Towards best practice in national health workforce planning

Maureen V McCarty and Bethany J Fenech
Med J Aust 2013; 199 (5): S10-S13. || doi: 10.5694/mja12.10309
Published online: 29 October 2013


This is a republished version of an article previously published in MJA Open

National health workforce planning is not a new concept. In 1995, the Australian Medical Workforce Advisory Committee (AMWAC) was established under the Australian Health Ministers’ Advisory Council (AHMAC) to “assist with the development of a more strategic focus on medical workforce planning in Australia”.1 In 2000, the Australian Health Workforce Advisory Committee (AHWAC) was established by AHMAC to oversee national-level, government-initiated health workforce planning in Australia, covering the nursing, midwifery and allied health workforces. Following a review of AHMAC workforce committees, AMWAC and AHWAC ceased operating in June 2006; however, at the same time, the Council of Australian Governments (COAG) agreed to a significant national health workforce reform package which included the establishment of the National Health Workforce Taskforce (NHWT). The NHWT was a time-limited entity created to develop strategies to meet the National Health Workforce Strategic Framework outcomes.

Each of these organisations carried out national health workforce planning. The importance of national workforce planning is recognised, given the challenges Australia is facing to its health workforce now and into the future. Such challenges are well documented2,3 and include an ageing population; expected increased demand for health services and increasing expectations for service delivery; changing burden of disease; and broader labour market issues. The national health reform agenda also reinforces the importance of national workforce planning. The majority of health expenditure relates to the health workforce,4,5 so any system reform subsequently has an impact on workforce. For example, many recent reforms have focused on the delivery of primary health care — the introduction of Medicare Locals, GP Superclinics and support for new roles such as nurse practitioners through enabling access to the Medicare Benefits Schedule — all of which will affect the primary care health workforce. The importance of national workforce planning was also reinforced by the National Health and Hospitals Reform Commission, which noted in 2009,

Health Workforce Australia and national health workforce planning

In 2008, COAG agreed to the National Partnership Agreement on Hospital and Health Workforce Reform, which acknowledged that a national, coordinated approach to health workforce reform with a particular focus on linking efforts of health and higher education sectors was necessary. Subsequently, Health Workforce Australia (HWA) was established as the national agency to progress health workforce reform in Australia and address the challenges of providing a skilled, innovative and flexible health workforce. HWA is a Commonwealth statutory authority, the HWA Board is its governing body, and HWA reports to the Standing Council on Health (SCoH, previously the Australian Health Ministers’ Conference).

The Australian Health Ministers’ Conference commissioned HWA to undertake a workforce planning exercise for doctors, nurses and midwives over a planning horizon to 2025. This project was to present (and measure) possible future health workforce outcomes and training implications under a range of workforce planning scenarios. It was initially known as the National Training Plan; however, in recognition of the fact the planning scenarios identify a range of future health workforce outcomes arising from various potential policy options, of which training is only one, the report has been renamed Health Workforce 2025 — Doctors, Nurses and Midwives (HW 2025). HW 2025 was conducted in two phases. Phase 1 developed projections for the size and type of the health workforce (doctors, nurses and midwives) needed to meet future service requirements from 2012 to 2025 under a range of alternative “futures”, including:

Phase 2 modelled the training pipeline necessary to meet the size and type of the health workforce identified in phase 1. That is, it provides the estimated numbers of professional entry students, graduates and trainees (for doctors) required between 2012 and 2025 to achieve a workforce in balance at the end of the planning period. Results of HW 2025 were presented to the Australian Health Ministers through the SCoH in April 2012.

In developing HW 2025, HWA followed a number of key principles to ensure the projections are robust, realistic, sophisticated and able to be applied nationally.

Key principles
Authoritative national planning approach

While all states and territories have conducted health workforce planning, such planning is for their own specific purposes and is conducted using different datasets, assumptions and methodologies. This means the projections developed are generally not comparable or able to be aggregated to present a national picture. HW 2025 has been developed to be able to provide this authoritative national approach with its use of a consistent methodology and national data.

Looking forward

One of the key principles underpinning HW 2025 is that it will be an ongoing process in which projections will be continually improved. There are several factors that will be pursued with the aim of improving HW 2025 projections.

Consideration of skills or competency-based planning

In Australia, it is recognised that in addition to this form of traditional workforce planning methodology, there is a need to enable planning for the health roles and models of service delivery that will best meet the needs of consumers and be responsive to regional planning requirements.9 In addition to workforce planning, HWA has a focus on workforce innovation and reform to encourage the development of health workforce models to support new models of health care delivery. The workforce modelling tool developed as part of HW 2025 will be able to test and evaluate the likely impact of reform predictions and theories.


There is an ongoing need for health workforce planning to meet the challenges the Australian health workforce is facing now and in the future. Health workforce projections provide a tool to enable planning by highlighting areas of potential workforce imbalance that may call for government intervention or reform. While health workforce projections have been generated at national and state and territory levels previously, this was often done using different datasets, assumptions and methodologies, making it difficult to provide a nationally coherent view of the future health workforce. Through HW 2025, HWA is developing a set of nationally authoritative, consistent and coherent health workforce projections that can be used for health workforce planning. In particular, the iterative nature of HW 2025 provides a means for planners to monitor the impact of incremental adjustments to the health workforce, taking account of significant changes in the health system or underlying social and economic environment.

Provenance: Commissioned; externally peer reviewed.

  • Maureen V McCarty1
  • Bethany J Fenech2

  • Health Workforce Australia, Adelaide, SA.


Competing interests:

No relevant disclosures.


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