Table 3 Synthesized assessment of shortlisted HWP models for the allocation of service requirements across cadres
Models identified | Capacity for needs-based projections of service requirement | Capacity for local-level planning | Capacity to accommodate short planning horizons | Capacity for multi-professional planning | Capacity to conduct scenario analyses | Capacity to engage the workforce | Capacity to account for changing practice patterns | Capacity to account for population mobility |
|---|---|---|---|---|---|---|---|---|
Adjusted service target-based planning [19] | Identifies the need for services based on the incidence and prevalence of health problems, demographic characteristics of the population, and service targets | Can be conducted at all levels | Can describe current alignment or use population projections to project future service requirements | Designed for multi-professional planning; projects for all professions with relevant scopes of practice that are involved in the provision of the targeted package of services | Can be run using a baseline “status quo” scenario and alternative scenarios to assess the potential impact of labour market interventions | Engagement with workers and experts to develop the planning methodology, define time allocated to each task, and to account for contextual factors in the process of allocation | Addresses overlap between scopes of practice and can account for proportion of time dedicated to non-clinical and alternative clinical activities | Not addressed |
Plasticity matrices | Utilization-based | Can be conducted at multiple geographic levels (including local) | Can describe current alignment or produce prospective estimates | Designed for multi-specialty physician planning and can be applied for multi-professional planning; uses the concepts of within specialty, and between specialty plasticity | Projects under a variety of scenarios and incorporates visualization features to assess impact of policy scenarios | Clinical advisory board and technical experts provide input throughout model development | Concept of plasticity predicates that individual physicians within the same specialty may provide different scopes of service, while the scope of service of physicians in different specialties may overlap | Not addressed |
Linear programming [20] | Combines oral health needs and utilization | Conducted in one regional health authority that comprises 5 subregional authorities; projections of need are produced at the level of the subregion and amalgamated to the regional level | Produces 5-year projection, but can be used descriptively | Use of linear programming to explore optimization of skill mix between dentists, dental nurses, dental therapists, and dental hygienists | Explores future scenarios for the use of skills within a dental team to inform dental therapy training | Consults an expert steering committee to define scenarios and assess the maximum proportion of care that could be undertaken by dental therapists rather than dentists | Incorporates the prevalence of part-time work in the dental therapist workforce into scenarios | Not addressed |