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The AGPT Workforce Planning and Prioritisation (WPP) project aims to deliver robust, independent, evidence-based advice to DoHAC and the GP specialty Colleges to inform AGPT training placement priorities.
By looking at these two elements together, the WPPOs aim to identify upcoming areas of need for GP trainees to future-proof healthcare services for communities across Australia.
The common approach across the various WPPOs involves a workforce needs and training capacity assessment using data obtained from the Commonwealth at a GP catchment level. The size and breadth of the separate jurisdictions necessitates a different form of data collection and evaluation across the country. In Victoria, for example, there are 153 GP catchments. These are non-overlapping geographical areas that depict a boundary to show where patients will generally travel to access most of their GP services.
It’s important to understand that this analysis is being done at the GP catchment level, and not within a GP practice itself.
The WPP team aims to provide the Commonwealth with accurate information about community need for the GP workforce, collating demographic data, population data and qualitative data from broad regional consultation to identify supply, demand and training capacity. Then there is an analysis of the gap between demand and supply in a GP catchment, drawing on supply indicators such as the number of GPs in a catchment, the FTE of GP’s, and the number of services that are being provided to patients based on Medicare data. At the end of the workforce needs assessment, the WPPOs will compare and contrast GP catchments to provide a workforce need ranking based on the data looking at demand and supply.
Looking at training capacity and training quality in the catchments is a key element of the WPP.
So how does the WPPO work out what training capacity looks like and how do they measure it?
There is as yet no fixed method of performing the WPP grant activities.
Measuring training quality is something the WPPOs are only now developing and working on. They are really happy to hear feedback on what “quality training” means to different people, which underpins their need to engage with supervisors, GPs, practice managers and registrars: to make sure they are representing the story of their catchments appropriately. So when they look at training capacity, this is what they have heard directly from you, and from your colleagues and other stakeholders.
These are the important things the WPPOs need to be thinking about:
The WPPOs do not have all of this information available. So they need to engage with key stakeholders within their local communities to understand:
The experience of supervisors and training practices that are currently in place who may not be in areas of need going forward… Is this being taken into consideration?
Are those two reports mutually exclusive to the point where that won’t be factored in workforce and capacity?
No, they’re definitely not mutually exclusive. The WPPOs will be combining workforce need and training capacity to determine one overall priority level.
There will be five priority levels for the GP catchments and each of those priority levels comes with a recommendation that the WPPOs put forward to the Colleges on what needs to be done in this area. For example, priority one catchments have a high workforce need, and an identified high training capacity. So they’re ready to go.
The WPPOs have worked through a scale that also goes down to areas that have got a high need but low capacity. So these are priority areas they need to act on to increase training capacity – and that could be any number of things identified through this report. They might need remote supervision models, they might need more supervisors, there might need to be more practices accredited. There will be possible local solutions provided within each GP catchment.
It is really important that the WPPOs understand the role of the supervisor, the training quality, the satisfaction of our supervisors, and their intent to supervise into the future. All of these factors come into play when talking about future planning to give clarity to what’s happening in these catchments.
WPPOs are also piloting an analysis of Training Pathways as one of the outcomes they want to achieve for GP trainees as part of the WPP is being able to provide a training environment where registrars can train in or complete their whole pathway in one particular region, to help prevent them having to move around all the time.
For those that do want to settle in areas, understanding training pathways and gaps in training pathways will be really helpful and a really useful tool for the Colleges to be able to plan and support registrars as they move through their training.
The next part of the WPP is looking at workforce needs ranking and a training capacity ranking for each GP catchment and translating this into one of five priority levels.
WPPOs will provide the government and GP colleges with advice on current actions, recommendations and future recommendations so they can understand what needs to be done to build capacity in areas that don’t have capacity at the moment.
It is critically important that the WPP team engage with people on the ground at the coalface working in GP practices. They need to talk to registrar’s, supervisors, practice managers and other key stakeholders in this area to identify issues, barriers and solutions and capture this information in their reports that are provided to the Commonwealth and to work with the Colleges to find solutions.
| 1. Supervision | 2. Practice Characteristics | 3. Training Quality | 4. Lifestyle |
|---|---|---|---|
| Access to accredited supervisors | Access to Accredited General Practices (meet RACGP standard) | Are trainees experencing diverse paitent load (e.g. structured) | Access to Housing |
| Capacity to supervise based on clinical workload | Access to Accredited AGPT Training Facilities | Capacity to work across Community facilities (e.g.RACF) | Access to Schools |
| Supervision: Trainee ratio | Active and Accredited AGPT Training Facilities | Access to Childcare | |
| Quality Supervision | Access to Training Space within GP Practices | Access to Aiport | |
| Supervisor Satisfaction | Access to Multidisciplinary Teams | Access to Public Transport | |
| Supervision complexity of Trainees | Sense of Community Belonging (culture) | ||
| Quality Internet Connectivity | |||
| Dinning and Leisure Opportunities | |||
| Sports and Recreation Facilities |
WPPOs need to continue to and already have engaged with current past and future AGPT registrar’s to continue to develop the training capacity rubric. WPPOs really need to engage with those who are coming through the system as well, because things change quite quickly.
WPPOs are engaging with supervisors and practice managers about what impacts training capacity. They know that practice managers run the practices and do a fantastic job, they’re often the first point of call, particularly from a training perspective. So it’s really important to engage with those practice managers who can provide us with that information.
The things that WPPOs want from general practices, supervisors and practice managers, we really want to find out their perspectives. So from a supervisors perspective, what are the things that matter to you, and how can we use that information within our reports. WPPOs want to know about your experiences. They think it is really important to find out the experiences you’re having in regard to supervising, and training your trainees as well as getting some suggestions from you as to how to solve or look at these problems. They don’t know everything, they are asking for that information.
What are some of the things that are missing that you can identify for WPPOs? And solutions?
The best possible way to improve the quality of training?
WPPOs certainly not saying that GP training has been at a poor quality but they are looking to how we can contribute to improvement. WPPOs need to look at continuous improvement and hear from supervisors to get that information that leads to improvement.
What is consistent is that we all want quality practices, quality training and quality supervision.
What would you use to measure quality when WPPOs are talking about quality training, quality supervision? Is there a metric you’re using?
What outcomes would the WPPOs use to measure quality?
WPPOs do not think there is an absolute measure of quality. It’s about talking to registrars and supervisors to try and identify what quality supervision is.
Trainees have different ideas to describe what they think quality is. WPPOs pull all this information together and try to come up with an answer to what we can measure that against.
The matrix below shows a number of different factors that influence the quality and capacity of training. These are indicators that registrar’s say has an impact on where they would choose to go.
| 1. Supervision | 2. Practice Characteristics | 3. Training Quality | 4. Lifestyle |
|---|---|---|---|
| Access to accredited supervisors | Access to Accredited General Practices (meet RACGP standard) | Are trainees experencing diverse paitent load (e.g. structured) | Access to Housing |
| Capacity to supervise based on clinical workload | Access to Accredited AGPT Training Facilities | Capacity to work across Community facilities (e.g.RACF) | Access to Schools |
| Supervision: Trainee ratio | Active and Accredited AGPT Training Facilities | Access to Childcare | |
| Quality Supervision | Access to Training Space within GP Practices | Access to Aiport | |
| Supervisor Satisfaction | Access to Multidisciplinary Teams | Access to Public Transport | |
| Supervision complexity of Trainees | Sense of Community Belonging (culture) | ||
| Quality Internet Connectivity | |||
| Dinning and Leisure Opportunities | |||
| Sports and Recreation Facilities |
This is a national approach. WPPOs are applying the same methodology to look at both rural regional and metropolitan GP catchments.
What WPPOs are hearing and what they are finding is that the situations that WPPOs are dealing with are very different depending on what GP catchments they are working with.
From conversations with colleagues in metropolitan PHN’s that they are experiencing enormous growth in populations in some of the outer corridors around Melbourne and that’s having a big impact on the numbers of GPs that we have available in those areas. It is a real supply and demand issue.
Being able to forecast these sorts of population growth is going to be really helpful when WPPOs are looking at the future placement of AGPT registrar’s, whereas in perhaps some of our rural communities, WPPOs are finding, they have supervision, difficulties trying to provide supervisors in some of these GP catchments, where they have practices that are keen to have GP trainees, but they might be solo practices with limited capacity. So this presents a different and unique challenge in those catchments. It is the same approach, but very different solutions and very different issues that WPPOs need to capture.
What about where there’s huge capacity to train but low workforce need? How do WPPOs preserve that?
Is that something that’s been factored in as at the moment WPPOs have some really engaged supervisors? Obviously, there are members who are very concerned that they won’t have training going into the future and they have set themselves up for it, they’ve gone to great expense and put a lot of investment of time and energy into it.
WPPOs do include these in their recommendations and their priority levels. WPPOs do address catchment areas that have a lower workforce need, and a higher training capacity so that they are flagging these issues with the Colleges so that they’re aware.
One of the reasons WPPOs have different indicators are to looking at quality. This is very important. There’s a need to put registrar’s into certain places where there is workforce need. It is also really important to have a look at the quality of training to make sure WPPOs do not lose that quality of training moving forward.
Ultimately, to have the independence and evidence based information, provided a report to the Colleges around the training capacity and the workforce need. So that then there’s more visibility, more informed information to assist, the decisions associated with distribution, training and support.
WPPO’s have an important role in generating those ratings so that it can then be used for informed decision making with transparency and visibility.
The Commonwealth will be utilising the findings from the WPP organisations to work with the Colleges to inform prioritisation to support a better distribution of GP trainees across the country.
Murray PHN is the lead WPPO for Victoria with experience in servicing and providing support to the Victorian catchment jurisdiction. It is anticipated that there will be some commonalities across each of the jurisdictions but they all have their own respective Workforce Planning and Prioritisation Organisation.
Policy and funding responsibilities, ultimately responsible for the AGPT program and its structure, architecture and resourcing.
Training responsibilities for registrar’s. They manage the program delivery for registrar training, previously delivered by the RTO system.
Organisations undertaking the workforce planning and prioritisation role of identifying workforce need and training capacity. This process is conducted through a robust and independent process in collaboration with stakeholders to have an understanding of the local context in order to support the training and distribution of registrar’s within each of the jurisdictions.
Part of a consortium of Victorian PHNs that are undertaking the WPPO role in capturing workforce need and training capacity information, assessing this information and providing independent reports to the department.
Jodie Green
Email jodie.green@wapha.org.au
Philippa Gately
Email P.Gately@chnact.org.au
April Robinson
Email: april.robinson@ntphn.org.au
Matthew Vincent
Email matthew.vincent@gpex.com.au
Nick Kaine
Email kaine@hrplustas.com.au
Date reviewed: 13 October 2023
GPTA Ltd t/as GP Supervision Australia
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