Environmental Scan - Government of Nova Scotia

Physician Resource PlanningAn Environmental Scanrisk of thromboembolic strokes than the non-diabetic population, and stroke-related mortality and morbidityare increasing in the diabetic population 75 .Of all the identified modifiable risk factors for stroke, hypertension appears to be the most important, owing toits high prevalence and its associated three- to fivefold increase in stroke risk. Based on epidemiological data,approximately 50 percent of strokes could be prevented if hypertension were eliminated (Source: NHS EnglandCentre for Workforce Intelligence).England NHS workforce planning for neurologists uses a broad parameter of neurologists having an average ofthree clinics per week with five new patients per clinic, then this equates to one neurologist per 125,000population. Currently there is one neurologist per 150,000 in the United Kingdom.The Royal College of Physicians Association of British Neurologists conducted a detailed programmatic basedreview of neurology workforce requirements 76 . The review projected neurologist requirements for acomprehensive service including acute care (emergency care), scheduled outpatient care, and long-termconditions (e.g. MS, epilepsy and movement disorders. The provision of a adult neurology service requires oneFTE consultant neurologist per 70,000 population. The broader target of one FTE per 43,500 populationincludes stroke (stroke subspecialists), neurophysiology and neurorehabilitation.23.2.9 Palliative MedicineThe NS approach to palliative care is based on a service model which includes palliative care physician(s) ineach DHA. This role is integral to the function of established district specialist palliative care teams which areresources to primary care providers in a shared care model. This is secondary and shared care for patients withadvanced illness, often in their homes. The necessary resources required for this model are local 77 .23.2.10 RespirologyCurrently, and in comparison to, Nova Scotia:• There are 11.8 respirology specialists or 1.0 FTE per 80,173 population in Nova Scotia.• Benchmark(s):• The U.K. Royal College of Physicians’ 2005 Consultant physicians working with patients reportestimates a requirement of 1.0 FTE respiratory medicine consultants per 37,000 head ofpopulation 78 . The Sentinel Services are the incidence of lung disease, in particular asthma andchronic obstructive pulmonary disease (COPD).• In 2009/10 British Columbia had 75 adult respirologist FTE or 1.0 per 59,400 with an average of7,200 services per 1.0 FTE.• Nova Scotia in 2009/10 has 11.8 FTE or 1.0 per 80,173 performing an average 2,059 FFS andshadow-bill services per 1.0 FTE.• A report to the Canadian Thoracic Society Education Committee included a recommendation fromPGME Respirology Directors of 1.0 FTE per 50,000. The RCPSC 1988 recommendation was 1.0respirologist per 81,000, which is equivalent to about 1.0 FTE per 73,000 population. This75 Sood, M.M., Bueti, J., et.al., The Intersection of Risk and Benefit: Is Warfarin Anticoagulation Suitable for AtrialFibrillation in Patients on Hemodialysis?, CHEST October 2009 vol. 136 no. 4 1128-113376 U.K. RPCS, Assoc. British Neurologists, Local adult neurology services for the next decade, June 201177 NS Department of Health and Wellness, Provincial Hospice Palliative Care Project", Final Report & Recommendations inOctober, 200578 U.K. NHS Centre for Workforce Intelligence, August 2010209 | Page Social Sector Metrics Inc. & Health Intelligence Inc. | 12/31/2011