An evaluation of New Zealand’s iterative Workforce Service Reviews: a new way of thinking about health workforce planning

Abstract

To ensure New Zealand's health workforce was fit for purpose, Health Workforce New Zealand (HWNZ) funded Workforce Service Reviews (WSRs) to develop visions for service reconfiguration and workforce for 2020. This paper describes what makes the WSR processes work, for whom, and in what circumstances. Semi-structured interviews informed by a realist evaluation approach were conducted to obtain perceptions and experiences of WSR participants from four WSRs: eye health, palliative care, anaesthesia and aged care. The WSR process was a successful means of bringing together professionals from across the health disciplines and building sector capacity to develop new ways of thinking about service and workforce planning. WSRs were constrained by: mixed signals about process and outcomes; being challenged not milestone focussed; lacking clarity about ownership of visions; and variable clarity about next steps. WSRs were optimised by having: a lead clinician with policy know-how, ability to inspire, bring people together, distil ideas into coherent frameworks; and a project manager with project enablement skill sets and expertise in complex systems, implementation, change management. Evidence now exists at a point in time about what makes the WSR processes work. Implications for HWNZ are presented using a capacity-building framework to inform future decision making regarding WSRs. WHAT IS KNOWN ABOUT THE TOPIC? More appropriate workforce planning is required to meet the challenges facing the health workforce, from both the demand and the workforce side. To ensure New Zealand's healthcare workforce was fit for purpose, HWNZ initiated an iterative WSR process in topic specific areas. The WSRs process was designed to develop a vision of the relevant health service and workforce for 2020, and models of care that were patient-centred and team-based. WHAT DOES THIS PAPER ADD? The paper provides evidence that the WSR process was a successful means for bringing together professionals from across the health disciplines and building sector capacity to develop new ways of thinking about service and workforce planning. The paper presents key enablers of, and barriers to, the WSR iterative process. WHAT ARE THE IMPLICATIONS FOR PRACTITIONERS? The evaluation revealed that a multitude of factors can influence the capacity of the WSR process at the individual (workforce skills and abilities), organisational (leadership and interactions) and systems (infrastructure) levels. Implications for HWNZ on ways to build the capacity of the WSRs according to three capacity-building dimensions are presented to inform future decision making.