2023 NSW Election
Occupational therapy services should be available to everyone in NSW when and where they need them.
We are calling on candidates for the 2023 New South Wales Election to address allied health workforce challenges as a priority to ensure everyone can access vital occupational therapy services in NSW when they need them, regardless of their situation or location.
The health system is under pressure and allied health workforce challenges have been exacerbated by the ongoing effects of the COVID-19 pandemic, which is negatively impacting service delivery for our communities.
Investing in initiatives that enable a strong multidisciplinary allied health workforce across health, education and disability is critical to ensure individuals have access to services that enable them to participate in the daily activities they need to live and thrive across all domains.
OTA has written to the major parties contesting the NSW State Election seeking information and undertakings on issues of concern to our members. Responses will be posted here as they are received to enable members to make an informed decision at the ballot box on 25 March 2023.
We are calling on all parties and candidates to support the following priority areas this election:
1. Address critical allied health workforce shortages and increase access to occupational therapy services for consumers
According to data from the Australian Government Department of Health, occupational therapy is the fastest growing registered allied health profession, with the total workforce increasing by 7 per cent per annum between 2015 and 20191.
Despite this growth, there is significant difficulty attracting and retaining occupational therapists to meet demand across public, private, academic and community settings. Waitlists for occupational therapy services are long and the public health system is under significant strain.
Workforce shortages and consistent vacancies are resulting in excessive workloads, burnout, and high staff turnover. Whilst there are difficulties across all grades of occupational therapy, shortages are most pronounced among senior experienced clinicians. This has flow on effects to the provision of adequate supervision and support to early career therapists and in turn, results in lengthy waitlists for consumers to access occupational therapy services.
Achieving a sustainable workforce relies on investment in attracting and developing the next generation of occupational therapists, as well as retaining existing clinicians.
We are calling on the next NSW Government to invest in the attraction and retention of occupational therapists as part of a diverse, multidisciplinary public health workforce. This includes exploring innovative ways to incentivise and deliver clinical placements for the growing occupational therapy student cohort.
2. Enable access to occupational therapy-specific treatment, care and support for individuals with mental illness or psychological distress
Occupational therapists are a key part of the contemporary mental health system, working across all areas of mental health to support the mental health and wellbeing of individuals. The increasing demand and complexity for both public and private mental health services is overwhelming an already inundated mental health workforce resulting in clinicians ‘burning out’ and leaving the workforce.
An additional challenge for the public mental health occupational therapy workforce is the proliferation of general “mental health clinician” roles in the public health system. These roles are not discipline-specific and can be filled by occupational therapists, psychologists, social workers, or registered nurses.
To achieve a diverse, multidisciplinary workforce, occupational therapists must be provided with opportunities to develop both specialist and generalist skillsets.
Limiting prospects to general mental health roles can significantly impact client outcomes and patient flow as well as reducing opportunities for discipline-specific career progression, support, supervision and retention of senior staff. This can also impact the attraction of new graduate occupational therapists to careers in public mental health.
Achieving a diverse multidisciplinary mental health workforce relies on investment in those individual disciplines – discipline-specific support, training and development opportunities are critical to attracting and retaining clinicians and improving mental health outcomes.
We are calling on the next NSW Government to commit to an increase in discipline-specific occupational therapy mental health roles in the public health system.
With 1 in 10 Australian children aged 5 to 18 years having a disability, and almost 90% of these children attending mainstream schools, and 1 in 5 students receiving an educational adjustment related to disability, a ‘whole of school’ approach to education support is essential.
Access to school-based occupational therapy services:
- Enables vital prevention and early intervention for students experiencing psychosocial difficulties or developmental delay;
- Promotes social and emotional wellbeing and equips students to manage challenges effectively from a young age;
- Supports students to maximise their participation and engagement in a learning environment;
- Reduces strain on teachers by directly supporting students with additional needs and/or building the capacity of teachers to support these students.
Regrettably, the role of occupational therapy in schools is currently undervalued by the New South Wales Government. Student and educator access to occupational therapists in New South Wales schools is extremely limited and inconsistent, relying on schools to make local decisions to utilise their Resource Allocation Model (RAM) funding to fund occupational therapists in their schools which inhibits equity of access.
The establishment of the Specialist Allied Health and Behaviour Support Provider Scheme did not address funding of occupational therapists in NSW schools but rather provided a process for checking and co-ordinating a health practitioner had met all requirements such as working with children check prior to accessing schools.
Further, there are significant gaps in the services offered to high school students in NSW, with most occupational therapy services when they are arranged, focusing on early years of schooling.
There is increasing understanding of the importance in addressing the social and emotional wellbeing of young people, especially through the critical transition period of high school. This is an extremely vulnerable time for young people and with the growing challenges of navigating social media, the ongoing impacts from isolation during the COVID-19 pandemic and the increasing rate of youth suicide.
Occupational therapists have a significant role to play in working with high school students to address these issues through strengths-based, behaviourally oriented, interventions to improve engagement at school, development of healthy life habits, increasing confidence in daily activities, and supporting the development of self and responsibility.
As a priority multidisciplinary allied health teams should be embedded within both primary and secondary school structures and enabled to work collaboratively with teachers. Occupational therapists should form an integral part of these multidisciplinary learning and support teams in the school setting.
We are calling on the next NSW Government to invest in a model that embeds and supports the direct employment of occupational therapists with the NSW Education system.
Recent disasters including the COVID-19 pandemic and natural disasters are having ongoing impacts on the health and wellbeing of the NSW community leading to increasing demands on health and social services, suitable housing and long covid recovery support. Vulnerable and disadvantaged populations are most affected.
Long waitlists currently exist for public housing and the private rental market is prohibitive for many. This is even more challenging for individuals with a disability that require modifications to their homes to enable their safe and sustainable participation in activities of daily living. Occupational therapists are highly experienced at assessing home environments and making recommendations for modifications, however a shortage of suitable building stock is causing considerable delays in modifications and subsequent delays in individuals being housed safely.
The long-term physical, psychological and social effects of the COVID-19 virus on individuals and the community continue to develop. Predictions estimate between 5 -10% of individuals who have had COVID still experience symptoms 3 months post diagnosis2.
Occupational therapy has a vital role to play in COVID-19 rehabilitation and recovery, especially in chronic pain management, cognitive and mobility difficulties, psychological health and supporting individuals to return to work/employment/school.
Investment in health services, social services and affordable housing, specifically for those with disability, mental illness and the ageing population.
Dedicated, accessible and coordinated multidisciplinary specialist supports which include occupational therapy, to support individuals suffering the long-term physical and psychological impacts of COVID-19 to rehabilitate, recover and adapt.
We are calling on the next NSW Government to take a proactive approach to address the ongoing physical, psychological and social effects experienced by many in the NSW community as they recover from recent disasters.
24 March 2023
After asking the parties to strongly consider addressing the points above, OTA received detailed responses from the following parties:
1 Australian Government Department of Health. (2021). Allied health in Australia. Retrieved from https://www.health.gov.au/health-topics/allied-health/in-australia.
2 Australian Institute of Health and Welfare (2022) Long COVID in Australia – a review of the literature, catalogue number PHE 318, AIHW, Australian Government.