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29 February 2012

Dear Colleague

Science and Technical Workforces

In August 2011, Health Workforce New Zealand (HWNZ) established a health and education sector working group to consider how education, training and workforce planning across the health-related science and technical workforces might be better managed to meet growing demand for services, and toprovide a workforce that is equipped to adapt quickly to changes in technology and models of care.

The Science and Technical Workforces Working Group (the Working Group)was required to provide HWNZ with a report on the above matters by 31December 2011.

The Working Group’s report is attached, along with some specific questions generated by the Working group and its report. We would appreciate your comments on the report and answers to the questions so that we can decide on the next steps.

The closing date for comments is Monday 14 May 2012. Your comments should be emailed to p la nn in g @ h ea l th w o r k f o rce. g o v t .n z . An analysis of the feedback will be provided to the HWNZ Board and a decision will be made on the next steps. Information about the next step will be sent to you. We expect this to be in June or July 2012.

Yours sincerely

Brenda WraightDirectorHealth Workforce New Zealand

Science & Technical Workforces Working Group Report (December 2011)Health Workforce New Zealand 2

HEALTH SCIENCE AND TECHNICAL

WORKFORCES WORKING GROUP

REPORT TO THE HEALTH WORKFORCE NEW ZEALAND BOARD

December 2011

Contents

1. Executive summary and recommendations

2. Background2.1 Science and technical workforce

2.2 Health Workforce New Zealand’s view

2.3 The Science and Technical Workforces Working Group

3. Defining the science and technical workforces

4. Aims

5. A science and technical workforce model for New Zealand

5.1 A model for the science and technical workforce

5.2 Science and technical workforce planning

6. Recommendations

Appendix 1: Science and Technical Workforces Working Group Terms ofReference

Appendix 2: Science and Technical Workforces Working Group members

Appendix 3: Health sector science and technical professions list

Appendix 4: Regional training hubs


1. Executive summary and recommendations

The health-related science and technical professions comprise over 20 occupational groups of regulated and unregulated professions. Many of the science and technical occupational groups are small, and many often work in isolation.

New Zealand’s ability to meet future demand for science and technical workforces is compromised by the size and the level of training required for some professions and by the exclusion, in some cases, of the relevant science and technical professions from the development of service delivery plans.

Health Workforce New Zealand (HWNZ) established a small working group, for around four months, to consider:

what we want our science and technical workforce to look like in the future

how workforce planning might be improved across the science and technical professions and in relation to workforce planning in otherhealth professions.

Collectively, the working group had a good understanding across a wide range of health-related science and technical professions, their training and service delivery needs.

In this report, the working group suggests the following overarching definitionof ‘science and technical’ professions in the health sector:

Professions that primarily provide technical and scientific expertise to support the diagnosis, monitoring, management and treatment of health conditions independently or in conjunction with other health professionals to ensure safe, effective, quality patient care.

This definition should not be viewed as the final definition, but rather as a starting point.

New Zealand needs a health system and a health workforce that is:

i. fit for purposeii. able to adapt to changing technology and models of care iii. sustainable in the future.

Within this context, the working group believes that New Zealand needs a health science and technical workforce where professionals work to the top of their scope of practice, and where the training and workplace environment supports science and technical professionals to do this.


There are some basic principles that any model for developing and sustaining New Zealand’s science and technical workforce in the future must encompass. These include balancing generalist and specialist training, recognising the value of clinical experience and the impact of clinical training on service delivery and trainers, recognising areas of commonality in training programmes, and encouraging a focus on skill sets rather than professional boundaries.

In relation to workforce planning, the working group believed that there would be merit in a single co-ordinating entity. Such an entity would ensure consistency in the assumptions used for workforce forecasting across the science and technical professions. It would also ensure that workforce planning for the science and technical workforce was not carried out in isolation from other health workforce planning.

The working group suggested that the regional training hubs being established throughout 2011 might be the best place to co-ordinate workforce planning for the science and technical and other health workforces.

Reco mm end ation s

The working group recommends that the HWNZ Board circulate this report for sector comment, particularly:

Is there a need for better co-ordination of workforce planning for the science and technical workforce?

Provide an indication of whether the list of science and technical professions is basically accurate.

Where is there currently multi-disciplinary education and training between different science and technical professions?

Where should there be more multi-disciplinary education and training? Where should the balance lie between a generalist and a specialty

focus in education and training?

Depending on the results of that consultation, the working group recommends a second working group be established to develop a more specific science and technical workforces education and training framework that:

begins to look at profession/service-specific details fosters an environment in which professionals work to the top of their

scope of practice develops mechanisms to ensure that service delivery models are

developed with input from all relevant workforces, including the scienceand technical sector

will provide national body endorsement of national standards of practice (the working group acknowledges that much work will be needed before national standards can be developed and endorsed).

This group will need to draw on profession-specific expertise.


2. Background

2.1 Science and technical workforce

The health-related science and technical professions comprise over 20 occupational groups of regulated and unregulated professions. Estimates of the proportion of the New Zealand health workforce involved in science and technical professions vary, generally ranging between five and 15 percent. Five key variables impact on the estimated figures:

i. Whether the calculation includes or excludes the private health sector.

ii. Whether the calculation includes or excludes administrative employees in the health sector (e.g. District Health Board human resource and finance, and Ministry of Health employees).

iii. The lack of workforce data for some professions, particularly those not regulated under the Health Practitioners Competence Assurance Act 2003.

iv. How ‘science and technical’ is defined.v. The overlapping of roles into technical areas by other professions

(eg nursing scopes working into scientific and technical areas) without reference to the relevant technical and scientific professional body.

Many of the science and technical occupational groups are small. For example, there are fewer than 10 medical photographers working in New Zealand. Science and technical professionals often work alone or in very small groups and therefore have limited peer/professional support.

Because of their size and the level of training required, many of these professions could be considered vulnerable, placing New Zealand at risk of being unable to meet future demand for these professions.

Our ability to meet future demand in the health-related science and technical sector is further compromised by the development of service delivery plans often not involving the relevant science and technical workforces.

In 2007, District Health Boards New Zealand’s (DHBNZ’s) Allied and Technical Workforce Strategy Group identified the key challenges for many of the health-related science and technical workforces in New Zealand’s public health sector. The key challenges were:

workforce supply and demand underdeveloped career pathways lack of training opportunities.1

1 Future Workforce The Technical Health Workforce Employed in DHBs DHBNZ New ZealandJuly 2007


2.2 Health Workforce New Zealand’s view

District Health Boards Shared Services (formerly DHBNZ) advises that the situation was still much the same for these professions in 2011. While individual DHBs may work to address local issues around their science and technical workforces, Health Workforce New Zealand (HWNZ) holds the view that there is little co-ordinated regional or national approach to future workforce planning or training. HWNZ believes there is also little or no co- ordination of common training elements across the science and technical professions in New Zealand.

In HWNZ’s view, supported by some individuals and groups within the health sector, the status quo for the science and technical workforce does not provide the best results for the New Zealand health system or the public. Some within the sector have commented to HWNZ that, currently:

individual practitioners and/or professions are often isolated and lack peer support

there is little co-ordination between training numbers and future workforce planning

there is potential for technology to make some professions obsolete or to merge with or develop into another profession, and the workforce concerned could be more easily redeployed if training were co- ordinated across the science and technical professions

low critical mass of many of the science and technical professions amplifies the impact of workforce shortages and vacancies, and thecapacity for career development and training provision in the profession

there is little flexibility for career changes or working across two or more professions without training for each profession separately

some professions may be trained to a higher level than required in the workplace while others (particularly overseas-trained practitioners) may not be working to the top of their scope of practice for a variety of reasons

some professions are trained in-house with no nationally agreed standard to ensure skills are adequate and transferable to other DHBs/providers.

Due to the small workforces of many of the health-related science and technical professions, a profession may quickly become vulnerable. Key variables that may result in a profession becoming vulnerable include the availability of training courses or positions and new technology, particularly‘unexpected’ technology.

For example, over the last 12-18 months three training providers have discontinued or signalled an intention to discontinue distance learning programmes:

Massey University (New Zealand): medical laboratory science


Swinburne University (Australia): clinical perfusion Monash University (Australia): nuclear medicine technology.

Low workforce demand translates to low enrolment numbers for some science and technical training programmes and programmes are not considered commercially viable.

Where there are viable numbers to establish programmes, the larger technical and scientific workforces have been able to get agreement to new programmes, though often taking several years of approach. Two new programmes scheduled for their first intake of students in 2013 are:

Otago Medical School Postgraduate Diploma in Echocardiography Otago Medical School Masters in Technology (Cardiac Devices).

2.3 The Science and Technical Workforces Working Group

HWNZ decided to establish a working group, for around four months, to:

consider the merits of a base qualification(s) and modular approach to education and training for New Zealand’s science and technical workforces

develop a framework to demonstrate how a base qualification(s) and modular approach might be structured

consider how a single science and technical professional entity might function in the New Zealand context, particularly in providing co- ordinated workforce planning.

A copy of the Science and Technical Workforces Working Group Terms ofReference is attached as Appendix 1.

The working group members were selected with the intention of pulling together a group that collectively had a good understanding across a wide range of health-related science and technical professions, their training and service delivery needs. A list of the Working Group members is attached as Appendix 2.

3. Defining the science and technical workforce

There are two levels to defining the health-related science and technical professions:

i. Defining the ‘science and technical’ health sector as a whole.ii. Determining which individual health professions belong within the

science and technical sector.

While the working group has attempted to address both these aspects, the working group is very aware that the definitions in this report should not be applied too rigidly. The overarching definition and decisions about which professions are included will be further refined if work is done to look at the


education and training curricula and the workplace skill sets required for individual science and technical professions and service delivery areas.

The working group has, as a starting point, developed the following overarching definition of ‘science and technical’ professions in the health sector:

Professions that primarily provide technical and scientific expertise to support the diagnosis, monitoring, management and treatment of health conditions independently or in conjunction with other health professionals to ensure safe, effective, quality patient care.

A list of the science and technical professions (and their descriptions) the working group considers are likely to fit within the science and technical health sector is contained in Appendix 3. Again, this list should not be viewed as complete, but rather as a starting point.

4. Aims

New Zealand needs a health system and a health workforce that is:

i. fit for purposeii. able to adapt to changing technology and models of care iii. sustainable in the future.

Within this context, the working group believes that New Zealand needs a health science and technical workforce that:

provides a clear national standard for the health-related science and technical professions2

allows easier movement between professions to respond to changing demands without having to re-train from the beginning

provides for easier movement from some science and technical professions to emerging professions in the health sector

finds a balance between a more ‘generalist’ approach (to enable a technician to work across several service areas in smaller hospitals or in primary care and community services) and the opportunity to specialise

develops the science and technical workforces in a way that supports smooth adoption of innovation in technology and models of care

2 The inclusion of a ‘national standard’ here is not intended to take over the role of the regulatory authorities in setting scopes of practice and qualifications in relation to professions regulated under the Health Practitioners Competence Assurance Act 2003. Rather it is intended as an overarching, non-profession specific standard on which professions can build profession specific training programmes and standards.


provides co-ordination of workforce planning across the science and technical workforces, and alignment with workforce planning in other health workforces such as medical and nursing

provides a more nationally consistent and co-ordinated science and technical workforce, incorporating career structures that may make these workforces more attractive career options

reduces the impact of training providers discontinuing distance-learning programmes or to help increase enrolment numbers, making distance- learning more viable in the long-term

increases the capacity and capability for smaller hospitals, community health care providers and private hospitals to participate in training, leaving the larger, specialist hospitals to provide the higher level, specialist training

ensures that education and training programmes are consistent with international education and training standards

where appropriate, builds on the existing education and training programmes that are currently accessed

provides equal leverage to existing funding to access professional development.

5. A science and technical workforce for New Zealand

5.1 A model for the science and technical workforce

The working group is clear that there are some basic principles that any model for developing and sustaining New Zealand’s science and technical workforce in the future must encompass. A model must:

maintain a balance between providing generalist education and trainingand the trainees’ desire to focus on a particular area

include workplace clinical training (the ratio of academic to clinical focus will vary between different professions)

recognise that there is not a ‘one size fits all’ model, so the model mustallow for variations and exceptions

provide a framework that individual professions can align their current education and training programmes to, allowing them to identify gaps, areas for improvement, and areas of commonality with other science and technical professions (where education and training programmes could be combined)

encourage a focus on identifying and training required service skill sets rather than on professional titles and boundaries

recognise the impact of training on trainers and service provision recognise the value of and support the trainer.

5.2 Science and technical workforce planning

HWNZ asked the working group to consider whether or not there would be merit in having a single entity to provide workforce planning across all the science and technical professions working in the health sector.


The working group held the view that there would be merit in a single co- ordinating entity. Such an entity would ensure consistency in the assumptions used for workforce forecasting across the science and technical professions. It would also ensure that workforce planning for the science and technical workforce was not carried out in isolation from other health workforce planning.

The working group suggested that the regional training hubs being established throughout 2011 might be the best place to co-ordinate workforce planning for the science and technical and other health workforces.

HWNZ has collaborated with District Health Boards (DHBs), education providers and professional associations to establish four new regional training hubs to support effective health professional training. One of the key responsibilities of the training hubs is to ensure workforce training aligns with national service delivery needs and regional clinical service plans. The hubs are expected to improve the quality and consistency of training programmes, which should enable better use of available resources and reduce duplication. Further information about the regional training hubs is provided in Appendix 4.

The initial focus of the regional training hubs is on pre-vocational medical training, but the intention is for the training hubs to extend their role over time to encompass a range of health professions. The science and technical professions could be incorporated into the regional training hubs in the future. This may provide greater opportunity for including the science and technical workforce in service delivery planning and to improve equity of access to existing funding for professional development across the health professions.

6. Recommendations

The working group recommends that the HWNZ Board circulate this report for sector comment, particularly on the following questions:

Is there a need for better co-ordination of workforce planning for the science and technical workforce?

Provide an indication of whether the list of science and technical professions is basically accurate.

Where is there currently multi-disciplinary education and training between different science and technical professions?

Where should there be more multi-disciplinary education and training? Where should the balance lie between a generalist and a specialty

focus in education and training?

Depending on the results of that consultation, the working group recommends a second working group be established to develop a more specific science and technical workforces education and training framework that:

begins to look at profession/service-specific details


fosters an environment in which professionals work to the top of their scope of practice

develops mechanisms to ensure that service delivery models are developed with input from all relevant workforces, including the scienceand technical sector

will provide national body endorsement of national standards of practice (the working group acknowledges that much work will be needed before national standards can be developed and endorsed).

This group will need to draw on profession-specific expertise.


Appendix 1

TERMS OF REFERENCE

HEALTH SCIENCE AND TECHNICAL WORKFORCES

WORKING GROUP

Introduction

There are over 20 health-related science and technical professions in New Zealand’s health sector, comprising around five percent of our health workforce. Many of the science and technical professions are small in number and they often work in isolation from each other and from other health workforces.

Health Workforce New Zealand (HWNZ) has formed the view that there is little co-ordination between training, service delivery and future workforce planning either within some individual science and technical professions or across different but related professions. HWNZ holds the view that, in many cases, there is little flexibility across the professions to, individually or collectively, adapt quickly to meet the demands of often rapid changes in technology and models of care that may require a new skill set or the redeployment of a workforce made obsolete by changing technology or models of care.

HWNZ believes that New Zealand’s capacity and capability within the science and technical workforce would be improved by a more co-ordinated approach providing nationally consistent training standards across the health-related science and technical professions, greater flexibility for career change, and alignment of training and future workforce planning.

Developing and implementing a co-ordinated approach to training and future workforce planning within the science and technical health sector would be a long-term undertaking. The first step would be to convene a health and education sector working group to identify the challenges and map out a framework for education and training that will fit most of the science and technical professions working in the health sector, with the aim of ensuring the most effective workforce possible for New Zealand.

Role of the Working Group

The Health Science and Technical Workforces Working Group (the WorkingGroup) is established by HWNZ. The Working Group is charged with:

considering the merits of a base qualification(s) and modular approach to education and training for New Zealand’s science and technical workforces


developing a framework to demonstrate how a base qualification(s)and modular approach might be structured

considering how a single science and technical professional entity might function in the New Zealand context, particularly in providing co- ordinated workforce planning.

Accountability

The Working Group is accountable to and provides advice to HWNZ and theHWNZ Board.

Deliverables

The Working Group will identify the health-related science and technical professions working in New Zealand, in both the public and private health and disability sectors. A preliminary list of professions is provided in Appendix 1.3

The Working Group will develop a workforce development / training model for the health-related science and technical professions that:

identifies one or more ‘base’ or ‘core’ level science and technicalqualifications

builds specialty qualifications on to the base level qualifications.

The Working Group will identify any science and technical professions that are unlikely to fit such a model.

The Working Group will assess how such a model might achieve the objectives outlined below, and any other relevant objectives agreed by the Working Group.

The Working Group will consider the merits of establishing a single professional entity to:

provide a support network across the health-related science and technical professions

take on the role of accrediting training programmes to ensure co- ordination, consistency and flexibility so that training programmes adapt to fit changing workforce needs and models of care

provide a central source of workforce information from its membership, which could be used for national planning and evaluation.

The Working Group will provide to the HWNZ Board, within four months of theWorking Group’s appointment, a written final report that:

proposes a workforce development / training model

3 The list of professions initially compiled as Appendix 1 to the Terms of Reference has been superseded by the list of professions and their descriptions provided in Appendix 3 of this report.


comments on how the proposed model might achieve the objectives outlined in the section below

gives the working group’s view on the merits of establishing a singleprofessional entity for the science and technical professions.

Objectives of the training model

The objectives of the training model are to:

provide a clear national standard for the health-related science and technical professions

establish a ‘base level’ of generalist training across the professions or groups of professions, allowing easier movement between professions to respond to changing demands (without having to re-train from the beginning)4

provide easier movement across science and technical professions or from some professions to emerging professions in the health sector

increase the capacity and capability for smaller hospitals, community health care providers and private hospitals to participate in training (including the use of simulation training), leaving the larger, specialist hospitals to provide higher level, specialist training

provide a more ‘generalist’ approach that may enable a technician towork across several service areas in smaller hospitals or primary care and community services as some lower level hospital services are moved into the community

minimise the impact of training providers discontinuing distance learning programmes or help increase enrolment numbers thus making distance learning for other courses viable in the long term

be consistent with moves to bring greater co-ordination and consistency to education and training across medicine (prevocational and vocational) and other health professions.

Composition of the Working Group

Collectively the Working Group will have the following expertise and attributes

knowledge of and expertise in undergraduate health-related science and technical profession education and training in New Zealand and overseas

knowledge of and expertise in postgraduate education and training programmes in the health-related science and technical professions

knowledge of New Zealand’s current health services delivery in both hospital and community settings

an understanding of the health service delivery needs in order to meet future demands reflecting New Zealand’s ageing population and ethnic mix

4 HWNZ recognises that there are likely to be some science and technical professions that will not fit this type of approach. These exceptions should be identified by the Working Group.


an ability to think creatively to provide solutions that are not constrained by traditional health professional boundaries or current service delivery models.

Terms and conditions of appointment

The Director of HWNZ (the Director) will appoint the members of the WorkingGroup.

Any member of the Working Group may at any time resign as a member by advising the Director in writing.

The Director may discharge any member or appoint new members in response to any changes to the key tasks that are being addressed or to replace a member who is discharged or resigns.

The Director will Chair the Working Group. The Chair will preside at any meeting of the Working Group at which they are present and will arrange for their delegate or another Working Group member to Chair any meeting the Chair is unable to attend.

Conflicts of interest

Members must perform their functions in good faith, honestly and impartially and avoid situations that might compromise their integrity or otherwise lead to conflicts of interest.

Members attend meetings and undertake Working Group activities as independent persons responsible to the Working Group as a whole. Members are not appointed as representatives of professional or educational organisations and groups. The Working Group should not, therefore, assume that a particular group's interests have been taken into account because a member is associated with a particular profession, group or training provider.

When members believe they have a conflict of interest on a subject that will prevent them from reaching an impartial decision or undertaking an activity consistent with the Working Group’s functions, they must declare that conflict of interest and withdraw themselves from the discussion and/or activity.

Servicing and funding the Working Group

HWNZ will provide administrative, policy and analytical support to the WorkingGroup.

HWNZ will fund travel and associated costs for three face-to-face Working Group meetings over the four month period of the Working Group’s appointment. HWNZ will also fund costs associated with additional Working Group meetings held via teleconference or video conference within the appointed four months.


Appendix 2

Science and Technical Workforces Working Group

Members

Brenda Wraight (Chair) Director, Health Workforce New Zealand

Alasdair McIntosh Pharmacy Industry Training Organisation

Angela Morgan Cardiac physiology

Howell Round Medical physics

Julia Metcalfe Medical radiation technology and sonography

Mike Powell Anaesthetic technology

Phillip Barnes Medical laboratory science

Health Workforce New Zealand 17

Appendix 3

Science and technical professions descriptions

Profession Definition/description

Anaesthetic technicians Usually work under direct supervision of registered anaesthetists in both public & private settings. They assist anaesthetists, prepare operating theatres and clinics for anaesthetic procedures. This includes, but is not limited to, the insertion of indwelling canulas such as intravenous lines, insertion of nasal temperature probes into nasal cavities, use of a haemocue for blood sampling to establish biomedical profiles, insertion of intra-oral devices to maintain airway flow, responsibility for operation of anaesthetic machines that maintain airway flow during anaesthesia.

Audiologist Study, identify, measure & treat hearing disorders, provide hearing aids & other listening devices to assist those with hearing loss. May include workplace & classroom assessments of sound levels.

Audiometrists Performs hearing evaluation on adults and hearing aid fitting services

Biomedical engineers & An interdisciplinary field in which the principles, laws, and techniques of engineering, physics, chemistry, and otherbiomedical electronic technicians physical sciences are applied to facilitate progress in medicine, biology, and other life sciences. Biomedical

engineering encompasses both engineering science and applied engineering in order to define and solve problems in medical research and clinical medicine for the improvement of health care. Biomedical engineers must have training in anatomy, physiology, and medicine, as well as in engineering

Cardiac Sonographers Sonographers that specialise in the anatomy and function of the heart. Use equipment to examine and evaluatethe heart's chamber size, muscle and valve function, blood flow & arrangement of the parts. Cardiac sonographers do not generally make diagnoses, they report findings to a cardiologist for analysis/diagnosis.

Clinical Dental Technicians Provide prosthetics appliances to patients and provide technical support to other clinical and Lab staff

Clinical perfusionists Members of the open heart surgery team, mainly responsible for the heart-lung machine. Uses a number of technical, mechanical & electronic devices to ensure oxygen reaches the patient's body through the blood, even when the heart and lungs are not functioning, and controlling the machinery that temporarily takes over a patient's respiratory and/or circulation of blood during open heart surgery.

Science & Technical Workforces Working Group Report (December 2011)

Science & Technical Workforces Group Report (December 2011)Health Workforce New Zealand 18

Clinical physiologists: Cardiac Respiratory Sleep

Three scopes of practice: Cardiac, Respiratory and Sleep. Responsible for diagnostic testing, descriptive analysis of results and interpretation of diagnostic tests. Responsible for invasive and non-invasive procedures, for assessing treatment options and providing assessment and management of long term treatment where technological devices are the chosen therapy for a medical condition; i.e.: pacemakers, implantable cardiac defibrillators, continuous positive airway pressure support, non-invasive ventilation.

Cytogeneticists Detects and analyses hereditary diseases and abnormalities, through studying chromosomes obtained from samples of blood, bone marrow, body fluid, amniotic fluid or foetal tissue.

Dental hygienists Treat gum disease and help people maintain good oral health. Tasks may include assessing and provisionally diagnosing gum disease, test saliva for tooth decay, take and develop x-rays if registered to do so, whiten teeth, make mouthguards for sports and stents for bleaching teeth, maintain orthodontic appliances for patients.

Dental Technicians Provide lab support to clinical dental technicians

Dental therapists Provide children and adolescents with routine dental care and refer patients for more specialist dental care. Tasks may include restoring teeth, providing preventive treatment, extracting first teeth with local anaesthetic, taking x- rays of the mouth, providing education and promotion in the community and to individuals.

Gastroenterology scientists &technicians

Use technical mechanical and electronic instruments to measure various parameters within the digestive tract

Genetic associates Work with individuals, couples and families to provide risk assessment, genetic information and support. Associates work closely with consultants from other specialties and genetic testing laboratories.

Magnetic resonance imaging technologists

Use MRI scanners, radio frequency waves and magnetic fields to diagnose possible injury or disease.

Medical laboratory scientists &technicians

Scientists who work with pathologists and carry out laboratory tests on blood, tissue and other samples taken from patients. Tasks may include using and maintaining specialised laboratory equipment, evaluating results, communicating results to hospital. Technicians help scientists and pathologists with tests and other duties in a diagnostic medical laboratory.

Medical photographers Produce accurate and objective images that record injuries, diseases, the progress of medical procedures / operations. Images can be used for measurement and analysis, to accompany medical / scientific reports, articles and research papers.

Medical physicists Professionals with education and specialist training in the concepts and techniques of applying physics in medicine.


Medical physicists working in the clinical environment are health professionals, with education and specialist training in the concepts and techniques of applying physics in medicine, competent to practice independently in one or more of the subfields (specialties) of medical physics.

Medical radiation technologists Produce diagnostic radiographs or carry out diagnostic procedures either independently or in collaboration with a radiologist or other medical practitioner. They evaluate the diagnostic quality of the images and take corrective measures as required. The practice of Diagnostic Imaging General Technologists involves the use of ionising radiation which may include CT, mammography, lithotripsy and angiography. Responsibilities may also include Intravenous luer placement, and other duties as requested within workplace guidelines by an attending radiologist, medical practitioner or employer. Diagnostic Imaging General Technologists must demonstrate competencies in patient care, patient positioning, use of imaging technology, radiation safety, clinical responsibility, organisation for the examination, and quality assurance.

Neurophysiology scientists &technicians

Responsible for diagnostic testing on central and peripheral nervous system, descriptive analysis of results and clinical reporting . Intra-operative monitoring of spinal cord functioning in orthopaedics and Neurosurgery and Neurosurgery

Nuclear medicine technologist Use radiopharmaceuticals in the diagnosis and treatment of disease. The practice involves the manufacture, administration, imaging and quantification of diagnostic radiopharmaceuticals to demonstrate organ and molecular function as well as the delivery of therapeutic radiopharmaceuticals to treat a number of pathologies. Involved in the operation of gamma and PET imaging systems with or without sealed sources of radioactive materials or X-ray tubes for attenuation correction, anatomical fusion, transmission imaging or diagnostic CT ( when appropriately trained). Competencies include but are not limited to patient care, patient positioning, preparation and administration of radiopharmaceuticals, radionuclide safety, radiation safety, clinical responsibility, organization for the examination, in vitro diagnostic testing , radionuclide therapy and quality assurance.

Orthotists & prosthetists Orthotists makes braces or devices, like special footwear, to aid or correct skeletal injuries or problems. Prothetists make artificial limbs.

Pharmacy technicians Assist pharmacists with the dispensing of prescription medicines. This may include all parts of the dispensing process but is always done under the direct personal supervision of a pharmacist.

Radiation therapists Primarily concerned with the planning and implementation of radiation treatment and issues of care and wellbeing of people diagnosed with cancer and other conditions undergoing radiation therapy. They plan and apply ionising radiation to patients in accordance with the prescription of an Oncologist. Radiation Therapists provide specific care to patients prior, during and after treatment, educating patients in regard to procedures as well as how to deal with radiation reactions. Radiation Therapists must demonstrate competence in patient care, treatment design and delivery and radiation safety, clinical responsibility, organisation of the treatment, and quality assurance.


Renal dialysis technicians Operate dialysis equipment that remove extra fluid, salt and other waste from the blodd while maintaining levels of certain other chemicals. They prepare patients for dialysis, monitor the patient and the dialysis machine, and keep the machine in good working order.

Sonographers Operate ultrasonic imaging devices to produce diagnostic images, scans, videos, or 3D volumes of anatomy and diagnostic data. Sonographers view, analyse and modify the scan to optimise the information in the image. Mustbe registered with the medical Radiation Technologists Board and have passed an examination that is approved by the Medical Radiation Technologists Board or awarded and exemption to practise by the board

Sterile service technicians Performs and has operational responsibility for technical procedures related to the preparation of sterile instruments, supplies and equipment for use in medical and surgical procedures: maintains environment integrity and equipment of sterile supply services. Operates sterilisers and all processing equipment. Performs technical and mechanical work in the inspection, decontamination, servicing and equipment. Ensures instruments andequipment are operating properly prior to issuing. Provides instrument picking and case cart packing to support the efficient and timely provision of instruments and sets to theatres, ICU's and ED's.

Vision Hearing technicians Provide screening according to the National Vision Hearing Screening Protocols (those employed/contrated byDHBs).

Health Workforce New Zealand 21

Appendix 4

Regional training hubs

(Source: h tt p:/ /www.h e a lth wo rkf o rce.go vt.n z/ou r -wo rk/reg ional -train ing-hub s)

Health Workforce New Zealand (HWNZ) has collaborated with District Health Boards (DHBs), education providers and professional associations to establish four new regional training hubs (hubs) to support effective health professional training.

The four hubs, each covering a population of approximately one million people, cover the 20 DHB regions:

Northern (Waitemata, Auckland, Counties Manukau and Northland DHBs) Midland (Waikato, Taranaki, Lakes, Bay of Plenty and Tairawhiti DHBs) Central (Midcentral, Whanganui, Hawkes Bay, Wairarapa, Capital and Coast,

and Hutt Valley DHBs) South Island (Southern, Canterbury, South Canterbury, West Coast and Nelson

Marlborough DHBs).

Initial project plans and governance structures were developed in the first half of 2011 and it is expected that all four hubs will be fully operational by the end of December2011. Each hub has actively involved clinicians in the development process.

Role of th e h ub s

Key responsibilities of the training hubs include:

Standardising training/education programmes using educational principles and assessments in collaboration with the various colleges, educational providers, professional associations, DHBs, PHOs, private sector and HWNZ

Co-ordinating clinical placements to support specialist training programmes Supporting trainees to develop and implement career plans and provision of

mentoring services Providing peer reviewing learning opportunities Sourcing traditional and non traditional accredited student placements Ensuring workforce training aligns with national service delivery needs and

regional clinical service plans Administering workforce initiatives, e.g. voluntary bonding, leadership

development, Advanced Trainee Fellowship Scheme and support for HWNZ innovations such as the Physician Assistant role.

Implementing and overseeing a national skills and simulation based education strategy.

The hubs are expected to improve the quality and consistency of training programmes which should enable better use of available resources and reduce duplication.

Through regional collaboration and co-ordination they can offer more varied and flexible support for trainees and improve the skill level of trainers and mentors. This new approach should ensure a more effective and efficient way of supporting health

Science & Technical Workforces Working Group Report (December 2011)

professionals on their educational journey and closer alignment between clinical training and service delivery needs.

Sta tu s of th e h ub s

The integration and coordination of pre-vocational medical training is a priority for the four hubs but all will have responsibility for all clinical training. The Midland, Central and Southern hubs are taking the opportunity to use a multi-disciplinary approach from inception, while the Northern hub has broadened its scope to also include allied health and nursing.

The Northern and Midland hubs are undertaking specific project work for medicine, with PGY1 and PGY2 standardisation, and project work for the nursing and midwifery and allied and technical workforces.

The Central and Southern hubs have drafted project plans and are discussing them with local stakeholders ahead of sign-off by their DHB Chief Executives in their regions. This is expected to be finalised by mid-November 2011.

All hubs are in the process of developing career planning processes which will become a HWNZ expectation for all trainees that it funds from 1 January 2011 onwards.

Ove rsi gh t of th e hub s

Each hub has its own local governance arrangements, integrated into regional decision- making systems and ensuring involvement of relevant stakeholders.

HWNZ will:

provide strategic direction and maintain a monitoring and oversight role work closely with the hubs individually and collectively through the establishment

phase provide ongoing guidance and support for clinical and academic matters relating

to the implementation of regional training plans.

HWNZ has worked with the National Health Board to develop a reporting framework aligned to existing processes through which the hubs will report progress from 1 July2012 on a number of specific workforce priorities such as career planning and implementation for PGY1 and PGY2. HWNZ will seek input from the hubs in determining the hubs’ other priorities for the immediate, medium and longer term.

Science & Technical Workforces Working Group Report (December 2011) Hea l t h W o r kf o r ce N ew Zeal a nd 22

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