Home' Australian Pharmacist : Australian Pharmacist August 2012 Contents Australian Pharmacist August 2012 I ©Pharmaceutical Society of Australia Ltd. 629
Nurse numbers not
increasing fast enough
Australia's nursing and midwifery
workforce is continuing to grow, but not
as quickly as Australia's population,
according to an Australian Institute
of Health and Welfare (AIHW) report
released last month.
The report, Nursing and midwifery
workforce 2011, shows that in 2011,
the total number of nurses and
midwives registered in Australia was
326,669, a 6.8% increase since 2007.
Despite the increasing numbers of
registered and employed nurses and
midwives, when compared to the
population, supply decreased by 1.3%
between 2007 and 2011, from 1,095 to
1,081 full-time equivalent nurses and
midwives per 100,000 population based
on a 38-hour week.
AIHW spokesperson Vicki Bennett
said that the number of nurses and
midwives employed in nursing also
increased between 2007 and 2011
-- up 7.7% from 263,331 to 283,577.
Of those employed in nursing and
midwifery, 36,074 were midwives,
though only 15,523 reported working in
midwifery as the principal area of their
'Supply also varied regionally, ranging
from 1,102 full-time equivalent nurses
and midwives per 100,000 population
in major cities to 995 in outer regional
areas to 1,336 in very remote areas
based on a 38-hour week.
The nursing and midwifery workforce
is also getting older, with the average
age increasing from 43.7 to 44.5 years
between 2007 and 2011. The proportion
of nurses and midwives aged 50 or
older also increased from 33% to 38.6%.
Doctor numbers rising
The supply of employed medical
practitioners increased between 2006
and 2010, from 346 to 366 full-time
equivalent practitioners per 100,000
population -- a 13% rise in practitioner
numbers according to the Australian
Institute of Health and Welfare Medical
workforce 2010 report.
Between 2006 and 2010, the number
of medical practitioners employed in
medicine, in all states and territories
other than Queensland and Western
Australia, increased by 13.3% from
46,336 to 52,497. In 2010, 93.6%
(49,128) were working as clinicians, of
whom 36.1% were specialists and 35.3%
were general practitioners.
Medical practitioner supply across
remoteness areas ranged from 400
full-time equivalents per 100,000
population in Major cities to 185 in
Outer regional areas. In contrast, the
variation in the supply of GPs was
smaller between Major cities and
Outer regional areas (105 and 103
full-time equivalents per 100,000
The average age of medical
practitioners did not change from
2006 to 2010 (45.9 years). However,
the proportion of employed medical
practitioners aged 55 and over
increased from 25.5% to 26.4% over the
'Under the current model, if you want to
increase one of the medicines to reduce
blood sugar, you write the report and
it goes back to the GP. Even in the ideal
model you're probably looking at an
absolute minimum of a week before that
patient is seen. If it was a prescribing
pharmacist, they could write the
prescription on the spot'.
This is echoed by Louise Deeks,
a Pharmacy Lecturer and researcher
at UC and a UK registered pharmacist
prescriber. Her registration involved
completing a Practice Certi cate in
Pharmacist Independent Prescribing at
the University of Strathclyde in Scotland.
The quali cation was then noted on her
She told Australian Pharmacist that she
quali ed as a pharmacist prescriber
because of the delays between nding an
issue and resolving it.
At that time Louise worked as a
consultant pharmacist in a falls clinic.
'We went into people's homes, we made
the recommendations. We had an
acceptance rate of over 90% from the
GPs of our recommendations but there
was the delay between our home visits
and the prescriptions being written
'It could be a week or more. There was a
gap -- being able to prescribe would make
it more e cient and patient focussed.
'The great thing is that it really does t
with pharmacists. I was working in a team
where all the nurses were prescribers
and I wasn't. That was quite frustrating
because we were going and doing
outreach. I could sometimes ask a nurse,
"can you prescribe this?" That was a little
bit hard. I was concerned about it,' she
Assoc. Prof Kyle believes prescribing is
just a tool in a toolbox.
'There is no magic in it. It is another
skill that can be taught, just like a
physiotherapist can be taught how to
manipulate a joint.
'The size and contents of the tool box
are as varied as the di erent toolboxes
of the di erent trades. Most include a
hammer, Phillips head screwdriver and a
pair of pliers.
'I would be worried if a mechanic used a
plane, or a builder used a multimeter, or
a plumber used a hod. It is a case of using
the right tool for the job!'
Meantime, while the investigations and
debate on non medical prescribing goes
on, the population continues to age, rates
of chronic disease continue to rise and
the headlights on the road train -- that is
the political imperative for governments
to deliver on health -- get brighter and
closer as it roars continues down the
highway to the future.
1. Brown J, Picton C. Competency framework to meet the needs
of all prescribers. Clinical Pharmacist 2012;4(6)157--8
2. Consultation on a health professionals prescribing pathway
(HPPP) in Australia. May 2012. At: www.hwa.gov.au/
3. Nissen L, Kyle G, Stowasser D, et al. National Health Workforce.
Non-medical prescribing. Final report, June 2012. At: www.
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