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Introduction

21 st Victorian Rural Doctors Conference Rural and Regional Workforce Status: What are the trends? May 2013. Introduction. Presenting some broad trends in the Victorian rural & regional GP workforce Looking at past 10 years (2002-2012) Data from various sources but predominantly:

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Introduction

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  1. 21st Victorian Rural Doctors ConferenceRural and Regional Workforce Status: What are the trends?May 2013

  2. Introduction • Presenting some broad trends in the Victorian rural & regional GP workforce • Looking at past 10 years (2002-2012) • Data from various sources but predominantly: • RWAV Medical Practice Update (annual census amongst RA2-4 practices) • RWAV GP Workforce & Skills Update (annual survey amongst RA2-4 GPs, last 3 years approx. 75% response rate) • ABS census data • DoHA GP workforce statistics (based on Medicare data)

  3. Trend 1:Increased numbers of GPs in rural and regional Victoria

  4. Victorian GPs - Head Count & FWE2001-2011 • Growth in Melbourne & Geelong in line with pop growth (18%) • Growth in rural & regional significantly greater than pop growth (6%)  15% 5,020 RA1 – head count 4,362  19% 3,882 Number of GPs RA1 – FWE 3,268  32% 1,690 RA2-RA4 – head count 1,282  35% 1,181 877 RA2-RA4 – FWE Source: Australian Government of Department of Health and Ageing 2011, General Practitioner Statistics, http://www.health.gov.au/internet/main/publishing.nsf/Content/General+Practice+Statistics-1

  5. GP (FWE):Population by Remoteness AreaVictoria Source: Australian Government of Department of Health and Ageing 2011, General Practitioner Statistics, http://www.health.gov.au/internet/main/publishing.nsf/Content/General+Practice+Statistics-1 Australian Bureau of Statistics, Census 2001 and 2011, Population by Remoteness Areas, 30 April 2012 http://www.abs.gov.au/AUSSTATS/abs@.nsf/DetailsPage/3218.02010-11

  6. Trend 2:Increased numbers of OTDs in rural and regional Victoria

  7. GPs - Head Count by ATD/OTD2002-2012  OTDs comprise 38% of the total Victorian GP workforce Victoria (all)  25% 7,033 Total – head count 5,637 Australian trained – head count  2% 4,392 4,321 Number of GPs  101% 2,641 Overseas trained – head count 1,316 Source: Australian Government of Department of Health and Ageing 2011, General Practitioner Statistics, http://www.health.gov.au/internet/main/publishing.nsf/Content/General+Practice+Statistics-1

  8. Proportion of OTDs in GP Workforce  OTDs comprise 46% of the rural and regional Victorian GP workforce Victoria (RA2-RA4) Source: RWAV Database, accessed 1st May 2013.

  9. OTDs Working in RA1 vs RA2-52002-2012 • Note however: • Over the past 10 years 4,570 new OTDs in AUSTRALIAN GP workforce • 2,700 of these (59%) working in RA1 (major cities) Source: Australian Government of Department of Health and Ageing 2011, General Practitioner Statistics, http://www.health.gov.au/internet/main/publishing.nsf/Content/General+Practice+Statistics-1

  10. Trend 3:GPs are working fewer hours

  11. Mean Hours Worked (excluding on-call) • GPs reduced their working hours by (mean average) 2.6 hours/ week over past 10 years • This equates to ≈ 110* fewer FTE GPs • Similar data for all Australian GPs • (3.4 hr/ week decline from 1999-2009)1 • Attributed to : • increasing proportion of females in workforce • ageing workforce • changing work-life expectations Victoria (RA2-RA4) Mean average hours worked per week Source: RWAV Database, accessed 1st May 2013. *Based on 1FTE=35 hours/ week X 48 weeks 1Joyce, C. (2012). The medical workforce in 2025: what’s in the numbers? MJA Open 1: Suppl 3.

  12. Trend 4:Feminisation of the GP workforce

  13. Proportion of Females in GP Workforce  Females comprise an increasing share of the rural & regional GP workforce Victoria (RA2-RA4) Source: RWAV Database, accessed 1st May 2013.

  14. Proportion of Females Commencing Medical Studies  This trend will continue for some years Australia Source: Medical Training Review Panel. Fifteenth report. Canberra: Commonwealth of Australia, 2012. Figures from 2011-2016 projected.

  15. Proportion of GPs Working Part-Time Victoria (RA2-RA4)  Females significantly more likely to work part-time Source: RWAV GP Workforce & Skills Update 2012.

  16. Trend 5:Ageing of the GP workforce

  17. Age of GPs Victoria (RA2-RA4) Victoria (RA2-RA4) Mean average age (years) % of GPs in age bracket  Around 1 in 3 GPs aged 55+ years Source: RWAV Database, accessed 1st May 2013. Australian Government of Department of Health and Ageing 2011, General Practitioner Statistics, http://www.health.gov.au/internet/main/publishing.nsf/Content/General+Practice+Statistics-1

  18. Mean Weekly Hours by Age Group Victoria (RA2-RA4) Mean average hours worked per week • 55-64 year olds work the longest hours • In 20 years, will today’s 35 year old GP work the hours of today’s 55 year old GP? Source: RWAV GP Workforce & Skills Update 2011.

  19. Trend 6:Decline in practise of procedural skills

  20. Procedural Skills % of GPs claiming to regularly practise skill Victoria (RA2-RA4) decline (n=847) (n=567) (n=517) decline steady decline • An RWAV survey in 2012 suggests OTDs with obstetric procedural skills are deterred by complex/ expensive registration & retraining process Source: RWAV GP Workforce & Skills Update 2002, 2007, 2012.

  21. Trend 7:Growth in corporate practice numbers

  22. Corporate Practices Corporate Victoria (RA2-RA4) Solo Victoria (RA2-RA4) Corporate ownership as a % of all practices Solo practice as a % of all practices • Number of corporate practices has tripled over past 5 years Source: RWAV Medical Practice Update 2007-2012. Corporate and solo practices are self-defined by the practice from a list of response options.

  23. Trend 8:Growth in medical students

  24. Medical Graduates from Australian Universities 2006-2016  143% 3,970 Number of medical graduates  144% 3,254 Total Domestic 1,633 1,335  140% 716 International 298 Source: Medical Training Review Panel. Fifteenth report. Canberra: Commonwealth of Australia, 2012. Figures from 2011-2016 projected.

  25. GP Specialty TrainingGP trainees as a % of all advanced training positions • Less than 1 in 3 medical students enter GP advanced training • Data from the VicNet survey of new AGPT entrants : • up to 50% of those choosing rural pathway did so because did not get into 1st choice • compared with <10% for general pathway entrants Australia GP trainees as a % of all advanced trainees Source: Medical Training Review Panel. Fifteenth report. Canberra: Commonwealth of Australia, 2012. Figures from 2011-2016 projected.

  26. Summary & Future Challenges • Significant increase in GPs in rural & regional Victoria over past 10 years • RA2-4 GP: population ratios comparable to RA1 (approx 5% less) • ‘Pockets of maldistribution’ persist however at the local level • Have highlighted some future challenges – reduced working hours & procedural skills, feminisation & ageing of the workforce • Increased medical graduates coming through the pipeline • How do we: • encourage them to train as GPs? • encourage them to work in rural and remote areas?

  27. RWAV’s Involvement in Workforce Support • Workforce planning and annual MDS • Research partnerships with universities - eg nursing & AHP workforce retention • Work collaboratively with uni rural health clubs & National Rural Health Students’ Network • Work in partnership with the Victorian RTPs under the VicNet banner to promote the AGPT program • Work with practices, health services, Medicare Locals and other organisations to recruit and support GPs, locums, nurses & AHPs • Work in partnership with VACCHO and ACCHS to support and develop the capacity of the Aboriginal health workforce

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