Workforce planning is an essential element in achieving functional and sustainable healthcare across the palliative care sector (DoH 2019). A key challenge faced by the palliative care sector is the increasing demand for services due to an aging population and growing prevalence of chronic diseases, which places greater pressure on the palliative care workforce. As such, understanding the size, demographics and distribution of the palliative care workforce is key to meeting ongoing demand for palliative care in Australia.
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The information in this section was last updated in October 2021.
Key points
- There were 273 full-time equivalent palliative medicine physicians (1.1 per 100,000 population) and 3,157 palliative care nurses (12.4 per 100,000 population).
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Females accounted for 2 in 3 (64%) employed palliative medicine physicians and 9 in 10 (93%) palliative care nurses.
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The vast majority of the palliative care workforce worked in Major cities – 9 in 10 (87%) employed palliative medicine physicians and 3 in 4 (72%) employed palliative care nurses.
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3 in 4 (76%) employed palliative medicine physicians worked in a hospital setting, compared with about half (52%) of employed palliative care nurses.
Between 2014 and 2019:
- There was a 50% increase in the number of employed palliative medicine physicians (from 195 to 292 physicians) and a 10% increase in the number of palliative care nurses (from 3,312 to 3,658 nurses).
The palliative care workforce consists of a number of health professional groups including specialist palliative medicine physicians, nurses, nurse practitioners, general practitioners, pharmacists, other medical specialists (such as oncologists and geriatricians), as well as other health workers, support staff and volunteers (see Box WK.1).
The information presented in this section describes 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’). Information on other professions who may provide palliative care, such as those noted above, is not presented due to a lack of comprehensive data.
The information on palliative medicine physicians and palliative care nurses presented in this section was derived from the National Health Workforce Data Set (NHWDS) for the period 2014 to 2019. Further details on the NHWDS are outlined in Data Sources section.
Box WK.1 Physicians and nurses specialising in palliative care
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 practise 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 they have undertaken and their scope of practice. Enrolled nurses have completed a 2-year Diploma of Nursing and work under the supervision of a registered nurse. Registered nurses have completed a 3-year Bachelor of Nursing, and have a broader scope of practice that may include assessing patients and developing a nursing care plan, supervising enrolled nurses and junior registered nurses, providing specialised nursing care and performing leadership roles such as nursing unit manager (DoH 2021). Nurse practitioners are registered nurses who have completed masters-level education and are endorsed by the Nursing and Midwifery Board to practice autonomously in an advanced and extended clinical role to diagnose, plan and deliver high quality comprehensive health care (NMBA 2016).
Nurse practitioners, registered nurses and enrolled nurses may complete a variety of short or more comprehensive courses (including postgraduate certificate and Masters qualifications) if they wish 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).
Palliative medicine physicians
In 2019, there were 292 palliative medicine physicians employed in Australia, which accounted for 1 in 127 (0.8%) of all employed medical specialists.
The standard full-time working week (1 full-time equivalent, FTE) for medical practitioners is defined as 40 hours (38 hours for all other professions, including nurses; AIHW 2017). In 2019, there were 273 FTE (1.1 per 100,000 population) palliative medicine physicians, which included 213 clinical FTE physicians (see Table WK.1).
In addition, there were 6 paediatric palliative care physicians in Australia in 2019 (MBA 2020). These paediatric physicians are not included in the numbers presented here.
Age and sex
In 2019, almost 2 in 3 (64%) employed palliative medicine physicians were female, which was almost twice as high as for all medical specialists (34%).
Female palliative medicine physicians were younger than male physicians, with around 3 in 4 (77%) female physicians aged under 55, compared with 3 in 5 (59%) male physicians. For both male and female palliative medicine physicians, the 35–44 age group accounted for the highest proportion of palliative care physicians, accounting for 29% and 42% of male and female physicians respectively. In this age group, there were more than twice as many female palliative medicine physicians than males (78 female physicians compared to 31 male physicians; see Table WK.1).
Hours worked
In 2019, palliative medicine physicians worked on average 37.4 total hours per week, which was less than the average weekly hours for all employed medical specialists (42.5 hours). The average clinical hours worked per week (29.1 hours) was also less than for all employed specialists (35.4 hours).
Female palliative medicine physicians worked less hours on average per week than males (35.4 compared with 40.8 total hours per week; see Table WK.2).
Average total hours worked varied by jurisdiction, ranging from 34.3 hours per week in Victoria to 41.0 hours per week in Queensland (see Table WK.3).
Nationally, there were 1.1 FTE (0.8 clinical FTE) palliative medicine physicians per 100,000 population in 2019. The rate of FTE palliative medicine physicians per 100,000 population ranged from 0.9 in Victoria and South Australia to 1.3 in the Australian Capital Territory (Figure WK.1).
In 2019, nearly 9 in 10 (87%) employed palliative medicine physicians worked mainly in Major cities (255 physicians, compared with 36 physicians in Inner and Outer regional areas combined).
Taking into account differences in population sizes across remoteness areas, the FTE per 100,000 population for palliative medicine physicians was 1.3 in Major cities compared with 0.5 and 0.6 in Inner and Outer regional areas respectively (see Table WK.4).
Principal role and work setting
Of the 292 employed palliative medicine physicians in 2019, 269 (92%) were principally employed as clinicians, while the remainder were principally employed as administrators, teachers or educators, and researchers (see Table WK.5).
Around 3 in 4 (76% or 222) palliative medicine physicians were employed in a hospital setting, followed by 24 (8.2%) in outpatient services, 21 (7.2%) in other community health care services, and 14 (4.8%) in private practices (see Table WK.6).