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.
Excerpts from publication.
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