Alternative Approaches to Health Workforce Planning: Final Report

The aim of this report is to critically examine the role of quantitative approaches to national health workforce planning. Health care is a labour intensive industry with between 60% and 70% of health care expenditures devoted to the health workforce. The decisions made by the health workforce have large effects on population health, health care costs, and access to health care. Health workforce planning exercises, and the decisions made using their findings, can therefore have a major impact on the operation of the health care system, health care costs, and health outcomes.
The findings of this report relate largely to the fact that the existing quantitative approaches used in health workforce planning have ignored the interaction of the health workforce with the broader health system. These models have focussed on quantifying the size of the problem rather highlighting cost-effective solutions. Furthermore, health workforce planning models consider each workforce (e.g. doctors) in isolation from other workforces and from the rest of the health care system. They ignore the effect of more doctors and nurses on health outcomes and costs.
The health workforce is embedded in the provision of services to patients which ultimately try to improve health outcomes of the population using the resources available. It is essential to be able to analyse health workforce requirements in the context of the broader health care system. This thinking should flow through to the type of quantitative approaches being used in health workforce planning, and the type of data being used to support it.
A key issue in determining the future direction of health workforce planning is the clear articulation of the types of policy questions it should address. This would help to guide the collection and use of data and modelling beyond the current forecasting approaches, towards being able to help address a wider range of more pertinent policy questions.