National Centre for Education and Training on Addiction (nceta) Submission National Drug Strategy Consultation: 2010 Introduction




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National Centre for Education and Training on Addiction (NCETA)

Submission
National Drug Strategy Consultation: 2010



Introduction
The development of a new National Drug Strategy (NDS) provides an opportunity to spotlight the crucial, but often overlooked, area of workforce development.
The recent evaluation of the previous National Drug Strategy 2004-2009 noted that:
An appropriately sized, skilled and qualified workforce is critical in sustaining effective delivery of interventions. Capacity to implement programs has been limited by staff shortages and turnover, and skill gaps in the alcohol and other drug (AOD) sector specifically and in the Australian workforce generally. The NDS contribution to training programs and resources is highly valued, as is the work of NCETA in developing a concept of workforce development far broader than education and training. More attention is needed to building the capacity and profile of professionally-trained, specialist AOD workers. Attention is needed to competitive pay and conditions, incentives and benefits. A new national AOD workforce development strategy, as proposed by NCETA and recently discussed by IGCD, will be an important initiative.” (Siggins Miller, 2009, p. ix)
The evaluation also noted that, to date, the NDS program outcomes have strengthened Australia’s capacity to address AOD use and AOD-related harms, through investment in a range of areas including strengthened partnerships and collaborations between the various levels and sectors of government and workforce development and structures (Siggins Miller, 2009).
The following submission, developed by the National Centre for Education and Training on Addiction (NCETA) focuses on the importance and centrality of a national strategic approach to workforce development under the auspices of the new NDS.
How can structures and processes under the National Drug Strategy more effectively engage with sectors outside health, law enforcement and education?
Which sectors will be particularly important for the National Drug Strategy to engage with?
The importance of partnerships

Throughout the various iterations of the NDS there has been a significant focus on partnerships. Siggins Miller (2009) in their recent evaluation of the NDS noted that one of the strengths of the NDS was its ability to act on the basis of mutually-respectful partnerships among diverse contributors. They also highlighted the fact that this was a uniquely Australian approach to drug policy that had produced highly regarded outcomes for diverse areas within the Australian community (Siggins Miller, 2009).


The need for engaging in partnerships across and within sectors and with the community in general will continue to be an important consideration for the next NDS. Importantly, NCETA contends that the health, law enforcement and education sectors will need to continue to explore opportunities to strengthen their partnerships while also looking at opportunities to engage with other levels of government, such as local government and also the non-government sector.
In relation to engaging with other sectors, the child and family welfare sectors are a particularly important sector especially in relation to raising the profile of family sensitive practice within the AOD field.
The following section focuses on the need to build partnerships between the AOD and the child and family welfare sectors.
Family Sensitive Practice in AOD Assessment and Treatment – Building Partnerships with the Child and Family Welfare Sectors

A substantial proportion of Australian children have a parent / care-giver undergoing AOD treatment. Anecdotal sources suggest that the proportion of AOD clients who are parents is substantial and has increased concomitantly with the increasing age and extended drug using careers of clients.


While having a parent with an alcohol and / or drug-related problem does not automatically imply harm to the child, there is a strong body of research that indicates that these children are at higher risk of abuse and neglect, developmental and behavioural problems, or of developing an AOD problem. It is known that children who live in households where their parents or primary caregivers are problematic substance users are at much greater risk of poor health and well-being outcomes in general (AIHW, 2009). Estimates of the extent of problematic parental AOD use in cases of child protection substantiations vary from approximately 50% to 80% of cases within the child protection system in Australia (Ainsworth, 2004; Jeffreys, Hirte, Rogers, & Wilson, 2008; Odyssey House, 2004), and often co-exist with other risk factors such as domestic violence and mental illness.
The AOD treatment workforce can play an important role in ensuring the safety and welfare of clients’ children. The extent to which Australian AOD treatment agencies employ child and family sensitive work practice models is currently unknown and the traditional focus on drug use and the drug user remains the dominant treatment paradigm: “…it is not uncommon for researchers, social workers and other professionals to become overly focused on the extent of substance misuse, rather than on the impact that it is having on family functioning, relationships within the family and the experience for the child” (Forrester, 2004, p. 167)
There is a growing awareness among the AOD and child / family welfare sectors of the effects of AOD use on the individual, their children and ultimately their family. In addition, there has also been a greater recognition that the separate and isolated approaches that are often used by the two sectors to work with children and their parents can have major limitations and unintended consequences. This change in awareness is relatively recent and has important implications for both sectors particularly in relation to improved collaboration. A crucial step forward is to increase the perception of the relevance of each sector and to challenge the long-held view that: “each service’s main area of expertise and interest is at best of peripheral concern to the others and at worst, thought to be a distraction from ‘real work’” (Kearney & Ibbetson, 1991, p. 107).
While there has been some effort in this area1, there remains much that needs to be done at the level of front line workers, policy and protocol development, service delivery modification and cross sectoral collaboration.
A family sensitive approach goes beyond treatment environments, as it can operate across a number of levels, for example:


  • Service delivery: e.g. consideration of families and children within treatment and services, developing the skills and attitudes of workers.

  • Organisational: e.g. organisational guidelines for Family Sensitive Practice, culturally appropriate services, processes for interacting with other services, family sensitive physical environments within services.

  • Systems and Services: e.g. building knowledge and partnerships for Family Sensitive Practices across services and sectors.

  • Policy: e.g. Prioritisation of family sensitive practice within policy, facilitating structures and resources.

NCETA notes the growing awareness among the AOD and child / family welfare sectors of the need for greater cooperation to address the needs of AOD clients, their children and their family. In order to facilitate change, NCETA recently completed a collaborative project with the Australian Centre for Child Protection that examined the role of AOD workers and the factors that influence child and parent sensitive practice within the AOD treatment field. In a related initiative, NCETA is developing a user-friendly, practical resource for AOD workers, managers and policy makers to assist them to better address the needs of clients’ children.


NCETA recommends that the new NDS highlights the importance of the AOD sector engaging in partnerships with the child and family welfare sectors and that greater emphasis is placed on the importance of family sensitive practice.
Emerging Issues and New Developments
Responding to emerging issues

Over the past 20 years, the AOD field (and the wider health/community services sector) has experienced unprecedented changes that have major implications for the development of a responsive and sustainable AOD workforce. Provision of quality and timely AOD responses has been substantially impacted by:




  • changing patterns of substance use (including earlier onset and extended duration of use)

  • increased prevalence of polydrug use2

  • unprecedented increasing in use of pharmaceutical substances

  • a growing recognition of mental health/drug use co-morbidity

  • an expanding knowledge base

  • advances in treatment protocols and

  • an emphasis on evidence based practice.

There is also evidence suggesting that the level of prescription pharmaceutical opioids, stimulants and benzodiazepines has increased dramatically in Australia over the past decade (Nicholas, 2002; Parliament of Victoria Drugs and Crime Prevention Committee, 2007). The reasons for this are complex and not all relate to the misuse of these drugs. Other important factors include the ageing of the population and more aggressive pain management practices. Nevertheless, there is little doubt that as these drugs have become more widely prescribed they become more widely misused and this has a number of implications for workforce development in the alcohol and other drugs sector. Dealing with this issue will also require not only building the skill level of AOD workers, but also policy and protocol development, service delivery modification and cross sectoral collaboration.


NCETA notes the imperatives of the new NDS being sufficiently flexible and responsive to new and emerging issues and developments and that it provides for mechanisms that can be used to identify and respond appropriately to those new and emerging trends.

Could the IGCD and MCDS more effectively access external expert advice and if so, how?
Better utilisation of external expert advice

The evaluation of the three national AOD research centres along with the recent NDS evaluation found that the three centres continue to produce expert advice about emerging trends at short notice. It was also noted that policy deliberations and implementation often involved broader consultation with key stakeholders including local governments, the private and non-government sectors, consumer groups, industry groups, the research community and the wider community. These external sectors (i.e. external to the existing NDS governance arrangements), however, engage with the policy process primarily by invitation and on an ad hoc basis. It was therefore suggested that strengthening the role of sectors beyond government that are involved in service delivery, research, drug user groups, and people affected by drug use would assist in building better policy (Siggins Miller, 2009).


NCETA recommends that, consistent with the findings from the NDS Evaluation, the new NDS and associated structures incorporate effective consultation mechanisms for engaging with key external advisers.

Where should efforts be focused in reducing substance use and associated harms in Indigenous communities?
How could Aboriginal and Torres Strait Islander peoples needs be better addressed through the main National Drug Strategy Framework?
In that context, would a separate National Drug Strategy Aboriginal and Torres Strait Islander Complementary Action Plan continue to have value?
Building the capacity of the Indigenous AOD workforce

It is acknowledged that indigenous Australians are at high risk of health and social problems associated with AOD use (Gray, Saggers, Atkinson, & Strempel, 2004). They are often marginalised in terms of health care services and other forms of social inequalities such as income, housing, education and employment (Trewin & Madden, 2005). Compared to non-Indigenous Australians, a larger proportion of Indigenous Australians live in remote areas where health services are limited (Trewin & Madden, 2005). Cultural differences can add to difficulties in accessing culturally safe health care and AOD services (Henry, Houston, & Mooney, 2004).


There are comparatively few Indigenous people employed in the health and human services fields. Indigenous health professionals comprised only 1% of the total health workforce in 2001 (Pink & Allbon, 2008). This contrasts with the proportion of the Australian population who are Indigenous, which is 2.5% (Australian Bureau of Statistics, 2007).
Indigenous AOD workers are an especially important segment of the AOD workforce and they carry a particularly heavy load. They are often not highly trained or well supported but nonetheless are required to carry out a wide range of demanding roles. In addition, they are often ‘on call’ 24/7 and as a result many experience high levels of stress and burnout.3
The Indigenous AOD workforce has complex and pressing needs. These needs are largely due to due to:


  • rural/remote issues such as recruitment retention, limited access to clinical supervision and training, limited funding and managerial support

  • Indigenous client base issues such as the need for community acceptance, literacy and language issues, and the stress arising from dealing with often complex and emotional presentations

  • workforce development issues facing the wider indigenous health workforce such as lack of career paths, wage disparity, gender imbalance, and high levels of work demand.

Strategies are required that extend the focus beyond the training of existing Indigenous AOD workers at the level of Certificate III and Certificate IV (as important as this is) to incorporate a broad and comprehensive recruitment and capacity building strategy. This could include the following strategies:




  • recruit Indigenous high school students into tertiary education

  • provide managerial training

  • mentoring and support programs

  • pro-active leadership identification and training programs

  • advanced skill development at postgraduate level.


NCETA recommends that a co-ordinated national approach is required that can address a wider range of issues impacting on the Indigenous AOD workforce. This approach should involve specific culturally appropriate workforce development strategies that:


  • increase the numbers of Indigenous AOD workers and non-indigenous AOD workers who deal with Indigenous Australians

  • engage and build the AOD skills and knowledge of other Indigenous health and human service agencies

  • expand the role and capacity of Indigenous communities to effectively identify and address community AOD issues

  • build the capacity of non-Indigenous AOD workers to address the AOD needs of Indigenous clients.



Where should effort on the support and development of drug and alcohol sector workforce be focused over the coming five years?
Where should efforts be focussed over the coming five years to increase the capacity of the generalist health workforce to identify and respond to substance use problems?
Development and implementation of a National AOD Workforce Development Strategy

The evaluation of the 2004-2009 National Drug Strategy (NDS) noted that:

There has been a stronger emphasis on workforce development in recent years. NCETA’s focus has changed over the years from developing and delivering AOD training programs (it filled a problematic gap in this area in its early days) to research on workforce development issues. This research has provided much of the evidence for workforce development policies and action plans.
Australia is an international leader in AOD workforce development research, primarily through the work of NCETA, and that this is one of the positive outcomes of the current phase of the NDS.
This leadership has not yet been translated into a national workforce development strategy and implementation plan.”

(Siggins Miller, 2009, p. 64).


The NDS evaluation noted the importance of investing in the recruitment of new workers, the retention of the existing workforce and modelling to estimate future needs and the need to identify strategies to ensure a future supply of an appropriately skilled and qualified workforce (Siggins Miller, 2009).
While Australia has not produced a national AOD workforce development strategy, considerable progress has been made over the past five to six years in regard to workforce development, particularly at the jurisdictional level. However, these efforts to-date have been piecemeal and uncoordinated and a nationally co-ordinated approach has been lacking.
A national strategic approach is urgently needed and would allow for:

  • a more analytical, proactive approach rather than an ad-hoc, reactive approach

  • reduced duplication across sectors and jurisdictions

  • more efficient use of resources

  • development of a national pool of competence

  • a risk mitigation strategy

  • effective application of evidence based best practice

  • duty of care for funding decisions.

The implementation of such an approach would also result in better outcomes for both clients of services and the community at large.


In order to inform the development of a National AOD Workforce Development Strategy, NCETA has recently completed a soon to be published report that describes the background, context and issues currently facing the AOD workforce and outlines the steps for developing a national AOD Workforce Development Strategy (A.M. Roche & Pidd, 2010).
An overarching model of workforce development is proposed which is comprised of five levels:

  1. Systems

  2. Organisations

  3. Workplaces

  4. Teams

  5. Individuals.

NCETA maintains that a national workforce development strategy needs to address each of these levels and facilitate and support evidence based practice initiatives that target both organisations and individuals. At the organisational level, initiatives are required to facilitate the integration of workers’ new knowledge and accommodate changes in work practices accordingly. At the individual level, initiatives that improve access to information and build skills to translate this information into work practice are required. In addition, initiatives are also required that develop effective partnerships between research and service delivery agencies.


NCETA recommends that a range of sectors need to be involved in developing a national AOD workforce strategy. These sectors include:

  • health

  • human service

  • law enforcement/criminal justice

  • housing

  • employment

  • mental health

  • disability services

  • education

  • child care and child safety protection.

Further, NCETA also recommends that:



  • the production and implementation of an effective national workforce development strategy for the AOD field requires strong coordination, leadership, and collaboration across jurisdictions, government departments, sectors, and individual agencies

  • a comprehensive strategy will need to clearly define actions to be undertaken, provide timelines, and allocate responsibility for implementation.

To achieve this, high level support will be required to inform the development of a strategy, provide funding for the production and implementation of the strategy, and assist with intersectoral collaboration. This can be best achieved by a nationally co-ordinated approach involving the IGCD and the Australian Government.


NCETA strongly recommends the development of a National AOD Workforce Development Strategy as a key priority in the new NDS.
Proposed establishment of a National AOD Workforce Development Advisory Committee

NCETA recognises that the development of a national strategic approach to workforce development needs to be informed and guided by a range of external experts and advisers. As such, NCETA contends that a committee should be established to assign responsibility for the production of a workforce development strategy to an appropriate individual or organisation and oversight of the production process.


NCETA recommends the establishment of a national AOD workforce development Advisory Committee, facilitated by NCETA, with representatives from all key relevant national and jurisdictional bodies to deliberate on all major workforce development issues, develop nationally agreed and consistent positions, and advise on workforce development strategies.
A Better Understanding of the AOD Workforce

The AOD workforce is part of the community/human services and health industry sector which is Australia’s third largest employer, employing more than 1.1 million Australians and comprising more than 10% of the workforce (Community Services and Health Industry Skills Council, 2009). Over the past 10 years there has been a 38.7% growth in employment in this sector and this trend is expected to continue.


It has been estimated that the community services and health sector will contribute 24% of all workforce growth to 2012, growing at a rate of 3% (170,000 new jobs) per year (Community Services and Health Industry Skills Council, 2008). That is, one in four of all new jobs created over the next five years will be in the health and community services sector. While this growth will provide an important contribution to the future health and welfare of Australians and Australia’s future economy, it also presents a substantial workforce development challenge.
The AOD field not only sits within the wider health and community/human services sector, it also forms part of the education and law enforcement / criminal justice sectors. It is thereby impacted by a wide range of contextual factors of relevance to these sectors that are central to the development of a national workforce development strategy.
Key issues relevant to this wider context include:

  • the availability of a skilled and effective generic workforce, appropriately distributed across the population

  • the implementation of long term planning processes and cooperation between all jurisdictions to achieve workforce goals

  • the impact on Australia of worldwide shortages of particular groups of workers; such shortages particularly impact rural and remote areas.

To meet the future AOD needs of the Australian population in an environment of worldwide health and other workforce shortages may require initiatives that include:


A number of generic trends also impact on service delivery both within the AOD field and wider health and community/human services workforce. These include:



  • increases in consumer demand and expectations

  • new developments in technology

  • changing models of care

  • an increase in knowledge of genetic factors impacting upon disease

  • a trend towards more targeted therapies

  • increasing demand for services.4

Compounding the increased demand for health and community/human services in general are substantial difficulties in recruiting and retaining qualified staff, particularly in rural and remote areas. This is an on-going issue in the AOD sector (Duraisingam, Pidd, Roche, & O'Connor, 2006; Pitts, 2001; Wolinski, O'Neill, Roche, Freeman, & Donald, 2003).


Australian governments have introduced a range of targeted policies to address workforce shortages (e.g., overseas trained doctor programs, additional nursing places, subsidies for rural doctors, etc). However, these strategies alone may not be sufficient to meet the challenges facing Australia’s health and community/services workforces at large and the AOD workforce in particular.
NCETA suggests that it is important that the new NDS and associated strategies, including a national AOD workforce development strategy, are informed by a better understanding of what constitutes the AOD workforce.
Specialist and Non-Specialist AOD workers

It is important to note that the AOD workforce is not restricted to AOD specialist workers employed in AOD specialist organisations. The AOD workforce comprises two distinct groups:




  1. frontline AOD specialist workers (who may work in AOD specialist organisations agencies or in AOD programs within non-AOD specialist organisations), and

  2. generalist workers (who work in the mainstream workforce, not the AOD sector, but have extensive contact with the wider community and are thereby well placed to implement AOD prevention and intervention strategies).

In profiling the specialist AOD workforce, NCETA notes that a total of 13 AOD workforce surveys (5 national and 8 jurisdictional) have been undertaken over the past decade. While differences between surveys in terms of survey methods and questions asked limit the degree to which the results of each survey can be compared, when viewed collectively, these studies allow for a composite profile of the AOD workforce to be developed (A.M. Roche & Pidd, 2010). The details of these surveys are presented in chronological order in Table 1.


Table 1: AOD specialist workforce surveys 2001-2009


National surveys

2001

National NGO survey (43 respondents)

Pitts (2001)

2002

An NCETA national survey of 234 specialist treatment agency managers

Wolinski, O'Neill, Roche, Freeman, & Donald (2003)

2003

An NCETA national survey of 1,024 mainstream workers engaged in AOD work

Freeman, Skinner, Roche, Addy, & Pidd (2004)

2005

An NCETA national survey of 1,345 specialist AOD workers

Duraisingam, Pidd, Roche, & O’Connor (2006)

2005

An NCETA national survey of 280 specialist treatment agency managers

Duraisingam, Roche, Pidd, Zoontjens, & Pollard (2007)

Jurisdictional surveys

2002

A survey of 745 Victorian AOD workers employed in agencies funded by the Victorian Department of Human Services

Victorian Department of Human Services (DHS) (2005)

2005

A survey of 136 Northern Territory AOD workers employed in 18 AOD specialist treatment agencies and AOD intervention programs

NT Department of Health and Community Services (2005)

2006

A survey of 134 ACT specialist AOD workers

McDonald (2006)

2007

An NCETA survey of 167 South Australian AOD workers employed in 18 non-government AOD specialist agencies and 26 non-government mainstream agencies with AOD programs

Tovell et al. (2009)

2008

WA survey of 207 AOD workers from 35 NGO services – part of the 2007 Sector Remuneration Survey

WAAMH et al. (2008)

2008

A NSW Network of Drug and Alcohol Agencies (NADA) survey of 111 NSW non-government specialist workers and 85 managers of NSW non-government specialist treatment agencies

Gethin (2008)

2008

A survey of 492 workers employed in Victorian AOD agencies

Conolly (2008)

2009

A survey of 132 ACT workers from 9 AOD agencies

ACT AOD Sector Project (2009)

Professions involved in responding to alcohol or drug related problems can be classified as specialists or generalists. Specialist workers are usually located within an AOD-specific service (for example, psychologists, social workers, or counsellors who work in alcohol or drug treatment services). In contrast, a generalist worker may be required to respond to AOD-related problems, but may not work in a specific AOD setting (for example, nurses and general practitioners).


Increasingly it has become apparent that specialist workers can not be the only workers who respond to alcohol and other drug problems. However, specialist workers may be more able to treat dependent individuals as the greatest advantage of specialist treatment over generalist treatment is the longer period of time available to the specialist workers to engage, counsel and treat the client’s alcohol or drug related problems. Also, more recent interventions for AOD problems, such as the growing array of new pharmacotherapies, require specialised, technical knowledge, and thus are more suited to specialist intervention.
Both the AOD specialist and mainstream (generalist) workforce includes a number of occupational groups, that have specific and, in some cases, unique workforce development needs. A national workforce development strategy may require separate, but inter-related initiatives that target these groups.
NCETA contends that in order to accommodate the diverse needs of different AOD workforce groups a co-ordinated, multifaceted and flexible workforce development strategy is needed that acknowledges other workforce development initiatives and strategies that also include a range of occupational groups.
A Focus on Law Enforcement – Workforce Development Issues for Police

Over the past 20 years, Australian police have made significant contributions to the development, implementation and success of this country’s major AOD policy and intervention initiatives. Throughout this time, police have had heavy and growing demands placed on them to deal with AOD-related issues along with the demands associated with an increasing professionalisation of their workforce. Yet compared to other frontline workers, such as health workers and AOD workers, until recently there has been no systematic assessment of the AOD workforce development needs of police.


A recent report prepared by NCETA for the Ministerial Council on Drug Strategy (MCDS) examined the workforce development needs of police in relation to AOD issues (A. M. Roche, Duraisingam, Trifonoff, & Nicholas, 2009). Consistent with its broader program of work, NCETA has endeavoured:

  1. To identify AOD workforce development priorities for police

  2. To recommend relevant strategies to address workforce development needs

  3. To critique AOD training and professional development needs of police.

In conducting this exercise, NCETA has now taken a first step towards identifying what needs to be done, from a workforce development perspective, to enhance police responses to AOD problems. NCETA has found that more exploratory work needs to be undertaken, as has occurred with other professional groups but not yet for police, before embarking on specific actions. In particular, NCETA contends that a national workforce development strategy needs to be designed to identify the specific and unique needs of police and law enforcement officers in relation to their work in the AOD area.


In its report to MCDS, NCETA recommended that consideration be given to the establishment of a taskforce to develop to develop a comprehensive national workforce development strategy that caters for the unique, specific and jurisdictional AOD-related needs of police. Elements of such a strategy could include, but would not be limited to the following:


  1. A multi-tiered approach that addresses the key issues of systems-wide action, capacity building and professional development.

  2. An extension beyond a national training package / program, given the limitations and inefficiencies entailed in such an approach.

  3. A top-down approach engaging support from the highest levels and including senior managers to achieve essential organisational, infrastructure and culture change.

  4. A reflection of the emerging trend toward the professionalisation of policing and incorporate strategies to address leadership, management and related governance issues.


NCETA strongly recommends that the next iteration of the National Drug Strategy should specifically address the AOD workforce development needs of police.
What are the particular opportunities and challenges that technology development is likely to pose for the community and the alcohol and drug sector over the next five years?
Evidence based practice – translation of research into practice

A growing emphasis on evidence based practice and the way in which research, knowledge and skills are translated into practice are major challenges for the AOD workforce (A. M. Roche, 2001). Evidence based practice is the use of current best evidence to make decisions about work practices and it is one of the major drivers of workforce change. Evidence based practice requires the translation of research into practical strategies for workers. However, given the large amount of AOD research being generated, a passive translation process alone is insufficient to achieve work practice change (Bywood, Lunnay, & Roche, 2008; A. M. Roche, 2001).


A number of key barriers to evidence based practice have been identified. These barriers include:


  • lack of high quality research, in particular randomised controlled clinical trials (although the evidence base is growing rapidly in the AOD field)

  • research evidence that cannot be applied beyond specific settings

  • the complexity of AOD problems (Allsop & Helfgott, 2002; Evans, 2001)

  • limited expertise within the non-government sector to access, research and present new evidence

  • limited funding, time, and expertise within the non-government sector to conduct treatment evaluations (Gethin, 2008).

While there have been some advances in the AOD field concerning evidence based practice, more needs to be done to develop effective partnerships between researchers and practitioners in order to facilitate the translation of research into practice. The literature on the translation of evidence into practice highlights the importance of using theoretical models of change to understand the behaviour of professionals and the development of strategies required to change behaviour (Bero, et al., 1998; Davies & Nutley, 2002).


NCETA contends that it is imperative that the new NDS recognises the importance of evidence based practice as a key factor in the dissemination of research into practice.
Improving data collection systems

While Australia has excellent data collection systems in place in relation to tracking current and emerging drug trends, little work has been undertaken to use these data to estimate future workforce needs. Moreover, no nationally co-ordinated framework for workforce mapping and planning for the AOD sector has been developed. Another major deficit in the existing data collection systems is not being able to access wholesale alcohol sales data.


One of the key technological challenges confronting the AOD sector and the community currently and into the future is the need to be able to readily access timely and accurate data and information. Equally, this data needs to be able to be located, accessed and utilised relatively easily.
NCETA recommends that the new NDS acknowledges the need to improve current AOD data collection systems and to ensure that data is timely, accurate and easily accessible.

How can efforts under the National Drug Strategy better complement the social inclusion agenda such as addressing unemployment, homelessness, mental illness and social disadvantage?
Where should effort be focused in reducing substance use and associated harms among vulnerable populations?
A social inclusion agenda for the AOD workforce

AOD use and related problems cut across society and impact on a wide range of health, education, human service, police, and criminal justice workers and there is also a growing demand for services, policies and programs from specialist AOD agencies, as well as from generalist workers.


Comprehensive, inter-sectoral and long term workforce development planning processes are required to ensure an adequate AOD workforce for the future. Workforce development initiatives that are implemented across sectors, systems and agencies are the most efficient way to build workforce capacity. This requires strategies to optimise and strengthen integration and co-ordination between health, law enforcement and human services sectors (including welfare, housing, Indigenous and youth), especially in light of the emphasis on the social determinants of AOD problems and renewed interest in social inclusion.
There is also growing recognition that AOD problems do not exist in isolation and that they are usually accompanied by an array of complex factors. As a result there is greater emphasis placed on social inclusion strategies.
NCETA recommends that workforce development initiatives need to be cognisant of the broader health and human service systems within which AOD services operate. AOD-related problems are often complex and multi-faceted and thereby require interventions by multiple service deliverers.

Are publicly available performance measures against the National Drug Strategy desirable?
If so, what measures would give a high level indication of progress under the National Drug Strategy?
Evaluation and monitoring

The NDS evaluation highlighted the importance of monitoring program performance to get a better understanding of the extent to which the NDS and the complementary strategies have been implemented and have achieved their intended outcomes (Siggins Miller, 2009).


Equally, NCETA recognises the importance of ensuring that reliable and valid data concerning AOD workforce development strategies are available. While it is essential for workforce development initiatives to be based on best practice, there also needs to be a concomitant increase in development of an evidence base for workforce development.
NCETA recommends that, as part of a national AOD workforce development strategy:


  1. Regular national reviews (e.g., 3-yearly) of the AOD workforce should be undertaken to continue to monitor and map the demographic features of the workforce and assess workforce flows (including recruitment and retention). NCETA is the appropriately positioned body to undertake these surveys and to act as a central repository of data on the AOD workforce.

  2. Jurisdictional workforce surveys are also encouraged, but they should be undertaken with guidance from NCETA to ensure consistency and compatibility of the data collected. This will maximise the usefulness of available data and will add considerable efficiencies to the limited resources allocated in this area.



References



1 For example the Australian Government’s ‘Kids in Focus-Family Drug Support’ program and the previous ‘Strengthening Families Program’.

2 Australia has extensive and detailed data on patterns and prevalence of AOD use (e.g., NDSHS, ASSAD) together with excellent sentinel systems (e.g., IDRS, EDRS) to inform policies, programs and interventions.

3 At the time of writing, NCETA was completing a national study examining factors that contribute to Indigenous workers’ wellbeing, stress and burnout and ameliorative factors.

4 An Australian Community Sector Survey of service provision in 2007-08 found demand for services across the board increased 19% from the previous year. In addition the percentage of people eligible for services who were turned away increased by 17.3% (ACOSS, 2009).



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