Palliative care workforce
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In 2020, 279 full-time equivalent (FTE) palliative medicine physicians and 3,279 FTE palliative care nurses were employed in Australia. This section provides information on the number and characteristics of the employed workforce of physicians with a primary specialty of palliative medicine (referred to as ‘palliative medicine physicians’) and nurses working in palliative care (referred to as ‘palliative care nurses’).
This information was sourced from the National Health Workforce Dataset (NHWDS) for the period 2016 to 2020 and only includes medical practitioners and nurses, as these professionals can be specifically identified as palliative care providers using the Department of Health’s Health Workforce Data Tool (HWDT).
However, the palliative care workforce is made up of a broad range of professional groups, each playing a unique role in supporting people with a life limiting illness to receive comprehensive, patient-centred care. It is recognised that general practitioners, other medical specialists, social workers, occupational therapists, physiotherapists, and other allied health professionals form an integral part of the palliative care workforce. However, existing national data sources are not able to accurately capture the extent of palliative care services provided by these health professionals. See Data Sources section for further details.
The information in this section was last updated in October 2022.
Workforce planning is an essential element in achieving functional and sustainable healthcare across the palliative care sector (DoH 2019). Understanding the size, demographics and distribution of the palliative care workforce is key to meeting the increasing demand for palliative care and will assist in identifying current need gaps and aid future planning.
In Australia, both doctors and nurses usually complete specialised training in addition to their medical/nursing degrees to work in palliative care.
Medical specialists must have completed post-graduate specialist training to become a palliative medicine physician. Palliative medicine physicians are required to have completed 3 years of full-time equivalent training in either a paediatric or adult setting under the supervision of a palliative medicine physician. Successful trainees gain the qualification of Fellow of the Royal Australasian College of Physicians (FRACP) / Fellowship of the Australasian Chapter of Palliative Medicine (FAChPM) and are accredited to practice as a palliative medicine physician in Australia or New Zealand. Medical practitioners may also complete a 6-month Clinical Diploma in Palliative Medicine, but this qualification does not result in specialist accreditation (RACP 2020).
The classification of nurses in Australia varies with the type of training that has been undertaken (for more information see the Department of Health and Aged Care website). Nurse practitioners, registered nurses and enrolled nurses need to complete a variety of short or more comprehensive courses (including postgraduate certificates and Master’s degrees) to work in the field of palliative care, and postgraduate qualifications are generally required for nurses working in specialist palliative care services (Centre for Palliative Care 2021).
While data on nurse practitioners are included in National Health Workforce Dataset and have been reported in Factsheets for Nursing and Midwifery, nurse practitioners are not identified in the Health Workforce Data Tool, and are therefore not included in this section.
Note, the standard full-time working week (1 full-time equivalent, FTE) for medical practitioners is defined as 40 hours, while it is 38 hours for all other professions, including nurses.
Key points
In 2020:
- There were 279 full-time equivalent palliative medicine physicians (1.1 per 100,000 population) and 3,279 palliative care nurses (13 per 100,000 population).
- Women accounted for 2 in 3 (64%) employed palliative medicine physicians and 9 in 10 (92%) employed palliative care nurses.
- Most worked in Major cities – over 4 in 5 (84%) employed palliative medicine physicians and almost 3 in 4 (72%) employed palliative care nurses.
- 3 in 4 (75%) employed palliative medicine physicians worked in a hospital setting, compared with over half (56%) of employed palliative care nurses.
Between 2016 and 2020:
- There was a 29% increase in the number of employed palliative medicine physicians (from 234 to 302) and a 9.5% increase in the number of employed palliative care nurses (from 3,469 to 3,798).
- The rate of increase of employed palliative medicine physicians more than halved between 2019 and 2020 compared with the increases observed in previous years (3.4% increase between 2019 and 2020 compared with 7.7%–8.8% annual increases between 2017–2018 and 2018–2019).
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Who provides specialist palliative care services?
In 2020, there were 302 palliative medicine physicians (279 FTE) and 3,798 palliative care nurses (3,279 FTE) employed in Australia, accounting for 0.8% of all employed specialist medical practitioners and 1.1% of all employed nurses and midwives.
Of the 3,798 palliative care nurses, over 4 in 5 (85% or 3,220) were registered nurses and 15% (578) were enrolled nurses (only). In addition, 80 nurse practitioners (70 of whom were actually employed as a nurse practitioner worked in palliative care in 2020 (see Physicians and nurses specialising in palliative care for further details).
In addition, there were 6 paediatric palliative medicine physicians in Australia in 2020 (MBA 2020), making up 0.2% of all physicians with a primary speciality of paediatrics and child health (3,333).
Nurse practitioners and paediatric physicians are not included in the numbers presented here.
In 2020, for employed palliative medicine physicians and palliative care nurses:
- Most were women – almost 2 in 3 (64%) palliative medicine physicians were women, which was almost twice as high as for all employed specialist medical practitioners (35%); and 9 in 10 (92%) palliative care nurses were women, which is slightly higher than the proportion among all employed nurses and midwives (88%) (Tables Wk.1–2).
- Female palliative medicine physicians were younger than male palliative medicine physicians (78% and 63% were aged under 55, respectively); however, female palliative care nurses were older than male palliative care nurses (32% and 20% were aged 55 and over, respectively) (Tables Wk.1–2).
- The 35–44 age group was the peak age group of palliative medicine physicians (40%), with the number of physicians then declining with increasing age, from 28% at age 45–54, to 10% for those aged 65 and over. While for palliative care nurses, the proportion was more evenly distributed across the age groups, increasing from about 20% for 20–44 age group to 26–28% for those aged 45–64, and then declining to 4.6% for those aged 65 and over (Figure Wk.1).
- The rate of palliative medicine physicians (FTE per 100,000 population) ranged from 0.6 in Western Australia to 1.8 in Tasmania (data are not presented for Australian Capital Territory and North Territory due to small numbers). For palliative care nurses, the rate ranged from 0.1 in the Northern Territory to 3.8 per 100,000 population in New South Wales ( Figure Wk.1).
- More than half of palliative medicine physicians and palliative care nurses worked in a hospital setting (75% and 56%, respectively) and most were principally employed as clinicians (92% for palliative medicine physicians and 96% for palliative care nurses respectively) (Figure Wk.1).
Figure WK.1: Characteristics of employed palliative medicine physicians and palliative care nurses, 2020
Figure 1.1: This interactive visualisation shows the number and percent of employed palliative medicine physicians and palliative care nurses by age and sex. Female physicians aged 35-44 accounted for the largest proportion of palliative medicine physicians, and male physicians aged 20-34 accounted for the least proportion. Female nurses aged 45-55 account for the largest proportion of palliative care nurses, and male nurses aged over 65 accounted for the least proportion.
Figure 1.2: This interactive visualisation shows palliative medicine physicians and palliative care nurses by states and territories. The graph shows the number of employees, the number of FTE employee, FTE per 100,000 population, number of clinical FTE employees, and clinical FTE per 100,00 population. NSW had the highest number of physicians, while Victoria had the highest number of nurses.
Figure 1.3: This interactive visualisation shows palliative medicine physicians and palliative care nurses by principal role. The graph shows the number of employees, the number of FTE employee, FTE per 100,000 population, number of clinical FTE employees, and clinical FTE per 100,00 population. Clinician was the most common principal role of the job for both physicians and nurses.
Figure 1.4: This interactive visualisation shows palliative medicine physicians and palliative care nurses by work setting. The graph shows the number of employees, the number of FTE employee, FTE per 100,000 population, number of clinical FTE employees, and clinical FTE per 100,00 population. Hospital was the most common work setting for both physicians and nurses.
How long did they work each week?
In 2020, for employed palliative medicine physicians and palliative care nurses:
- Palliative medicine physicians worked an average of 37 total hours per week (29 clinical hours), which was less than the average weekly hours for all employed specialist medical practitioners (41 total hours and 34 clinical hours; Table Wk.3).
- Palliative care nurses worked an average of 33 total hours (31 clinical hours), similar to that worked by all employed nurses and midwives (33 total hours and 30 clinical hours).
- Men worked longer hours on average per week than women both for palliative medicine physicians (40 compared with 35 total hours) and palliative care nurses (35 compared with 33 total hours), consistent with the pattern observed for all employed specialist medical practitioners and all employed nurses and midwives.
- For palliative medicine physicians, the average hours worked varied by state and territory, ranging from 32 total hours per week in Victoria to 43 total hours in Tasmania (Figure Wk.2) (data are not presented for Australian Capital Territory and Northern Territory due to small counts).
- For palliative care nurses, hours worked per week ranged from 31 total hours in Victoria, South Australia and Tasmania, to 36 total hours in Northern Territory (Figure Wk.2).
- Administrators (as their principal role) had the longest working hours per week, with an average of 48 and 36 total hours per week for palliative medicine physicians and palliative care nurses, respectively (Figure Wk.2).
- Palliative medicine physicians worked on average 34–38 total hours per week across most work settings, except for those in tertiary education facilities who worked on average of 45 total hours per week (however this is based on very small counts with only 5 palliative medicine physicians working in this setting).
- Palliative care nurses working in outpatient services had the longest working hours per week (36 total hours), while those working in independent private practice had the shortest hours per week (19 total hours; Figure Wk.2).
Note, data are not presented for all settings due to small numbers – palliative medicine physicians data for residential aged care facility and other government department or agency and palliative care nurses data for commercial/business service and other educational facility are not presented.
Over 4 in 5 (84%) employed palliative medicine physicians and almost 3 in 4 (72%) employed palliative care nurses worked mainly in Major cities. There was a higher proportion of palliative care nurses working in regional areas (Inner regional and Outer regional combined) than palliative medicine physicians (27% compared with 15%; Table Wk.5).
Taking into account differences in population sizes for each remoteness area, the FTE per 100,000 population for palliative medicine physicians was 1.2 in Major cities, declining to 0.8 in Inner regional and 0.5 in Outer regional areas respectively. In contrast, the FTE rate per 100,000 population for palliative care nurses was relatively similar across most remoteness categories – ranging from 11 FTE in Outer regional areas to 14 FTE in Inner regional areas (Table Wk.5).
The average total hours worked per week for palliative medicine physicians increased with increasing remoteness, from 36 hours in Major cities to 40 hours in Inner and Outer regional areas. While for palliative care nurses, the average hours worked was similar for Major cities and Inner and Outer regional areas (around 32–33 hours per week) and increased to around 37 hours for those in Remote and Very remote areas (Table Wk.5).
Figure Wk.2: Average hours worked per week by employed palliative medicine physicians and palliative care nurses, 2020
Figure 2.1: This interactive visualisation shows average total hours and average clinical hours for palliative medicine physicians and palliative care nurses by sex. For both sexes, physicians had longer average total hours than nurses, while nurses had longer average clinical hours than physicians.
Figure 2.2: This interactive visualisation shows average total hours and average clinical hours for palliative medicine physicians and palliative care nurses by states and territories. Physicians in Tasmania had the longest average total hours, and nurses in North Territory had the longest average total hours out of any state and territory.
Figure 2.3: This interactive visualisation shows average total hours and average clinical hours for palliative medicine physicians and palliative care nurses by principal role. Administrators had the longest average total hours, while clinicians had the longest average clinical hours.
Figure 2.4: This interactive visualisation shows average total hours and average clinical hours for palliative medicine physicians and palliative care nurses by work setting. Physicians in tertiary educational facilities had the longest average total hours, and nurses in outpatient services had the longest average total hours.
How has the palliative care workforce changed over time, including during the COVID-19 pandemic?
Between 2016 and 2020, there was an increase in palliative medicine physicians and palliative care nurses, with the rate of increase steeper for physicians than for nurses. The number of employed palliative medicine physicians increased by 29%, from 234 to 302. This increase was steeper than that observed for all employed specialist medical practitioners (17% increase). For employed palliative care nurses, there was an overall increase of 9.5% over this period (from 3,469 to 3,798), with the increase steeper for registered nurses than enrolled nurses (11% compared with 1% increase, respectively). This overall increase in palliative care nurses was relatively similar to that observed for all employed nurses and midwives (11% increase) (Table Wk.1–2).
After accounting for population size, the rate of FTE palliative medicine physicians and palliative care nurses also increased slightly over the 5-year period from 2016 to 2020 – for palliative medicine physicians from 0.9 FTE (0.7 clinical FTE) to 1.1 (0.8 clinical FTE) per 100,000 population between 2016 and 2020, and for palliative care nurses the corresponding increase was from 12.2 FTE (11.3 clinical FTE) to 12.8 FTE (12.0 clinical FTE) (Figure Wk.3).
Over the 5-year period from 2016 to 2020, women accounted for 68% of the increase in palliative medicine physicians (an increase from 147 to 193 for female physicians, compared with 87 to 109 for males). Around 70–75% of female palliative medicine physicians were aged 35–54 and this remained relatively stable over the 5 years to 2020. Interestingly, the proportion of male physicians aged 35–54 increased from 44% in 2016 to 58% in 2020 (Figure Wk.3).
While most palliative care nurses were women (92%), there was a steeper increase in male nurses than female nurses between 2016 and 2020 – 35% compared with 7.6% increase, respectively. The largest increases for male nurses were among those aged under 35 (57% increase), which was 3 times as steep as for female nurses of the same age group (17% increase) (Table Wk.2).
The number of palliative care nurses that identified as Aboriginal and/or Torres Strait Islander has been steadily increasing since 2016 – from 28 to 49 between 2016 and 2020. This rate of increase (75%) was steeper than that for non-Indigenous palliative care nurses and all employed Indigenous nurses and midwives over this period (8.9% and 48%, respectively) (Table Wk.2).
The average number of total hours worked has declined slightly for palliative medicine physicians (from 39 to 37 hours) between 2016 and 2020. For palliative care nurses’ average hours worked has remained relatively stable (around 33 hours) over the same period (Figure Wk.3).
Impacts of the COVID-19 pandemic
The COVID-19 pandemic has presented many challenges, especially for the health and aged care workforce. Frontline healthcare workers have been central to the pandemic response and, like many, have had to adjust to different ways of working.
Although the number of palliative medicine physicians increased each year from 2016 to 2020, the rate of increase more than halved between 2019 and 2020 (3.4% increase) when compared to increases observed in previous years (7.7%–8.8% annual increases between 2017–2018 and 2018–2019; Figure Wk.3). This pattern was consistent with all employed specialist medical practitioners, where the rate of increase was slower in 2020 than in previous years (3.4% increase between 2019 and 2020 compared with 5.2–5.3% increases between 2016–2017 and 2018–2019).
In contrast, the rate of increase remained relatively stable for the number of palliative care nurses over the years from 2017–2020 (around 3–4% per year), despite the increase for all employed nurses and midwives slowing in 2020 compared with previous years (1% increase between 2019 and 2020 compared with 3% increase in the 2 years prior 2019; Figure Wk.3).
These data suggest that the effect of the public health response to the COVID-19 pandemic appears to have had a larger impact on employed palliative medicine physicians (and all employed specialist medical practitioners and employed nurses and midwives) than for palliative care nurses. However, more data over a longer period is needed to provide insights on the effects of the COVID-19 pandemic on the palliative care workforce.
Figure Wk.3: Trends in the number of employed palliative medicine physicians and palliative care nurses, 2016–2020
Figure 3.1 and 3.2: This interactive visualisation shows the trend of number of palliative medicine physicians, palliative care nurses, all medical practitioners, all employed nurses and midwives by sex and age, from 2016 to 2020. The number of all job roles trended upwards from 2016 to 2020.
Centre for Palliative Care (2021) Professional Development, Melbourne: Centre for Palliative Care, accessed 29 July 2022.
DoH (Department of Health) (2019) The National Palliative Care Strategy 2018, Canberra: Department of Health, accessed 29 July 2022.
MBA (Medical Board of Australia) (2020) Registrant data, Reporting period: 1 October 2020 to 31 December 2020, Melbourne: Medical Board of Australia, accessed 2 September 2022.
RACP (Royal Australian College of Physicians) (2020) Training pathways, Sydney: Royal Australian College of Physicians, accessed 29 July 2022.
National Health Workforce Dataset (NHWDS)
The Workforce Surveys are administered to all health practitioners registered by the Australian Health Practitioner Regulation Agency (AHPRA) and are included as part of the registration renewal process. The workforce surveys are voluntary. The respective surveys are used to provide nationally consistent workforce estimates. They provide data not readily available from other sources, such as on the type of work done by, and job setting of, health practitioners; the number of hours worked in a clinical or non-clinical role, and in total; and the number of years worked in, and intended to remain in, the health workforce. The survey also provides information on those registered health practitioners who are not undertaking clinical work or who are not employed. The information from the workforce surveys, combined with some National Registration and Accreditation Scheme (NRAS) registration data items, comprises the NHWDS.
Past and present surveys have different collection and estimation methodologies, questionnaire designs and response rates. As a result, attention should be taken in comparing historical data from the AIHW Medical Labour Force Surveys prior to 2010 with data from the NHWDS.
Details of medical practitioners, nurses and allied health practitioners registered with the Australian Health Practitioner Regulation Agency (AHPRA) are available for public access through the Department of Health’s Health Workforce Data Tool (HWDT). This report examines medical practitioners and nurses, as these professionals can be identified using the HWDT as specialist palliative care providers.
However, the palliative care workforce is made up of a broad range of professional groups, each playing a unique role in supporting people with a life limiting illness to receive comprehensive, patient-centred care. It is recognised that general practitioners, other medical specialists, social workers, occupational therapists, physiotherapists, and other allied health professionals form an integral part of the palliative care workforce; however, existing national data sources are not able to accurately capture the extent of palliative care services provided by these health professionals.
The numbers in this report reflect those extracted using the HWDT as of 1 July 2022. Workforce for each profession is defined as those employed in Australia in the profession, who specialise in or work in palliative care. Additionally, an employed health professional is defined in this report as one who:
- reported (the week before the survey) practising in Australia (including practitioners on leave for less than 3 months), or
- was involved with work that is principally concerned with their health discipline (including non-clinical roles – for example education, research, and administration).
Employed palliative medicine physicians only include practitioners whose main speciality is palliative care. Employed palliative care nurses include only nurses whose principal job area is palliative care. This excludes those practitioners who:
- practice palliative care as a second or third speciality
- are registered in the profession but are retired from regular work
- work outside the profession
- work in the profession but are on extended leave of 3 months or more
- are only engaged in unpaid/volunteer work or
- work outside Australia.
The full-time equivalent (FTE) is defined in this report as the number of standard-hour workloads worked by employed health professionals. The FTE is calculated by multiplying the number of employed professionals in a specific category by the average total hours worked by employed people in that category and dividing by the number of hours in a standard working week. The standard working week, equivalent to 1 FTE, is based on working 38 hours per week for all practitioners with the exception of medical practitioners, where it is defined as 40 hours. In this report, the FTE for palliative care nurses is therefore based on working 38 hours per week and for palliative medicine physicians 40 hours per week.
There may be differences between the data presented here and that published elsewhere due to different calculation or estimation methodologies or extraction dates. Additionally, the HWDT uses a randomisation technique to confidentialise small numbers. This can result in differences between the column sum and total and small variations in numbers from one data extract to another.
Further information regarding the Medical practitioner workforce and Nursing and midwifery workforce surveys is available from the Department of Health’s Health Workforce data website.
| Key concept | Description |
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Total number of hours a practitioner spends working in the area of clinical practice; that is, the diagnosis, care and treatment, including recommended preventive action, of patients or clients. |
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Employed |
An employed health professional is defined in this report as one who:
‘Employed’ people are referred to as the ‘workforce’ in this report. This includes only practitioners whose main speciality is palliative care and excludes those practitioners practising palliative care as a second or third speciality. It also excludes those who are registered in the profession but are retired from regular work, working outside the profession, working in the profession but on extended leave of 3 months or more, who are only engaged in unpaid/volunteer work or working outside Australia. |
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Full-time equivalent (FTE) |
The number of standard-hour workloads worked by employed health professionals. The FTE is calculated by multiplying the number of employed professionals in a specific category by the average total hours worked by employed people in that category and dividing by the number of hours in a standard working week. The standard working week is assumed to be 38 hours, equivalent to 1 FTE, for all practitioners with the exception of medical practitioners where it is assumed to be 40 hours. |
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The classification of nurses in Australia varies with the type of training they have undertaken. Nurse practitioners, registered nurses and enrolled nurses need to complete a variety of short or more comprehensive courses (including postgraduate certificates and Master’s degrees) to work in the field of palliative care, and postgraduate qualifications are generally required for nurses working in specialist palliative care services. |
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Palliative medicine physician |
Palliative medicine physicians are required to have completed 3 years of full-time equivalent training in either a paediatric or adult setting under the supervision of a palliative medicine physician. Successful trainees gain the qualification of Fellow of the Royal Australasian College of Physicians (FRACP) / Fellowship of the Australasian Chapter of Palliative Medicine (FAChPM) and are accredited to practice as a palliative medicine physician in Australia or New Zealand. |
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Total hours |
The total hours worked per week in the profession. |