1. PREPARED BY Health Workforce New Zealand Addressing Workforce Challenges Dr Ruth Anderson Acting Director Health Workforce New Zealand

2. WORKFORCE CAPACITY Capacity is limiting factor for National Bowel Screening programme Gastroenterologists (3 lists per week) - undertake approx. 60% of colonoscopies - registrar training duration average of 6 years - lead providers of colonoscopies in urban areas General Surgeons (1 list per week) - undertake approx. 40% of colonoscopies - registrar training duration average 5 years - lead providers of colonoscopies in rural and regional areas - increased pressure for surgical interventions Pathologists and Allied Health Science and Technical Workforces– expected shortages in face of increased demand 2

3. CURRENT STATUS GASTROENTEROLOGISTS: Numbers 3

4. CURRENT STATUS GASTROENTEROLOGISTS: Age Group 4

5. CURRENT STATUS INTERNAL MEDICINE (inc Gastro): Exit Rate 5

6. CURRENT STATUS GENERAL SURGEONS: Numbers 6

7. CURRENT STATUS GENERAL SURGEONS: Age Group 7

8. CURRENT STATUS GENERAL SURGEONS: Exit Rate 8

9. GASTROENTEROLOGY AND GENERAL SURGICAL REGISTRAR TRAINING GASTROENTEROLOGY Currently training 4-5 Gastroenterology registrars per annum Expected to increase to 6 Gastroenterology registrars per annum by 2016 Attrition rate 23.5% for specialists 30-34 years, 9.7 % at 35-39 years GENERAL SURGERY Currently training 20 General Surgery registrars per annum No projected increase in registrar numbers Attrition rate 27.3% for specialists 35-39 years, 22.1% at 35-39 years 9

10. CURRENT STATUS PATHOLOGISTS: Numbers 10

11. CURRENT STATUS PATHOLOGIST: Age Group 11

12. CURRENT FUNDING SUPPORT FOR TRAINING Health Workforce allocates $120 million for medical vocational training (Total Budget $178 million) DHBs provide salary component HWNZ Funding per annum for training only: Gastroenterology $42,518 per registrar General Surgery $57,994 per registrar 12

13. HEALTH WORKFORCE NEW ZEALAND’S ROLE To continue to work closely with stakeholders (training organisations (including colleges) employers, unions, associations, etc.) to provide coordinated: o workforce development interventions, and forward planning o proactive resolution of workforce challenges and issues Fund postgraduate professional health training and lead development of ‘extension of scope’ professional opportunities Assess strategic workforce needs, suitability for future purpose, and lead future planning Enhance, support and mandate regional initiatives Advise Minister, DG, DHBs and the wider sector on workforce 13

14. ACTION REQUIRED FOR NATIONAL BOWEL SCREENING PROGRAMME A commitment on part of all stakeholders to: Increase number of Gastroenterology and General Surgical Registrars Reduce new specialist attrition rates, particularly in 30-34 year age group Increase capacity in Pathologist, and Allied Health Science and Technical workforces Provide support for training by other health practitioners e.g., nurse endoscopists (potential to contribute 10-15% of colonoscopy demand) 14