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Commentary: developing and retaining a public health workforce for the 21st century: readiness for a paradigm shift to community-based public health.

The Partnership for the Public's Health work in supporting partnerships between local health departments and community-based organizations has offered important insights into the difficulties of changing public health practice to a more community-based model. Keys to these difficulties are workforce issues: availability, appropriateness of initial training, recruitment, retention, and issues of continuing education. These challenges and some positive examples are discussed.

California↗
PubMed1996

Allied health workforce shortages: the systemic barriers to response.

Over the last decade, the increasingly severe workforce shortages developing in some allied health professions have drawn the attention of university, government, and institutional researchers and policymakers. A 1991 American Hospital Association survey shows allied health professions dominating the "vacancy rate" list, with physical therapy (PT) and occupational therapy (OT) at the top. Separate surveys have documented growing shortages in the OT and Certified Registered Nurse Anesthetist (CRNA) areas. According to a recent survey by the South Carolina Hospital Association, hospital vacancy rates in OT and PT are particularly severe, but there are also significant shortages in the CRNA and Medical Technologist (ASCP) subfields. The imperatives of cost containment are increasing the demand in South Carolina and elsewhere for rehabilitative and outpatient care provided by many allied health professionals, but there is growing concern that the educational system will not be able to respond adequately to these growing workforce needs. These predictions of growing shortages are further confirmed by recent occupational forecasts issued by the US Bureau of Labor Statistics. Allied health researchers do not completely agree on the reasons for the development of subfield shortages, or on how severe they really are. Improving alternative career prospects for females low public and professional images, and employee burnout, among other factors, have been suggested. A survey of the allied health literature shows four additional broad areas of investigation.

Accreditation↗
PubMed1985

The health workforce. Some structural features illustrated.

A combination of structural features on both the supply and demand side make the labour market for certain health professionals relatively unique. These features are outlined and the occupations identified. The adjustment mechanism in the market for these occupations is considered to be highly responsive to these features; a simple model is outlined. Finally the model is brought to bear on the possible responses to two aspects of the WA market, firstly the perceived 'shortage' of registered nurses and secondly the longer term relationship of supply and demand in an industry with rapidly growing labour supply.

Allied Health Personnel↗
PubMed1994

Health workforce planning: an analysis of employer demand pertaining to the Victorian medical record administration & diagnostic coding workforces.

In 1990, LaTrobe University introduced the world's first Post-Graduate Diploma in Nosology, in response to unmet demand for diagnostic coders in Victoria. After the first graduates entered employment, a two-part study was undertaken. The composition, employment levels and projected institutional demand for the coding workforce (comprising medical record administrator coders, Nosologists and "unqualified" coders) were ascertained. In parallel, the current employment levels and projected demand for the institutional medical record administrator workforce also were investigated. The institutional variables of major health care role, annual inpatient discharges and operating sector were found to impact upon employment levels and demand for both workforces by current, prospective and non-employers. The study identified a minimal projected demand for nosologists, the reasons for which are postulated, and negligible projected demand for nonqualified coding personnel. The results highlight a health current and projected employer demand for both medical record administrators and medical record administrator coders.

Employment↗
PubMed2005

A survey of the specialist public health workforce in the UK in 2003.

OBJECTIVES: To identify the number and distribution of public health specialists in the UK. STUDY DESIGN: Cross-sectional survey. METHODS: Postal survey of UK members and fellows of the Faculty of Public Health and primary care trust directors of public health in England in October 2003. RESULTS: Of 1993 individuals surveyed, 1566 (78%) responded, of whom 1331 reported working as consultants or specialists in public health in the UK. Of the 1331, 891 (67%) were on the General Medical Council Specialist Register, 53 (4%) were on the General Dental Council Register, and 92 (7%) were in the process of applying for the Voluntary Register; 295 (22%) did not appear to be on any professional register or in the process of applying to the Voluntary Register. This equated to a total UK rate of 14.1 per million 'service' public health. There was substantial variation by region from 9.3 per million population in Wales and the South West to 18.0 per million population in the West Midlands and 19.5 per million population in London. An increase of 218 (21%) additional consultants and specialists in public health across the UK would be required to bring other regions up to the level of the highest region. CONCLUSIONS: This survey, although limited, being based on a survey of members and fellows of the Faculty of Public Health, shows that specialist public health is under capacity, is resourced in a highly variable manner, and needs to be built up to meet the challenges we face. A comprehensive workforce plan for public health is urgently needed.

Adult↗