Health workforce and access
A count of physicians in a region gives the number of licences. The number who see patients there, the number who stay, and the number of patients each one can take sit in other records. DDA examines recruitment, workforce supply, facility capacity, and the distance between people and services. This page covers workforce, capacity, and access. It does not cover clinical practice or the quality of care.
01 The delivery chain
Access to care in a community runs through a chain. A provider is trained and licensed. A community recruits the provider. The provider relocates and starts a practice or takes a hospital role. The provider stays. Facilities, staff, and equipment give the provider capacity to work. Patients then reach the provider within a reasonable distance and time.
A break at any link cuts access. A recruited physician who leaves after two years has cost the community the recruitment effort and left the same gap.
02 The evidence problem
The licensing college counts registrants. A registrant can hold a licence and work elsewhere, work part-time, or work in a role that carries no patient panel. Headcount overstates the supply that a community can use. Full-time equivalent counts come closer. They need a definition, and different sources define them in different ways.
Attachment data shows how many residents have a regular provider. The definition of attachment, and the geography, change from one source to another. Waitlist figures depend on who joins the list.
Hospital facility profiles give bed counts and occupancy. A bed count can differ between sources by one or two beds, and DDA records the source and date of each. An occupancy figure above the planned level shows a facility operating with no surge capacity.
Population figures come in health service area geographies that differ from municipal boundaries. A hospital can serve a catchment several times the size of the town where it sits. DDA states the geography behind every rate.
Comparison communities need a defined basis. A community that recruited well can differ in size, distance from a larger centre, or local incentives. DDA states what a comparison can and cannot show.
03 Where it usually breaks
Retention breaks most recruitment programs. A provider stays when the partner has work, the family has housing and childcare, and the practice model fits. A community that spends on signing incentives and not on retention conditions can fill positions and lose them again.
Practice model breaks continuity. A community that fills gaps with short-term locum coverage keeps services open and builds no panel. The cost is high and recurring.
Facility capacity breaks access even where providers exist. A hospital at full occupancy cannot add services without beds, staff, and equipment.
Distance breaks access at the edge of the catchment. Residents far from the facility can face long travel, road closures, and winter conditions. An average travel time hides them.
Housing and childcare break the recruitment offer. A recruit who cannot find a home does not arrive.
04 What the work can produce
The work can produce a workforce and capacity baseline, a recruitment and retention analysis with comparison communities, a facility capacity and occupancy review, an access analysis by travel time, a supply and demand scenario set, and an indicator set that shows early if retention or capacity is slipping.
05 Connected capabilities and related thinking
This area uses Labour and workforce analysis, Evidence reconstruction, and Land, infrastructure, and spatial analysis. For training pipelines, see Skills, training, and post-secondary. For housing and the supply of homes for recruits, see Housing and municipal planning.
06 Bring the question
Send the recruitment plan, the facility profile, the health workforce report, or the funding proposal. DDA will find the link in the chain that limits access and test what changes it.