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.