Developing Our People, Culture

and Capability

NSW Health Pathology Workforce Strategic Plan

2015 - 2017

Contents Executive Summary .............................................................................................................. 3

NSW Health Pathology Networks and Services .................................................................... 4

Our Workforce and Our People ............................................................................................. 5

Our Workforce ................................................................................................................... 5

Our People ........................................................................................................................ 7

Our Challenges ..................................................................................................................... 9

Technological Advancement .............................................................................................. 9

Strengthening Our Competitive Edge ................................................................................ 9

Health Reforms ................................................................................................................. 9

Demographic Trends ......................................................................................................... 9

Our Workforce Challenges .................................................................................................. 10

Attracting, Recruiting, Developing and Retaining Quality, Competent Staff ..................... 10

Workforce Redesign ........................................................................................................ 11

Workplace Culture Aligned to Our Values ........................................................................ 11

Communicating, Consulting and Collaborating ................................................................ 11

Ensuring a Safe Work Environment ................................................................................. 12

Managing Our Resources Well ........................................................................................ 12

Our People, Culture and Capability Strategic Priorities ....................................................... 13

Appendix A: A Summary of the Key Characteristics of Our Main Job Families ................. 15

Our Medical Workforce .................................................................................................... 15

Our Scientific Workforce .................................................................................................. 15

Our Technical Workforce ................................................................................................. 15

Our Nursing Workforce .................................................................................................... 15

Our Allied Health Workforce ............................................................................................ 15

Our Corporate Support Workforce ................................................................................... 15

Our Other Workforce ....................................................................................................... 15

3

NSW Health Pathology Workforce Strategic Plan

2015 - 2017

Executive Summary The challenges facing the pathology workforce and the health sector more broadly have

been well documented. The key for NSW Health Pathology is to be able to respond to

those challenges both now and in the future.

As at 30 June 2015, NSW Health Pathology employed 4,653 staff across a range of

occupations and professions including scientific, technical, medical, nursing, allied health

and corporate support. The median age of the NSW Health Pathology workforce is 46

years and 72% of staff are female. Seventy-three percent of our staff are employed in

scientific and technical roles. Eighty-six percent are based in metropolitan NSW (ie,

greater metropolitan Sydney, Newcastle and Wollongong) with 70% of staff based in the

greater metropolitan Sydney area.

The average tenure for NSW Health Pathology staff is 11 years. Around 20% of staff

have 20 or more years of service with NSW Health. Twenty-nine percent of staff are aged

55 years or older and are likely (and/or eligible) to retire within the next 10 years. Five

percent of staff are currently aged 65 years or older and able to retire at any time. The

staff turnover rate for NSW Health Pathology is 7.9%.

As a relatively new state-wide organisation, NSW Health Pathology is in a unique position

to respond to the workforce challenges facing public pathology service provision in NSW.

Over the next five to 10 years, significant challenges will arise due to the ageing of the

population and our workforce, the changing nature of service delivery, increasing levels of

automation and other developments in technology and the threat of competition from

private pathology providers. We will require a highly skilled and competent workforce that

is able to readily adapt and respond to these changes and challenges.

The NSW Health Pathology Workforce Strategic Plan 2015 - 2017 aligns to the NSW

Health Pathology Strategic Plan 2014 – 2018. It identifies initiatives to ensure we can

meet our ‘People, Culture and Capability’ strategic directions. That is, to manage our

services appropriately and achieve our key outcomes we need to excel in:

attracting, recruiting, developing and retaining quality, competent staff;

leading research and translating outcomes into practice;

effectively communicating, consulting and collaborating;

creating a positive culture aligned to our values; and

ensuring a safe working environment.

4

Introduction

The impending workforce shortage in the pathology sector, both nationally and

internationally, has been well documented for more than a decade. The predicted

shortage of pathologists and medical scientific workforce in Australia, particularly in rural

and remote locations, is a significant risk to sustainability of clinical pathology services.

Core issues are an ageing workforce and a shortage of qualified pathologists and

scientists. This situation is further compounded by issues such as: high staff turnover;

training and recruitment of blood collection staff, administrative and reception staff;

retention and replacement of staff; costs of on the job training; pathology being an

unpopular residency choice for medical staff; and recruitment of qualified people in rural

and remote areas. The workforce shortage is predicted to reach its peak in the next five

years with up to one third of the pathology workforce expected to leave. It is critical for

NSW Health Pathology to plan to address these issues to ensure we can sustain services

in a changing environment.

The full impacts of technological advancement, contestability, health reforms and

demographic trends over the next decade are not yet known. There is a consensus that

the next five to 10 years will see a period of significant change for public pathology

service provision and require new approaches to workforce issues. This will require

significant and coordinated service planning to understand service needs and inform

workforce planning and redesign to meet those future needs. The NSW Health Pathology

Workforce Strategic Plan 2015 – 2018 represents the first step towards designing our

workforce of the future. It also recognises that changes will begin impacting NSW Health

Pathology over the next three to five years. In that context, the priorities, initiatives and

actions may need to be reviewed to respond to new challenges. For these reasons, this

plan is for a three year rather than a five year timeframe.

NSW Health Pathology Networks and Services NSW Health Pathology provides public pathology, forensic and analytical science

services across the state. It consists of five clinical and specialist networks:

Forensic & Analytical Science Service (FASS);

Pathology North;

Pathology West;

South Eastern Area Laboratory Service (SEALS); and

Sydney South West Pathology Service (SSWPS).

5

Our Workforce and Our People The following information provides a shapshot of our people as at 30 June 2015.

Our Workforce

We employ 4,653 people with a full-time equivalent staffing level of 3,868. Our workforce

consists of 46% of people employed in technical roles, 28% in scientific roles, 12% in

administrative/corporate support roles, 8% in medical roles, 3% in nursing roles and 3%

in other roles. For the purposes of this plan, these roles will be referred to as our main job

families.

Figure 1: Main Job Families – NSW Health Pathology

We employ 87% of our people on a permanent basis, 9% on a temporary basis and 4%

work as casuals. Seventy percent of our people work on a full-time basis and 30% are

part-time.

Figure 2: Employment Status – Main Job Families

Total

Allied Health

Corporate Support

Medical

Nursing

Other

Scientific

Technical

0%

20%

40%

60%

80%

100%

AlliedHealth

CorporateSupport

Medical Nursing Other Scientific Technical

Casual

Part time

Full time

6

A summary of key characteristics of our main job families is included at Appendix A.

We have a relatively stable workforce with an average tenure of 11 years. Around 20% of

our workforce has attained 20 or more years of service.

Figure 3: Tenure – Main Job Families

Our current turnover rate is 7.9% with the most common reason for exiting (other than

resignation) being transfer to other government employment and retirement.

Figure 4: Exit Reason – Main Job Families

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

50-60 years

40-50 years

30-40 years

20-30years

15-20 years

10-15 years

5-10 years

3-5 years

1-3 years

Less than 12 months

0%10%20%30%40%50%60%70%80%90%

100%

Voluntary Redundancy

Transfer

Retrenchment

Retired

Resigned

Medical Retirement

Dismissed

Deceased

Cessation - Casual

7

Our People

Seventy-two percent of our staff are female and 28% are male. Average age is 46 years:

45 years for female staff and 47 years for male staff.

Figure 6: Staff Age and Gender

Gender profile varies across our main job families.

Figure 7: Gender – Main Job Families

0

100

200

300

400

500

600

700

800

20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80-84 85-89

Male

Female

0%10%20%30%40%50%60%70%80%90%

100%

AlliedHealth

Medical Nursing Other Scientific Technical CorporateSupport

Male

Female

8

Five percent of all staff are 65 years or older and are eligible to retire. Twenty-nine

percent are aged 55 or older. Our current retirement rate (ie, the proportion of those

retiring compared with the total number of staff who are eligible to retire with reference to

superannuation preservation age) is 5%. The distribution of people aged 55 years or

older varies across our main job families.

Figure 8: Proportion of Staff Aged Greater than or Equal to 55 years – Main Job

Families

Our people come from diverse backgrounds with 26% from a non-English speaking

background. Less than 1% identify as Aboriginal or Torres Strait Islander and 2% have a

disability.

0%

20%

40%

60%

80%

100%

Allied Health Medical Nursing Other Scientific Technical CorporateSupport

Yes

No

9

Our Challenges We face a number of key challenges that are having, and will continue to have, a major

impact on the pathology and forensic services workforce.

Technological Advancement

Increasing levels of technological change and automation of testing will promote structural

change in our workforce by:

changing the skill sets required;

creating new roles;

increasing demand for some roles; and

reducing demand for other roles.

In particular, advancements in genomics and genetic testing, point of care testing,

nanotechnologies, digital pathology, robotics and automation will have major impacts on the

mix, profile and size of the pathology workforce.

Strengthening Our Competitive Edge

The threat of competition from the private sector requires us to examine our services in new

ways and continually improve efficiency and productivity to ensure we are providing quality

services at exceptional value. This requires us to consider service configuration across the

state and options for standardisation, rationalisation and consolidation of services and tests

– in other words, what tests are performed where and how results are delivered. It is also

important for us to promote the value proposition our public pathology and forensic services

bring to our health and justice systems and to highlight the unique strengths we can offer.

Health Reforms

National health reforms (including the introduction of national funding and pricing models,

and increasing accountability and monitoring of hospitals’ performance) will increase

pressure for pathology to deliver safe and quality services for the lowest possible cost.

Improving our collaboration with internal and external stakeholders will be critical in this

context.

Demographic Trends

Australia’s population growth and the ageing of the population will be significant drivers of

increasing health expenditure over coming decades. Demand management and price control

will become increasingly important in managing health expenditure and will impact both the

demand for pathology services and the pathology workforce.

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Our Workforce Challenges The workforce challenges facing public pathology have been identified in various reports and

forums over the last decade, but as yet have not been addressed in terms of workforce

impact for our organisation.

Attracting, Recruiting, Developing and Retaining Quality, Competent Staff

In a number of locations, it has been identified that we have difficulty recruiting sufficient

skilled staff to meet service needs. Our inability to offer recruitment incentives has been

highlighted as a contributing factor.

The size and number of our rural and regional laboratories combined with the challenges of

maintaining rural services suggest a need for targeted rural packages and incentives for

staff. While some progress has been made across the broader NSW Health system, other

States have done more to address the workforce needs of pathology staff working in rural

and regional areas.

A number of the awards applying to our job families have not been reviewed for many years.

The awards are primarily targeted at hospital-based employment and do not recognise the

changes that have been happening within the pathology workforce. Career pathways are

limited for a number of our professions and occupations. There are also limited training

opportunities and poor succession planning. In particular, the award structure for scientific

staff is in need of urgent review to support a more modern and flexible career structure.

Changing the public perception of pathology from a service that is distant and unrelated to

patient outcomes to something that is critical to the patient journey is also important. Raising

the profile of public pathology and the opportunities and rewards of a career in pathology

needs to be a focus. There is also a need to consider the demands of 24/7 services and

lifestyle impacts of working at night and/or weekends on our workforce.

While we strive to be an organisation that appreciates and reflects cultural diversity, we still

have a lot to do in some areas. We currently exceed targets for employment of women and

people from non-English speaking backgrounds. However, we are significantly below target

for employment of Aboriginal and Torres Strait Islander people.

Skill shortages, knowledge loss and skill depletion are significant challenges we face now

and into the future. This is driven by a highly competitive job market particularly for

specialist skills.

There is concern about the insufficient numbers of pathologists to meet future workforce

needs. The current number of medical training positions is inadequate to meet future

demand for pathologists. While NSW previously has invested in training positions and

opportunities it is clear that more needs to be done. There also needs to be more

investigation into the effectiveness of pre-vocational and post-vocational training

programs for pathologists.

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For scientists, it is generally recognised that university undergraduate training does not

equip students with the necessary skills and competencies required for working in our

laboratories. This means NSW Health Pathology has to increase support for the training

and education of scientists at undergraduate level and provide programs to support the

transition of graduates to laboratory scientific practice.

For technical staff, the cessation of some diploma-level programs within the vocational

education and training system has limited their career advancement. There is also a lack

of vocational training and traineeship opportunities which further impacts technical staff.

The requirements for continuing medical education and continuing professional

development across our medical, scientific and nursing job families as well as allied

health staff also place considerable pressure on NSW Health Pathology to support our

staff to access appropriate development opportunities.

Workforce Redesign

Over the past decade there has been little attention paid to future service provision needs.

Designing the workforce of the future will require significant and coordinated service

planning to understand service needs and inform workforce planning to support those future

service needs. Fundamental to workforce redesign will be service reconfiguration. This work

will be critical in ensuring we have sufficient skilled and trained staff now and in the future.

While natural attrition and career progression will assist in reshaping the organisation and its

workforce, other strategies such as appropriate career transition, accelerated advancement

opportunities and succession planning will also need to be implemented.

Workplace Culture Aligned to Our Values

Our results in the YourSay 2013 workplace culture and engagement survey showed a

positive trend in employee engagement levels between 2011 and 2013. However, the results

indicate that more needs to be done to improve our workplace culture and ensure it is truly

aligned to our values. Significant work has been undertaken to establish a set of

organisational values and to articulate behaviours to promote our values. While our values

have been introduced, more needs to be done to embed our values across all levels of the

organisation. We also need to focus on managing unsatisfactory behaviours in a timely and

transparent manner.

Communicating, Consulting and Collaborating

Consultation with stakeholders has been a key feature of our journey thus far. Peak level

consultative arrangements with unions are in place and working well, these arrangements

support a generally positive and cooperative approach between management, staff and their

representatives.

12

More work needs to be done to build partnerships and collaborative efforts with educational

institutions both within NSW Health and outside NSW Health. In particular, there is

considerable work to be done to build strong partnerships with the Health Education and

Training Institute (HETI), vocational education and training institutions, tertiary education

institutions and relevant professional bodies and associations. Some progress has been

made with the inclusion of NSW Health Pathology on the Health Education and Training

Executive Steering Group. However it will be important to continue to advocate for pathology

staff who are generally underrepresented in terms of focus and attention paid to their specific

and unique education needs.

Ensuring a Safe Work Environment

NSW Health Pathology has made significant progress in the areas of safety, injury

management and workers compensation performance. This has been achieved through the

establishment of an overarching framework, dedicated resourcing and the introduction of

pathology specific policies and programs. However, sustaining these improvements requires

an increased focus on safety and injury prevention and promoting staff wellbeing to support

a move to a ‘safety’ culture.

Managing Our Resources Well

The focus on effective resource management and accountability is paramount. Salaries and

wages constitute around 68% of our overall annual operating expenditure. It is critical that

we continue to focus on being more effective and efficient in managing our staff resources.

Whole of government targets aimed at reducing annual leave are a key focus of current

government initiatives to reduce accrued staff liabilities. NSW Health Pathology has

committed to achieving the targets, however progress has been slow. NSW Health

Pathology will need to refocus its efforts and be more proactive in managing staff leave.

Overtime is another area identified by the NSW Audit Office which needs to be managed

and monitored.

The implementation of new business intelligence [Statewide Management Reporting (SMR)

Services] for NSW Health Pathology is an important first step in ensuring that managers

have a range of data available to assist them with their staff responsibilities. While NSW

Health Pathology has developed a performance framework including a suite of key

performance indicators, workforce analytics and specific workforce indicators must be

developed and reported to focus the organisation on things that matter.

13

Our People, Culture and Capability Strategic Priorities

The following ‘Our People, Culture and Capability’ strategic priorities have been identified to

respond to and address the organisational and workforce challenges facing NSW Health

Pathology over the next five to 10 years.

Our people, culture and capability strategic priorities for 2015 to 2017 are to:

1. Attract, recruit, develop and retain quality, competent staff

1.1. We will actively pursue options to increase the available supply of qualified and

skilled staff.

1.2. We will improve and better target our recruitment strategies and practices.

1.3. We will increase our focus on developing our staff at all levels and provide greater

opportunities for staff to access and participate in training and development

programs.

1.4. We will support our ageing workforce by introducing greater flexibility in work

arrangements (where appropriate) and transition to retirement programs.

1.5. We will review and project staffing needs and gaps to address the impending

workforce crisis and ensure succession planning fills identified gaps.

2. Effectively communicate, consult and collaborate

2.1 We will have effective consultative forums with key stakeholders.

2.2 We will increase our efforts to build partnerships and collaborative efforts with

educational institutions.

2.3 We will seek to ensure that clinical service and workforce planning are highly

integrated to enable us to identify and respond to our future service and workforce

needs.

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3. Create a positive culture aligned to our values

3.1 We will improve our employee engagement levels, our workplace culture and

encourage diversity in our workforce.

3.2 We will seek to increase the proportion of our staff who are Aboriginal and Torres

Strait Islanders.

3.3 We will continue to support women in the workplace.

3.4 We will explore ways to provide better balance between the operational demands of

a 24/7 work environment with needs for flexible work requests.

3.5 We will continue to support people from non-English speaking backgrounds and

people with a disability.

4. Ensure a safe working environment

4.1 We will increase our efforts to promote a healthy and safe work environment.

5. Manage our resources well

5.1 We will develop and report an enhanced suite of workforce analytics and specific

workforce indicators to focus the organisation on our ‘People, Culture and

Capability’ priorities.

Strategic priorities identified in this plan are aligned to our strategic plan and operational plan

priorities. Initiatives to achieve the strategic priorities have been developed following

consultation with internal and external stakeholders. Progress with implementing this plan

will be monitored and reviewed annually.

15

Appendix A: A Summary of the Key Characteristics of Our Main

Job Families

Our Medical Workforce

We employ 367 (309 full-time equivalent) medical staff, who have an average age of 47

years. Forty-eight percent of our medical staff are female with an average age of 44

years. Fifty-two percent of our medical staff are male with an average age of 51 years.

Our Scientific Workforce

We employ 1298 (1141 full-time equivalent) scientific staff, who have an average age of

47 years. Sixty-six percent of our scientific staff are female with an average age of 46

years. Thirty-four percent of our scientific staff are male with an average age of 49 years.

Our Technical Workforce

We employ 2123 (1686 full-time equivalent) technical staff, who have an average age of

44 years. Seventy-nine percent of our technical staff are female with an average age of

44 years. Twenty-one percent of our technical staff are male with an average age of 44

years.

Our Nursing Workforce

We employ 133 (96 full-time equivalent) nursing staff, who have an average age of 52

years. Ninety-two percent of our nursing staff are female with an average age of 52 years.

Eight percent of our nursing staff are male with an average age of 49 years.

Our Allied Health Workforce

We employ 18 (13 full-time equivalent) allied health staff, who have an average age of 37

years. Eighty-nine percent of our allied health staff are female with an average age of 37

years. Eleven percent of our allied health staff are male with an average age of 37 years.

Our Corporate Support Workforce

We employ 573 (503 full-time equivalent) corporate support staff, who have an average

age of 48 years. Seventy-nine percent of our corporate support staff are female with an

average age of 48 years. Twenty-one percent of our corporate staff are male with an

average age of 47 years.

Our Other Workforce

We employ 141 staff (119 full-time equivalent) staff in other categories (including couriers

and trades staff), who have an average age of 53 years. Twenty-eight percent of our

other staff are female with an average age of 50 years. Seventy-two percent of our other

staff are male with an average age of 55 years.