhat or extremely satisfied. Higher levels of dissatisfaction were reported by employees of private large multi-sited pathology laboratories than by those in the public sector. Career advancement opportunities, opportunities to do research, income and work/life balance were all factors in this dissatisfaction. Almost 2/3 of respondents (64 per cent) indicated they intended to stay in the profession for less than 10 years. These figures were also disproportionately higher for private sector employees. Key areas of concern were under staffing, lack of jobs for new graduates and low morale. These have been longstanding concerns having been identified more than 15 years ago. While there has been a steady increase in new graduates, there are few and potentially reducing numbers of jobs available to these graduates, as well as for intermediate and more senior professionals. Advancements in technology have changed the way many medical laboratory scientists roles function, but understanding from those outside of the profession of the limitations of this technology is a concerning problem for the profession.

The main issues facing the profession included a high level of dissatisfaction with income level, career development opportunities, job prospects and career pathways; the need for some form of registration, certification or accreditation to ensure appropriate levels of education and quality are maintained in the workforce, particularly with an increasingly privatised world where saving money appeared to be the main objective; and the impending 'brain drain' that is likely to occur with the retirement of many senior scientists and few people coming up through the ranks to replace them. When these issues are matched to the concerns that new graduates are having difficulty getting jobs, it provides for a somewhat dismal view of the future of the profession.

Key areas of consideration for the medical laboratory science workforce going forward include: (1) Review the impacts of privatisation on the medical laboratory science workforce with particular emphasis on the effect on quality of service, standards and available depth of skills; (2) Review the increased creation of technologist versus scientist positions, and the need to ensure there are knowledgeable, experienced scientists in the workforce for quality service provision and to support, mentor and educate new young scientists; (3) Provide more opportunities for career development and a clear career progression pathway, taking into consideration the need for secure employment; (4) Review the staffing levels in laboratories and the concerns associated with lack of jobs for new graduates; (5) Review the supply and demand for the profession in light of the technological changes that are occurring. Producing an increasing number of new graduates who are unable to find employment is problematic for the graduates and the future of the profession; (6) Encourage the development of a stronger voice for the profession to improve the professional recognition and understanding of the medical scientist role; (7) Consider of the need for some form of registration or certification to protect both the profession and the public, particularly with the diverse educational pathways to employment; and (8) Explore with the profession, additional ways to address the 'impending brain drain', concerns that the profession is 'dying', and low morale given the increasing importance that is being placed on the pathology testing within medical diagnoses.

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This report provides an overview of the exercise physiology workforce in Victoria in 2017. It is based on survey responses from 430 exercise physiologists, representing 50 per cent of exercise physiologists with Accredited Exercise Physiologist (AEP) status in Victoria at the time of the survey (ESSA, 2017); two focus groups involving a total of seven participants; two individual interviews; and surveys from 119 employers and managers of organisations that provide dietetic services in Victoria. When contrasted with 2017 data from Exercise and Sports Science Australia (ESSA) (ESSA, 2017), the respondent cohort included an over-representation of female respondents, but an accurate representation of individuals aged 35 years and under and those aged 55 and over.

The Victoria exercise physiology workforce is young and includes slightly more females than males. The profession saw high levels of growth in the early years of this decade. More recently, this rate of growth has reduced in the context of ESSA introducing more stringent training requirements for eligibility for AEP status. Research respondents reported working across public, private and not-for-profit sectors, although the largest single employment sector was the private sector (48 per cent). Across respondents' roles over time, there was a slight increase in individuals employed in metropolitan and regional areas of Victoria and a reduction in those employed in other parts of Australia. Participants' showed movement away from the private sector across their careers and towards the public sector. This shift is likely to reflect not only individual professional choice but also an increase in funding of public exercise physiology positions over time.

Work-life balance, continuing professional development opportunities and support, and career advancement opportunities were the most frequently identified variables relevant to employment choices. However, the proportion of respondents satisfied with these variables in their current employment was significantly lower than the proportion noting the variables to be very important. Lack of a career pathway and poor progression opportunities was a strong and recurring theme. Although 59 per cent of respondents reported being somewhat satisfied with their current work situation, only 23 per cent reported being extremely satisfied. Even so, more than half the respondent group indicated an intention to stay in the profession for more than 10 years from the time of the survey. Contributors to job satisfaction included making a positive difference to the health and quality of life of clients, having the chance to work across diverse clinical domains and service sectors, exercise physiology being valued in the workplace, contributing to the development of a new and growing workforce, and recognising small signs of improvement in career pathways for exercise physiologists.

The research revealed significant concern regarding lack of employment opportunities available for exercise physiologists. Participants explained that many of the roles that do exist are part-time and insecure (contract or casual). Those unable to secure employment as an exercise physiologist often worked in allied health assistant roles. This is believed to contribute to lack of recognition of exercise physiologists as autonomous professionals and perpetuates the poor professional and community awareness of the exercise physiology role, scope of practice, and evidence-base. Research participants reported pay rates lower than other allied health professions. Quantitative data indicated that one in four respondents were in a contracted position rather than a permanent role. Nearly a quarter of all respondents earned less than $40,000 and 68 per cent earned less than $70,000. Lack of equity in government and private health insurance rebates for exercise physiology services was identified as an important contributor to this situation.

Exercise physiologists were often employed in small numbers or in sole positions. In these circumstances, administrative and clinical supervision was often delegated to physiotherapy managers or professional from other disciplines. For many exercise physiologists (but not all) this made it difficult to access adequate profession-specific clinical supervision and compromised development of the role within their service. Participants highlighted the opportunity for more effective use of the available workforce and reduced clinical risk, if the roles, scope of practice, and differences between exercise physiologists, physiotherapists, and personal trainers were more clearly defined. Respondents emphasised the key role of exercise physiology in prevention of and responses to injury, illness, and chronic disease. However, respondents expressed frustration at the limitations on being able to contribute the professions' full potential due to inadequate attention to prevention and early intervention by [General Practitioners] GPs; inadequate understanding of the professions' role; and lack of rebates for clients at risk of chronic disease, in contrast to funding available for those with established chronic disease, disability or injury.

Key areas for future consideration for the exercise physiology profession include: (1) Improving community and professional understanding of the exercise physiology role, scope of practice, and evidence-base; (2) Developing employment opportunities, career pathways and progression opportunities that encourage exercise physiology as a long-term career choice; (3) Reviewing funding models and government and private health insurance rebates to align better with other allied health professions; (4) Establishing models of care and funding models that facilitate effective use of the knowledge and skills of exercise physiologists in prevention and early intervention; (5) Increasing knowledge of the employment destinations of exercise physiologists, not only in their early career but also over time; (6) Establishing opportunities for clinical supervision of exercise physiologists by other exercise physiologists, particularly for sole practitioners and professionals working in very small departments; (7) Achieving clarity regarding the points of differentiation and the similarities between exercise physiologists, physiotherapists, and personal trainers, and how the mix of roles can contribute most effectively and efficiently to achieving optimal individual and community health outcomes; and (8) Advocating for parity of pay and entitlements where exercise physiology is delivering professional services of an equivalent level of expertise and autonomy to other professions.

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This strategy sets the direction for workforce development and planning for Victoria's alcohol and other drug treatment sector to 2022. Input from individuals, organisations and representative bodies within the sector has been central to determining this direction. The strategy focuses on six key result areas (KRAs): (1) Improve workforce availability; (2) Build workforce capabilities; (3) Increase workforce diversity; (4) Improve worker health, wellbeing, safety and engagement; (5) Strengthen leadership and collaboration; and (6) Deliver person-centred, integrated care.

The strategy presents a new approach to workforce development and planning that reflects best practice, better data collection and planning. This approach promotes a capable and sustainable workforce with the necessary knowledge, attitudes, values and skills to deliver high-quality treatment that meets the needs of people with alcohol and other drug issues and their families, now and into the future.

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This report provides an overview of the occupational therapy workforce in Victoria in 2016-2017. It is based on survey responses from 1,217 individual occupational therapists (approximately 25 per cent of Victorian occupational therapists with registration with the Occupational Therapy Board of Australia (OTBA) in December 2016 (OBTA, 2017)), five focus groups involving 20 participants, two individual interviews, and surveys from 270 government, non-government, and private organisational respondents that provide occupational therapy services across Victoria. When contrasted with 2015 data from the Australian Institute of Health and Welfare (AIHW) (2016), the respondent cohort included an over-representation of individuals employed in the public sector, individuals over 35 years, and people living in regional and rural areas.

The occupational therapy workforce in Victoria is a young, female dominated and growing workforce. Participants to this research reported strong job satisfaction. Key contributors to this satisfaction included the holistic nature of their work and opportunities to work across different populations, in diverse roles, and for a range of different sectors. Within the workplace, individuals reinforced the importance of being able to make a difference to their clients, a positive team environment, supportive management, and opportunities to continue learning across their career.

Despite these positive observations, the occupational therapy respondents explained that services are under-resourced to meet current demands. Consequences were reported to include long waiting lists, an inability to meet agreed benchmarks for assessment and intervention, compromise to clinical outcomes through an inability to deliver evidence-based practice, concerns regarding service quality, concerns regarding client safety following hospital discharge or while waiting for services and equipment, risks for readmission, and an inability to deliver primary and secondary prevention services. Impacts on staff were also reported to be significant, including increasing unpaid over-time to meet clinical demand, reducing job satisfaction, increased sick leave, and burn out. The challenges of meeting clinical demand were reported to be exacerbated by the fact that many organisations do not provide backfill during staff leave.

When recruiting occupational therapists, numerous organisations reported receiving up to 50 applications for junior positions. Even so, a handful of organisations still reported having unfilled junior positions. Significant concerns were expressed by many respondents about the increasing numbers of new graduates potentially resulting in challenges securing employment. However, no strong evidence was found to support this concern. Recruiting to intermediate and senior positions was reported to be more difficult. Applicant numbers were markedly lower than for junior positions and it appeared to be difficult to attract a person with appropriate skills and experience. Career progression was raised as an important issue for the profession. Many respondents expressed frustration at the minimal opportunities to advance beyond grade 2. Where these opportunities existed, they typically required relinquishing a focus on clinical work in favour of a management or project-based role. Professionals reported that choosing to retain a clinical focus often meant sitting at the grade 2 level for the duration of your career, despite decades of experience and increasingly specialised clinical experience.

Although a clear majority of occupational therapists reported they have the skills and tools to carry out their roles, only half agreed they have access to adequate training to progress their career and mentorship to support career growth. The requirement for specialised training in specific areas of practice, to supplement the holistic foundations on which occupational therapy is built, was reported as a specific need. Occupational therapists employed in generic roles articulated the need for more discipline-specific training opportunities. Access to more affordable and accessible professional development opportunities was raised as an issue by many respondents. This was particularly problematic for part-time workers and professionals from regional and rural areas.

Key areas of consideration for the occupational therapy workforce going forward include: (1) Improving community and professional understanding of the benefits of meaningful occupational engagement as a key contributor to maintaining and improving physical and mental health, and the role of occupational therapy in this process; (2) Need to strengthen the evidence and knowledge base of the profession to improve referrals and develop business cases for optimal staffing levels to help improve patient outcomes; (3) Reviewing funding models and models of care to optimise clinical outcomes and client safety by enabling delivery of services consistent with current evidence-base; (4) Developing career structures that recognise and encourage expertise and experience; (5) Exploring mechanisms that will facilitate improved capacity to meet workforce demand at the intermediate and senior levels; (6) Review of pay, entitlements and rebates where different professions are delivering an equivalent service; (7) Exploring holistic nature and skill set of profession and how this can be leveraged to support workforce demand; and (8) Exploring settings within which occupational therapists can create greatest impact (e.g. paediatrics) for improving patient/client outcomes.

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This report provides an overview of the physiotherapy workforce in Victoria in 2015-2016. It is based on survey responses from 1,037 individual physiotherapists (approximately 15 per cent of the physiotherapy workforce identified by the Australian Institute of Health and Welfare (AIHW) or 15 per cent physiotherapists registered with the Physiotherapy Board of Australia), three focus groups involving 17 participants, and surveys from 73 organisations providing services across 299 different locations or sites. Female and older employees were over-represented in the survey sample compared to 2016 registration and 2015 workforce data.

The picture of workforce supply and demand for physiotherapy was mixed. As with other allied health (AH) professions, there has been a rapid growth in new graduates entering the physiotherapy profession, (AIHW, 2016) and increasing competition for jobs, particularly in the public sector. Despite this, there is anecdotal evidence of substantial unmet demand for physiotherapy services in the community. Some advertised physiotherapy positions receive more than 50 applications. Yet around 50 per cent of organisations said that they experience shortages of physiotherapists across lower and higher grades and vacant senior positions can take more than six months to fill. Indicators of workforce shortages include lack of services, service rationing, long waiting lists, increased delegation to [allied health assistants] AHAs and physiotherapists appointed at grades higher than their levels of skill or qualification.

The self-reported attrition rate from the physiotherapy workforce is 2 per cent in the next 12 months increasing to 27 per cent in five years. Approximately 15 per cent of physiotherapists propose to change their job within 12 months. The majority of participants said that they were moving to take up better job opportunities, better pay or better working conditions. Recruitment and retention of physiotherapists was more challenging in regional, rural and some outer metropolitan areas than in inner-metropolitan regions. Rural and regional employers face challenges including competition for staff with metropolitan employers, perceived lack of career development and continuing professional development (CPD) opportunities, as well as the more generalist nature of the work. Regional university training courses were seen to increase rural physiotherapy capacity and keep clinicians in regional/rural areas. Some organisations fund physiotherapy positions on short term, temporary or part-time contracts which are less attractive from a recruitment perspective.

Leadership from senior roles is necessary both to build advocacy on behalf of patients and the profession and to provide governance structures for more junior staff, regardless of their employment location. There are relatively few senior physiotherapy positions. Yet some organisations expressed challenges recruiting to senior physiotherapy roles, suggesting a lack of succession planning within the profession. Workforce capacity development and career advancement of the physiotherapy workforce requires access to CPD, particularly in rural areas. Other enablers include support from management, time, funding and availability of appropriate CPD. Failure to provide these enablers limits clinicians' ability to access further training which would provide career opportunities and advance the profession in its ability to meet community health need.

Physiotherapists have a high level of career satisfaction. While most are satisfied with the type of work they perform and the clients they work with, they would like to see improvements in their pay, professional development and career advancement opportunities. Physiotherapists are motivated by achieving a positive work/life balance, the type of work they do and clients they work with, and by having access to professional development opportunities. There was a suggestion that the physiotherapy profession should aim to attract students on the basis of their interpersonal skills and a desire to work with people, rather than academic ability. More appropriate marketing to prospective students may influence their ultimate career satisfaction and retention. There were no systemic skills gaps identified within physiotherapy, however several organisations identified specific skills that would be of benefit locally, including a mixture of clinical skills, knowledge of the health system, and supervision skills. Improved access to CPD may be a way to resolve several local skills gaps.

Key areas of consideration for the physiotherapy workforce going forward include: (1) Developing metrics of community need/demand for physiotherapy services; (2) Increasing evidence and knowledge base of the professions models of care to improve referrals and business cases for optimal staffing levels to improve patient outcomes; (3) Undertake modelling around AH, nursing and medical staffing numbers and mix that ensure optimal service capacity and health outcomes; (4) Improving health service workforce and succession planning to best meet community health need; (5) Improving clinical governance and support, particularly for private practitioners and those working for a large number of different employers; (6) Ensuring adequate supply and skills for growing areas of need, including acute and sub-acute areas, aged care, disability, complex patients and interdisciplinary roles; (7) Addressing attrition by providing support, flexibility and a career opportunities; (8) Developing business case's for areas in which physiotherapy can add value to the patient pathway including referral, diagnostic and treatment pathways, which are currently restricted by professional boundaries, funding models or organisational norms; and (9) Exploring workforce capacity opportunities such as skills that current physiotherapists bring from previous careers, current and potential interdisciplinary and advanced scope roles.

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This report provides an overview of the audiology workforce in Victoria in 2017. It is based on survey responses from 153 individual audiologists (approximately 21 per cent of Victorian audiology workforce (Audiology Australia, 2017)), as well as focus group and interview conversations with five audiologists, and surveys from 42 managers or team leaders of government, non-government, and private organisations that provide audiology services in Victoria. When contrasted with 2017 data from the Audiology Australia, the respondent cohort included an over-representation of females and lower representation of young audiologists.

The audiology workforce in Victoria is a feminised, young, stable and satisfied profession. Audiologists worked across the private, public and not-for-profit sectors but compared to other allied health professions, they were more likely to work in the private sector (50 per cent), mostly in private clinics. Across their careers, there was a movement of audiologists away from regional areas towards the city and away from hospitals towards private practice. Fitting hearing aids, diagnostic hearing testing and paediatric services were the most frequently reported primary areas of practice. Audiologists valued work life balance and in general, they achieved that in their roles. Satisfaction rates in the profession were very high. The vast majority of audiologists intended to stay in the profession for the long-term and 40 per cent planned to stay in the same role for more than five years.

Nevertheless, poor opportunities for career progression were a strong and recurring theme in the research. Senior roles were scarce and career pathways were not clear. While most audiologists were confident in their skills, there was evidence of a need to improve non-clinical skills, particularly communication with patients, quality and governance. Furthermore, the audiology profession has been under some pressure in recent years. A 2017 Australian Competition and Consumer Commission Inquiry into issues around the sale of hearing aids found that clinician independence and integrity had been compromised by use of sales-based remuneration arrangements. Later in 2017, a Federal Parliamentary Inquiry into the Hearing Health and Wellbeing of Australians was released, which reiterated these issues and recommended the Australian Government prohibit such practices in its services and the profession be nationally regulated under the Australian Health Practitioner Regulation Agency. These processes, while considered necessary, were damaging to the profession's reputation and have weighed heavily on professionals who were keen to rebuild trust in the profession. Audiologists also believed that the community and other health professionals needed to have a better understanding of the breadth of services they provide, beyond fitting hearing aids, and the importance of hearing health to general wellbeing. The Parliamentary Inquiry also foreshadowed a significant increase in audiology services, particularly for vulnerable groups, to meet unmet demand. While there appears to be sufficient numbers of audiologists graduating to fill positions available overall, there was a lack of publicly-funded services in the community, particularly in regional areas and Indigenous communities. If the Parliamentary Inquiry recommendations are implemented, the profession is likely to experience workforce shortages and regional practices will find it difficult to recruit.

Key areas for future consideration for the audiology profession include: (1) Rebuilding the reputation of the profession following questions around clinician independence and integrity as a result of sales-based remuneration arrangements; (2) Improving understanding of the profession amongst the community and other health professionals, particularly [General Practitioners] GPs; (3) Ensuring there are enough publicly funded positions to meet growing demand, particularly for Indigenous communities, children and people from low-SES [socio-economic status] groups; (4) Supporting professionals in coping with reforms arising from government inquiries into the industry, changing funding arrangements (particularly the introduction of the [National Disability Insurance Scheme] NDIS), and the possibility of tighter regulatory arrangements; (5) Providing more opportunities for career progression and recognition, possibly through credentialing and formalising advanced scope roles; and (6) Developing the non-technical skills of professionals, particularly communication, quality and governance.

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This report provides an overview of the allied health assistance workforce in Victoria in 2015-2016. It is based on survey responses from 334 individual allied health assistants (AHA) (approximately 33 per cent of the workforce); three focus groups involving nine participants, a supplemental qualitative survey of 66 practitioners; and surveys from 71 organisations providing services across 272 different locations or sites. The age and gender of survey respondents are comparable to recent statistics collected by the Victorian Public Sector Commission (VPSC) (2015) relating to public health sector employed AHAs.

The AHA workforce is a unique, skilled and educated group with broad life experience. This workforce comprised a diverse skill-set, with 80 per cent entering the profession from previous roles and/or professions; 25 per cent hold a bachelor degree and the majority had a Certificate IV as their main qualification for their AHA role. AHAs worked across diverse roles and settings, with the vast majority working for a single employer in the public sector. Most AHAs worked in a community setting with adults, particularly older adults, providing rehabilitation services. They worked with a wide range of allied health (AH) disciplines, in particular physiotherapy where over 60 per cent of surveyed physiotherapists reported working with AHAs. The AHA workforce is unregulated and does not have a formal organising professional body.

There was little evidence of workforce shortages for AHAs, with few unfilled positions and large numbers of applicants for vacant positions. However, AHAs felt that their skills could be used more appropriately in organisations where they worked. Similarly, the use of AHAs allow organisations to provide services that may otherwise not be provided (such as therapy groups), and was proposed to have increased service efficiency through reducing waiting lists and promoting early discharge. A shortage of AHAs was believed to reduce the efficiency of other allied health professionals (AHPs) because certain roles and tasks could be delegated to AHAs therefore improving productivity. There were no systemic skills gaps identified for AHAs; however several organisations identified a mixture of clinical and generic skills that would be of local benefit.

AHAs have the capacity to work across numerous roles, disciplines and services where they are able to effectively fill service gaps. However, because of the lack of standardised competencies and training for AHAs, the quality and consistency of knowledge varies widely and the majority of training occurs on the job. This perceived inconsistency of skills and knowledge may limit the transferability of roles between settings and sectors. In addition, this lack of shared understanding and recognition of the potential and capabilities of AHAs may serve to further their underutilisation and create a situation where there is inappropriate use of AHAs by AHPs.

Key areas of consideration for the allied health assistant workforce going forward include: (1) A cost-benefit analysis of the added value of employing AHAs to help support business case development for their future employment; (2) Improving clinical governance and support for AHAs; (3) Identifying a set of core competencies and a standard training framework for AHAs; (4) Embedding supervision of and delegation to AHAs into AHPs' undergraduate training; (5) Exploring the development of explicit career pathways between AHAs and AHPs; and (6) Developing leadership within the allied health assistance workforce to provide this workforce with a single basis for negotiation and future direction.

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The National Disability Insurance Scheme (NDIS) is about transforming the lives of people with disability for the better. This once-in-a-generation reform provides opportunities for allied health professionals to go beyond usual funding barriers to achieve positive outcomes for people with disability. The NDIS can only deliver high-quality services if there is a highly skilled and professional workforce. Allied health professionals play an important role in delivering the scheme. To properly support people with disability and complex support needs, allied health professionals will need more than entry-level qualifications.

The framework aims to develop the skills and knowledge of allied health professionals to better meet complex support needs for people with disability. Achieving the best outcomes for people with disability is the main goal of the framework. Allied health has a strong commitment to lifelong professional learning. Continuing professional development is required for registered and self-regulated allied health professions. Building the skills of allied health professionals aims to improve service quality and access to care. A consistent framework will help people with disability and their families/carers to choose allied health professionals with knowledge and skills that suit their needs.

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This report provides an overview of the social work workforce in Victoria in 2016-2017. It is based on survey responses from 1,294 individual social workers (approximately 25 per cent of the social worker workforce identified in the 2011 Australian Bureau of Statistics (ABS) census data or 15 per cent of Australian Association of Social Workers (AASW) estimates of Victorian social worker numbers). It also draws on focus groups and interviews involving 28 social workers, and surveys from 273 organisational respondents that provide social work services across in Victoria. Public sector and older employees were over-represented in the survey sample.

According to the workforce survey and qualitative research findings, social work services are currently under pressure in the public system in Victoria with social workers citing long waiting lists, large workloads and limited capacity. Demand is predicted to continue to rise with the ageing population, and increasing policy focus on family violence, disability and mental health support. Future areas of high demand include family violence, aged care, disability, mental health, child protection, and Indigenous mental health. There are existing service gaps in these areas and also in rural areas. There is also an important and growing role for social workers in emergency departments.

Social workers were generally satisfied in their careers and value the diversity their profession offers; however they felt they lacked professional recognition and standing. While there was a sense that social workers' status is improving in the state's hospitals, many still felt undervalued and in the community sector, there was a particular concern about non-degree qualified social workers using the social worker title and sometimes getting paid at a similar level. Another key issue for social workers was that career structures currently do not reward clinical expertise or specialty and this contributes to dissatisfaction and attrition in the profession. Approximately one third of respondents (32 per cent) were working at the grade 2 level, with a high proportion of social workers not able to progress beyond this level due to lack of available positions, particularly in regional and rural areas, and in the community sector.

Workforce burnout (compassion fatigue) can have a significant effect on this workforce, but this is substantially mitigated with effective supervision. Clinical supervision is a valued and integral element of the profession. Many social workers want more access to supervision or better quality supervision, provided by an experienced social worker, not someone from a different profession. Social work is a naturally innovative profession and social workers use their understanding of systems to suggest creative approaches that may not necessarily emerge from others with a more 'medical mindset'. Social workers often use their advocacy skills internally to lobby for new ideas, but the profession is perceived to lack the necessary status within organisations, as well as the level of evidence or documentation needed, to effectively advocate for different approaches to practice. Building a stronger research culture within the profession would assist with this.

Key areas of consideration for the social work workforce going forward include: (1) Improving professional understanding and definition of the social worker role; (2) Increasing research culture across the profession, and evidence and knowledge base of models of care delivery, to improve referrals and develop business cases for optimal staffing levels to improve patient outcomes; (3) Review of pay across the public, community and not-for-profit (NFP) sectors; (4) Developing career structures that recognise and encourage clinical expertise and experience; (5) Improving access to high quality supervision across the workforce to reduce compassion fatigue and increase capacity; (6) Investigate the need for increased social work services in rural areas; and (7) Embedding social workers where there are opportunities for prevention and early intervention by addressing psycho-social needs, such as in emergency departments and with ambulance teams.

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The Victorian Government made a commitment in 'Absolutely everyone' [available in VOCEDplus at TD/TNC 131.1055] to develop an employment strategy for people with disability. This is because despite the state's broader economic success, people with disability continue to face barriers and discrimination which leaves them significantly underrepresented in the workforce - and there has been very little change over the past 20 years. 'Every opportunity' is the Victorian Government's three year plan to enhance the economic participation of people with disability in this state. This whole-of-government plan was informed by community consultation on the state disability plan, and with the input of all government departments and the Victorian Disability Advisory Council.

'Every opportunity' takes a broad view of economic participation, encompassing the range of ways people contribute to and participate in the economy. The early actions detailed in the plan will underpin future work across three key areas of focus: education and learning pathways; employment opportunities; and business ownership and innovation. We will achieve our goals by taking action on public sector employment and government procurement, and through strong partnerships with Victoria's community and private sectors. Through 'Every opportunity', we have set a target of six per cent employment of people with disability across all Victorian Government departments by 2020, increasing to 12 per cent by 2025. The Victorian Public Sector Commission will lead the development of a separate action plan to realise this target, and we will also work closely with The Enablers, the Victorian Public Sector Network for People with Disability.

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