Australia has no centralised, up to date allied health workforce data for workforce planning purposes. Anecdotal evidence from a range of different providers tells us that there is a critical allied health workforce shortage in some professions, but there are limited available data to support or refute this.
The Department of Education Skills and Employment provides analyses of a range of allied health professions, by state, including a national analysis of health workforce shortages, however the most recent publication reflects 2017-2018 data.
For example, today (March 7, 2021), there are about 19000 social workers in Australia (depending on how you count them). In the first week of March, 2021, a search on job site Seek.com.au using the term “social work” yielded over 21,000 job advertisements, including a position paying up to $100,000 and open to final year social work students (see below).
First – a disclaimer – not all of the positions advertised under “social work” were exclusively social worker jobs, and the search output included a small number of roles that were misclassified. But a manual review of the first 2200 jobs (sorted by relevance) shows the huge diversity of roles that are unfilled, and in need of social care input (including case workers, NDIS case managers, foster care coordinators, domestic violence case managers, youth workers, housing officers… the list goes on).
By narrowing the search to “social worker”, the number of advertised positions halved, but even at over 9,000 vacancies (again not all strictly social worker roles), the vacancy rate is nearly equal to the total number of social workers registered with the Australian Association of Social Workers.
A quick scan of other allied health professions tells an equally dire story about allied health workforce shortages (see the summary in the table below). Based on job advertisement data alone, occupational therapy and speech pathology each have vacancies of around 17%; exercise physiology 14%; psychology 12%; and physiotherapy 10%. Aboriginal and Torres Straight Islander Health Practitioners had a staggering 50% vacancy rate- not all positions were for registered professionals – but it shows the challenges of filling positions with appropriately qualified First Nations people.
The Royal Commission into Aged Care Quality and Safety, among other recommendations, highlighted the importance of allied health in the delivery of effective services for seniors in our communities and residential aged care facilities.
Good news for the professions? Good news for the residents / clients? Good news for the sector?
Well, it would be if we had the workforce to meet those needs.
THIS IS A BURNING PLATFORM FOR THE ALLIED HEALTH WORKFORCE.
Where is the noise?
Well, where is the allied health workforce data?
Allied health workforce shortages has been a gradually boiling frog – the rapid, recent growth of the NDIS (National Disability Insurance Scheme) has changed the landscape of allied health employment. Simultaneously, the increasing recognition of the importance of delivering better value care in many states, means that health services are finally seeing the opportunities to keep people independent and healthy longer by employing allied health services.
But the allied health workforce frog has now boiled. The lack of centralised strategic planning for allied health means that no single organisation has visibility of the challenges facing the allied health workforce. However, if you ask any regional allied health clinician or employer; disability, aged care service or regional assessment service provider, they will tell you that the allied health workforce is at crisis point.
We believe this anecdotally. What evidence do we have to prove it?
Almost no good quality data, for the reasons listed in our article Why Don’t We Have Allied Health Workforce Planning In Australia – And What is the Solution?
So, for the purpose of this post, we looked at routinely available data to try to at least get an indication of the scale of allied health workforce demand versus supply.
The question we wanted to answer was how many allied health professions are there, and what are the shortages?
It sounds like a straightforward question, but it is not.
There is no nationally agreed definition of allied health. Only registered professions have an accurate count of the registered workforce – but that doesn’t mean that all registered professionals are all practicing clinically. Self-regulating professions were much harder to pin down.
Demand is more difficult to measure. As a proxy for demand, we looked at the job advertisements for a range of different allied health professions on Seek.com.au.
There are problems with these data as well – the advertisements are not all specific to a single profession (for instance every search yielded a small proportion of totally inappropriate results, such as car mechanics and a number of related roles, such as allied health assistants or administrators); it is in no way representative of the whole workforce demand (although our work with the Victorian Allied Health Workforce Research Program found that when employers advertise, most used Seek.com.au); some employers are hedging their bets to fill vacant roles – for instance, by advertising for a physiotherapist OR exercise physiologist, so not all advertisements are specific to a single profession. However any systematic data problems were likely to be equally distributed across the professions (rather than biasing the results of specific professions). And we don’t have anything else to go by.
So – let’s call this a quick snapshot of allied health supply and demand in the week of the royal commission findings, which we know is going to substantially increase demand for allied health.
As an indicator of salaries, we used Payscale Australia to report median salaries for each of the professions. The salaries were surprisingly low, and inconsistent with what some members of the profession were telling us (they tell us that they are paying well above these levels), but these results are consistent with what we found in the Victorian Allied Health Workforce Research Program, we have nothing else to go on, and this is what employers and prospective employees will see.
So this is the best we can do – and it doesn’t look good.
Ratio of number of professionals to advertised vacancy rates for a selection of allied health practitioners
|Profession||Median Pay (Range) (from Payscale Australia) Date 28 Feb 2021||No of Professionals (various sources)||Job Vacancies on Seek
(8 March 2021)
|Aboriginal and Torres Strait Islander Health Practitioner||N/A||8721||450 (search term Aboriginal and Torres Strait Islander Health Practitioner)||51%|
|Social work||$67580 ($61,0000 – 87,000)||18,261 by 2019 (Deloitte report 2019) (>100002 registered with AASW)||21,147 (search term social work) Or 9312 (using search term social worker)||50 – 120% (depending on search term)|
|Occupational therapy||$65,519 ($61,000 -80,000)||25,208¹||4304||17%|
|Speech pathology||$64410 ($61,000 – 89,000)||>80002||1387||17%|
|Exercise physiologists||$57,990 ($55,000 – 73,000)||6516 (2019 ESSA annual report)
|Psychology||$75,279 ($68,000 – 94,000)||40969¹||4919||12%|
|Physiotherapy||$66789 ($61,000 – 86,000)||38,628¹||4101||11%|
|Podiatry||$64,436 ($60,000 – 83,000)||5691¹||484||9%|
|Optometry||$86618 ($75,000 – 108,000)||6175¹||294||5%|
|Dietetics and nutrition||$62,023 ($54,000 – 81,000)||7473 (DAA website 8th March 2021)||242||3%|
|Pharmacy||$34.40 /hour ($31.20 – 37.54)||34922¹||1365||4%|
|Osteopathy||$64525 ($59,000 – $80,000)||2921¹||100||3%|
|Chiropractic||$69,965 ($54,000 – 89,000)||5893¹||137||2%|
¹Professions registered with AHPRA, and data from the December 2020 registration reports from the respective professions
2 Number of registered professional members listed on AHPA website March 2021
This needs to be the start of a discussion about how we systematically capture allied health workforce data; how we measure demand; and how we respond to it. In the absence of any information about the allied health workforce demand and supply, it is impossible to accurately plan for workforce needs. This, in turn will create difficulties implementing the Royal Commission findings and to fully meet the growing needs of the disability sector (and others).
Fortunately, the allied health workforce is very good at finding solutions to workforce shortages. We discuss 12 strategies to address allied health workforce shortages in this post.