Discussion paper consultation questions
Focus area 1: Strategic governance
Do the governance a
angements for the clinical placements program need to be strengthened or streamlined and how would this be best achieved? Do the existing legal instruments provide a useful source of guidance for how the clinical placements program should operate and, if not, how could these be improved? Do you consider that the responsibilities of all participants in the clinical placements program are clear, reasonable, and taken to the point of action and, if not, which aspects require attention?
Focus area 2: Resourcing
Do you consider there are any statewide or local program management resources changes or enhancements that should be made? What is your prefe
ed channel for receiving information and keeping connected with the clinical placements program? Do you consider that the principles underpinning the fees framework provide a reasonable policy basis and, if not, why and how do you think these should be modified? What, if any, further guidance would you like made available in relation to the application of fees for clinical placements? What are your expectations in relation to the resourcing of technology access for students on clinical placements?
Focus area 3: Risk
To what extent do the cu
ent governance and legal frameworks address risk within the clinical placements program? How could this be improved? What additional risks are there in the operation of the program at a local level that require further consideration by Queensland Health? Do you support the implementation of a Statewide clinical placement management system? Why or why not?
Focus area 4: Strategy and Policy
What, if any, further policy guidance would you like made available for the clinical placements program? Which aspects of the clinical placements policy framework are working well and how can it be improved? In your answer, please consider how it has borne the impacts of the COVID-19 pandemic. Which clinical placement requirements, if any, are the most difficult to implement and how could compliance be further supported?
Discussion paper consultation questions - Clinical Placements Strategic Review 2020
Discussion paper consultation questions - Clinical Placements Strategic Review 2020 Page 1
Microsoft Word - Attach 1 - Discussion paper fo~acements program (August 2020)
Clinical Placements Strategic Review - Discussion Paper
Clinical Placements
Strategic Review
Discussion Paper
September
Clinical Placements Strategic Review - Discussion Paper Page
Discussion paper
Published by the State of Queensland (Queensland Health), September 2020
This document is licensed under a Creative Commons Attribution 3.0 Australia licence. To view a copy of
this licence, visit creativecommons.org/licenses
y/3.0/au
© State of Queensland (Queensland Health) 2020
You are free to copy, communicate and adapt the work, as long as you attribute the State of Queensland
(Queensland Health).
For more information contact:
Workforce Strategy Branch, Department of Health, GPO Box 48, Brisbane QLD 4001, email
XXXXXXXXXX
Disclaimer:
The content presented in this publication is distributed by the Queensland Government as an
information source only. The State of Queensland makes no statements, representations or wa
anties
about the accuracy, completeness or reliability of any information contained in this publication. The State
of Queensland disclaims all responsibility and all liability (including without limitation for liability in
negligence) for all expenses, losses, damages and costs you might incur as a result of the information
eing inaccurate or incomplete in any way, and for any reason reliance was placed on such information.
Clinical Placements Strategic Review - Discussion Paper Page
Table of Contents
Foreword by Director-General 4
Have your say 5
Principles of engagement 5
Consultation questions 5
Assumptions 5
How to make a submission 8
Section One: Introduction 9
Purpose and scope of the review 9
Review question 9
Limitations 9
Context for the review 10
Outline of discussion paper 10
Section Two: Strategic policy drivers 12
Regulatory context 12
Queensland Health context 12
Section Three: Focus areas 14
Focus area 1: Strategic governance 14
Focus area 2: Resourcing 20
Focus area 3: Risk 25
Focus area 4: Policy 29
Section Four: Looking ahead 32
Summary 32
Challenges and opportunities 32
Next steps 32
Annexures 33
Annex A: Education providers with Student Placement Deeds as at July 2020 33
Annex B: Relevant sections of existing contracts and agreements 34
Clinical Placements Strategic Review - Discussion Paper Page
Foreword by Director-General
At the beginning of 2020, the Department of Health commenced a strategic review of the Queensland
Health clinical placements program. This program enables practical opportunities for student learning as
an essential pillar in the development of Queensland’s future clinical workforce.
What we could not have known when we embarked on this process, was how our reliance on our health
workforce would become so great as the year progressed, and as the challenges of managing the COVID-
19 pandemic came to the fore.
Queensland Health acknowledges and values its relationships with education providers and other
stakeholders in the provision of clinical placements to healthcare students. Our partnerships across
clinical professions have enabled the continuation of clinical placements throughout challenging
circumstances. The potential lessons to students from involvement in a significant health event are
invaluable.
I am pleased to present this discussion paper as part of the strategic review of the clinical placements
program. The review provides an opportunity to reflect on key strategic elements of the program, and
to ensure that the program framework continues to be effective, resilient, and responsive to the evolving
operating environment.
The review will explore cu
ent governance, resourcing, risk and policy matters, to ensure that the clinical
placements program continues to be aligned to the organisation’s objectives for pre-entry student
clinical education and training. This discussion paper forms part of the
oad engagement occu
ing with
key stakeholders involved in student clinical education and training.
I welcome the participation of all stakeholders in the review process and invite submissions in response
to the questions posed throughout this document.
Queensland Health is committed to advancing the health of all Queenslanders and to supporting
programs such as the student clinical placements program. Please take this opportunity to reflect on the
strategic and policy direction of the clinical placements program and consider the issues and questions
that are put forward for discussion. As we work to shape the direction of clinical placements in
Queensland, your contribution is greatly appreciated.
Dr John Wakefield PSM
Director‐General
Queensland Health
Clinical Placements Strategic Review - Discussion Paper Page
Have your say
In undertaking the strategic review of the governance of the clinical
placements program, Queensland Health is interested in capturing the views
of all program stakeholders. This will be achieved using a suite of engagement
mechanisms, tailored to meet the needs of our
oad stakeholder network.
Principles of engagement
The following principles of engagement1, as
general statements of good practice, have
een adopted in this project:
. Be inclusive – We know who to engage
. Engage with purpose - Our engagement is
deliberate and deliberative
. Seek early involvement – Our stakeholders
are involved as early as possible and
elevant in the project
. Be respectful and cognisant of stakeholder
need and expertise - Engagement
opportunities are multi-level
. Engage with authenticity – We value the
contributions of stakeholders
These principles do not prescribe specific ways
to engage, but their intentions underlie each
engagement opportunity. This review offers
stakeholders multiple mechanisms through
which they can participate, acknowledging
varying availability, accessibility, and
communication preferences.
Other consultation mechanisms will support
the contribution of input via opinion and
experience surveys, workshops, and
presentations. Stakeholders are welcome to
participate in the review to the extent they
1 Adapted from Government of South Australia, Better
Together: Principles of Engagement, Second edition.,
accessed 10 January 2020,
https:
ettertogether.sa.gov.au/media/W1siZiIsIjIwMTgv
choose and via their prefe
ed mode/s of
engagement.
Consultation questions
This discussion paper was developed to provide
contextual information about the strategic
functioning of the clinical placements program,
and to provoke interest in and reflection on its
strategic and policy direction. Stakeholders
wishing to contribute their thoughts and ideas
in response to the discussion paper are
encouraged to do so in the form of a written
submission to Queensland Health.
Questions in relation to each of the focus areas
of the review are posed in the applicable
sections of this document. The purpose of
these questions is to promote stakeholder
consideration and exploration of issues, and to
elicit views, experiences, and ideas in relation
to each of the topics. A consolidated list of the
consultation questions from the remainder of
the discussion paper is provided below, for
eady reference.
Assumptions
Queensland Health is conducting the review in
good faith and invites stakeholder input in
order to gain a better understanding of user
MDQvMTgvOTlsdnViOWlzMF9CZXR0ZXJfVG9nZXRoZXJfSGFu
ZGJvb2tfc20ucGRmIl1d/Better-Together-Handbook_sm.pdf>
Clinical Placements Strategic Review - Discussion Paper Page
and partner interaction with the program.
Queensland Health has an interest in
progressing changes to the program over time,
which improve it for all stakeholders, while
prioritising the integrity and probity of the
program as a State Government-operated
initiative.
Clinical Placements Strategic Review - Discussion Paper
Focus area : Strategic governance
. Do the governance a
angements for the clinical placements program need to be strengthened or
streamlined and how would this be best achieved?
. Do the existing legal instruments provide a useful source of guidance for how the clinical
placements program should operate and, if not, how could these be improved?
. Do you consider that the responsibilities of all participants in the clinical placements program are
clear, reasonable, and taken to the point of action and, if not, which aspects require attention?
Focus area : Resourcing
. Do you consider there are any statewide or local program management resources changes or
enhancements that should be made?
. What is your prefe
ed channel for receiving information and keeping connected with the clinical
placements program?
. Do you consider that the principles underpinning the fees framework provide a reasonable policy
asis and, if not, why and how do you think these should be modified?
. What, if any, further guidance would you like made available in relation to the application of fees
for clinical placements?
. What are your expectations in relation to the resourcing of technology access for students on
clinical placements?
Focus area : Risk
. To what extent do the cu
ent governance and legal frameworks address risk within the clinical
placements program? How could this be improved?
. What additional risks are there in the operation of the program at a local level that require further
consideration by Queensland Health?
. Do you support the implementation of a Statewide clinical placement management system? Why
or why not?
Focus area : Strategy and Policy
. What, if any, further policy guidance would you like made available for the clinical placements
program?
. Which aspects of the clinical placements policy framework are working well and how can it be
improved? In your answer, please consider how it has borne the impacts of the COVID-
pandemic.
. Which clinical placement requirements, if any, are the most difficult to implement and how could
compliance be further supported?
Clinical Placements Strategic Review - Discussion Paper Page
How to make a submission
The collection and consideration of stakeholder input will form a central part
of the review process and will provide the foundation for the review
ecommendations.
Written submissions in response to the above consultation questions, or to the review topics more
oadly, are welcomed, and may be forwarded to:
Clinical Placements Strategic Review
Workforce Strategy Branch
GPO Box 48
Brisbane QLD 4001
Email: XXXXXXXXXX
y 5pm on Friday 16 October 2020.
If you have any questions in relation to making a submission, please contact the review team on the
above email address or on telephone (07) 3708 5735.
Please note that updates on the progress of the strategic review of the clinical placement program will
e made available on the Queensland Health clinical placements website at
https:
www.health.qld.gov.au/employment/clinical-placement. This is also where other information
egarding the clinical placements program is located.
Clinical Placements Strategic Review - Discussion Paper Page
Section One: Introduction
The 2020 review of the clinical placements program is driven by emerging
legislative and governance changes, and the intention to optimise the
program for the evolving strategic health environment.
Purpose and scope of the review
Queensland Health seeks to ensure that the clinical placements program continues to support
organisational objectives for professional pre-entry clinical education and training. The purpose of the
eview is to examine the strategic frameworks that support the operation of the clinical placements
program across Queensland Hospital and Health Services (HHSs) and ensure that they are appropriate,
and able to facilitate the effective, responsive operation of the program.
The review will explore the clinical placement program’s governance a
angements, roles and
esponsibilities, resourcing, and risk provisions, and the strategic, legal and policy frameworks of the
program. Engagement activities will be undertaken to enable the collection stakeholder input.
Following a period of consultation, the review will deliver a report and recommendations in relation to
the four identified strategic focus areas: governance, resourcing, risk, and policy.
Review question
In representing the terms and conditions under which pre-entry clinical placements are
offered in Queensland Health facilities, what enhancements or additions or changes are
equired to the governance, documentation, and resourcing to ensure the program is
flexible, responsive, and fit-for-purpose?
Limitations
To align with the cu
ent program parameters, this review only refers to pre-entry clinical placements in
Queensland Health facilities. It does not include programs for work experience, non-clinical and
esearch-only placements, observerships, and grants program experiences (such as that offered by the
John Flynn Placement Program). By necessity, clinical placements provided in the private or not-for-
profit sectors are also excluded.
The experience of the COVID-19 pandemic throughout 2020 has
ought the opportunity for significant
experiences and learning across the heath sector. The pandemic is having far-reaching impacts, and its
effects have been, and will continue to be, evident on the clinical placements program. The lessons
that we continue to learn from the pandemic response will inform the clinical placements review;
however, Queensland Health is committed to offering a program that is robust and responsive every
day, not only during one-in-a-hundred-years events.
Clinical Placements Strategic Review - Discussion Paper Page
Context for the review
Evolving strategic environment
The clinical placements program must remain responsive to changes in the legislative and regulatory
frameworks within which it operates. As new legislation, such as the Human Rights Act 2019, is
introduced; as existing legislation, such as the Hospital and Health Boards Act 2011, is reviewed and
amended; and as contractual a
angements such as service agreements are updated, it is necessary to
periodically review the clinical placements program to ensure its ongoing compliance and
appropriateness.
The program must also be considerate of changes to the social, economic, and commercial
environments which impact the operation of the program. Australia’s experience with COVID-19 has
had implications for the higher-education sector which are expected to be reflected in changes to how
stakeholders interface with the clinical placements program. In reviewing the governance, resourcing,
isk, and policy aspects of the clinical placements program, Queensland Health aims to ensure that the
program remains resilient and flexible in the face of both internal changes and external forces.
Fit-for-purpose legal instruments
The clinical placements program incorporates the use of legal instruments which set out definitive
program parameters and accountabilities. A full review of the cu
ent Student Placement Deed
occu
ed in 2016, and a minor update to clinical placement provisions in Queensland Health service
agreements occu
ed in 2018. It is timely that the legal instruments that overarch clinical placements in
Queensland are reviewed to ensure their continuing efficacy and modernity. The strategic review of the
clinical placements program will provide the strategy and policy evidence base for recommendations of
any required amendments to the legal instruments used within the program.
Program resourcing considerations
In conducting the strategic review of the clinical placements program, it is timely to consider the
esourcing of the program and the resources required to support it. The review also provides the
opportunity to examine issues related to the charging and setting of clinical placement fees, including
the principles that underpin these processes.
Risk allocation and mitigation
While Queensland Health provides strategic leadership of the clinical placements program on behalf of
the State of Queensland, as noted above, the program is implemented at a local level by HHSs. While
this approach enables clinical placements to be flexible and tailored to local requirements, it introduces
complexity where mitigation relies on multiple sources.
Outline of discussion paper
The next section of the discussion paper provides background information and the policy context for
the Queensland Health clinical placements program.
Section Three explores each of the four review topics in more detail. For each topic, there is a
presentation about cu
ent a
angements and a
oad discussion of issues that have been identified or
Clinical Placements Strategic Review - Discussion Paper Page
options to consider for the future. Finally, consultation questions are posed for each topic, inviting
eaders to provide their own observations, views and ideas.
Section Four summarises the issues considered in the paper and rounds out the discussion with a look
at some high-level challenges and opportunities that are provided to contextualise the review
ecommendations.
Clinical Placements Strategic Review - Discussion Paper Page
Section Two: Strategic policy drivers
A capable and qualified health workforce underpins the delivery of safe, high-
quality healthcare. Health education and training providers, regulation and
accreditation bodies, and health service organisations all play important roles
in the system that develops the cu
ent and emerging health workforce.
Clinical placements for health students are an integral part of this system.
Regulatory context
Clinical placements occur within complex legislative, regulatory, policy, and practice frameworks. The
Health Practitioner Regulation National Law provides for registration and accreditation of the sixteen
(16) registered professions. The Australian Health Practitioner Regulation Agency (Ahpra) provides
student registration for pre-entry health practitioners (excluding psychology) and required professional
standards are set through profession-specific National Boards. For the non-registered health
professions, the National Code of Conduct for Health Care workers (Queensland) establishes
equirements for practice.
A plethora of health programs, covering medical, nursing, midwifery, allied, oral and other health
disciplines, are offered by numerous higher education providers including universities and registered
training organisations. In the case of the nationally registered health professions, education providers
secure accreditation of their health course offerings by the applicable National Board, which also
establishes the requirements for pre-entry clinical training. For non-registered professions, professional
associations stipulate clinical training requirements for membership and course accreditation.
Queensland Health context
The clinical placements program operates in alignment with Queensland Health’s ongoing commitment
to clinical education and training, as well as established strategic directions which guide the focus and
priorities of the program.
Ongoing commitment
The State of Queensland, acting through Queensland Health, has made a long-term commitment to
clinical education and the development of the future health workforce. It is accepted that expertise in
healthcare is developed over an extended period and the continuum of education can be tracked from
undergraduate teaching through clinical exposure, skills development, and continuing professional
development.2
2 The State of Queensland (Queensland Health) 2017, Advancing health service delivery through workforce: A strategy for Queensland
XXXXXXXXXX, Queensland Government, viewed 30 June 2020,
https:
www.health.qld.gov.au/__data/assets/pdf_file/0039/657993/QH959-Advancing-Health-Service-Workforce-publication-WEB-
2.pdf>.
Clinical Placements Strategic Review - Discussion Paper Page
Queensland Health counts the provision of clinical placements to pre-entry health students as one of
its core functions and responsibilities, and for the majority of professions it is the principal provider of
clinical placements for healthcare students in Queensland. For Queensland Health, the reciprocal
enefits of an effective clinical placements program are clear: the program assists students to satisfy
the practical training requirements of their health course; and these placements are critical to
knowledge and competency development in the next generation of healthcare professionals.
The pre-entry clinical placements program represents a deliberate investment in clinical
teaching and training that will directly contribute to a high-quality, sustainable
healthcare workforce for Queensland.
Strategic directions
The clinical placements program aligns to Queensland Health’s strategic directions for delivering
healthcare and pursuing innovation (directions 2 and 4 respectively of My health, Queensland’s future:
Advancing health 2026) by offering supportive learning environments for health clinicians of the future.
This commitment is further articulated in Advancing health service delivery through workforce: A
strategy for Queensland - . This strategy, which was developed in partnership with over
stakeholder organisations, recognises the
oad responsibility held across public, private, and not-for-
profit providers for education and training of the clinical workforce.
Strengthening links between healthcare and education through courses, clinical placements and
stakeholder relationships is identified as a key success measure in the strategy, linking to objective . ,
which is included below.
Advancing health service delivery through workforce: A strategy for Queensland - (excerpt)
Objective 3.1: Improve integration of the healthcare and education sectors to align supply to future jobs
and strengthen health careers and consumer care.
3.1.1 Collaborate with education providers and accreditation bodies to maximise flexibility and enhance
program responsiveness to emerging health sector requirements.
3.1.2 Strengthen clinical education and training placements through more streamlined processes, greater
consistency, increased support and extended learning opportunities
3.1.3 Partner with education providers and accreditation bodies to implement interdisciplinary education,
generalist career options and contemporary education pathways.
3.1.4 Promote careers in health through collaboration with high schools, VET sector and universities.
. . Develop and implement an education and training framework that establishes principles and
processes, and supports regional, rural, remote and u
an practice.
Clinical Placements Strategic Review - Discussion Paper Page
Section Three: Focus areas
Student participation in clinical teaching and training enhances the clinical
environment and offers a range of mutual benefits to the students, their
education providers, Hospital and Health Services, and clinical supervisors
interacting with students on placement. Each of these stakeholders has a
ange of responsibilities that contribute to the success of the placement
program.
Focus area : Strategic governance
The governance a
angements for the Queensland Health clinical placements program reflect legislated
oles and responsibilities under the Hospital and Health Boards Act 2011, as well as specific contractual
a
angements put in place to enable clinical placements to operate at a risk profile acceptable to the
State. This section of the discussion paper considers the appropriateness of the cu
ent strategic
governance a
angements.
Student Placement Deed
Under the clinical placements program, Queensland Health, on behalf of the State of Queensland,
enters into an agreement (known as the Student Placement Deed/Vocational Student Placement Deed)
with Australian education providers to allow students to undertake clinical placements in Queensland
Health facilities. Queensland Health first established centralised Deeds in 2005. This included Deeds
with Queensland, interstate, and international education providers. In 2009, Queensland Health moved
to only holding Deeds with Australian education providers, with clinical placements for externally
enrolled scholars managed through a Queensland-based university. The cu
ent clinical placements
program framework and the system of centralised Deeds was established before HHSs formed as
independent statutory entities and under different risk and expectation profiles.
The cu
ent Student Placement Deed sets out the overarching requirements for clinical placements,
and contractually governs placement activity. There are two versions of the Student Placement Deed,
eing for universities (Group A Deed holders) and vocational education and training (VET) providers
(Group B Deed holders). Student Placement Deeds have been aligned to a fixed timeframe rather than
an approval period from the date of finalisation to create consistency and reduce administrative
urden. Cu
ent Group A and Group B Deeds are in place until 31 December 2021.
The Student Placement Deed is supported by a detailed Schedule which is completed collaboratively
etween HHSs and education providers for each new placement a
angement for a student cohort.
These Schedules are attachments to the Deed proper and reflect the operational agreement that the
HHS and the education provider has reached in terms of the method and processes for allocation of
available placements within the HHS.
Finally, Student Deed Polls (and, where required, Supervisor Deed Polls) are completed, prescribing the
individual obligations of the named party.
Clinical placements cannot occur in Queensland Health facilities without an established and cu
ent
Group A or Group B Deed.
Clinical Placements Strategic Review - Discussion Paper Page
At the time of writing, Queensland Health has Student Placement Deeds in place with approximately
sixty (60) higher education providers, around two-thirds of which are universities (refer to Annex A for
a listing of cu
ent Deed-holders). While some of these education providers routinely place healthcare
students in Queensland Health facilities, many others only intermittently request placements under
their Deed a
angement.
Within the Queensland Health clinical placements program, placements occur across a
oad range of
health professions. Medical, nursing, midwifery, dental, and allied health placements are supported
under the program, as well as placements for VET courses such as enrolled nursing and aged care and
allied health assistants.
Service agreements
The Department of Health has a service agreement in place with each Queensland HHS. These
agreements detail the service delivery and reporting commitments of each HHS, in line with the
funding a
angements that support and enable the services to be delivered. Importantly, these
agreements provide for teaching and research services, along with expected outcomes and
performance measures.3
Each service agreement may vary, however HHS responsibilities in relation to clinical education and
training includes requirements to:
provide ongoing commitment and support to align processes and procedures with the student
placements framework,
ensure compliance with the obligations and responsibilities of the contractual a
angements
for clinical placements under the student placements framework, and
provide placements consistent with and proportionate to the capacity of the HHS.
Service agreements function as one of the core governance mechanisms for HHSs, thus the inclusion of
clinical placements in these agreements is key to the governance of the clinical placements program.
3 Queensland Government (Queensland Health) 2020, Service Agreements and Deeds of Amendment, Queensland Government, viewed
30 June 2020,
www.health.qld.gov.au/system-governance/health-system/managing/agreements-deeds>
Clinical Placements Strategic Review - Discussion Paper Page
Responsibilities
Figure 1 summarises the key responsibilities of participants in the clinical placements program, under
the existing governance frameworks and mechanisms.
Figure 1: Primary responsibilities of key stakeholders in clinical placements
The Department of Health is responsible for overarching governance of the clinical placements
program. This means education providers have one contractual relationship with the State of
Queensland. The Department provides a point of leadership and management for the program and sets
the strategic direction and policy parameters of clinical placement provision in Queensland Health
facilities. As the program and contract manager, the Department of Health is responsible for the overall
integrity and effectiveness of the clinical placements program. The Department liaises with education
provider placement coordinators and HHS placement coordinators, as required in the management of
the clinical placements program.
Education providers are responsible for a
anging and administering clinical placements on behalf of
their students by negotiation with the facility placement provider. This includes all co
espondence and
negotiation to secure placements, ensuring student compliance, responsibility for learning objectives
and assessment, and dealing with issues regarding performance or conduct. While placements are
ca
ied out in Queensland Health facilities, education providers are responsible for the students, their
conduct, competency, and all academic aspects of their placement experience including learning
objectives and assessment. Where required, it is also the responsibility of education providers to
secure student registration with Ahpra for the student cohort undertaking clinical training.
HHSs are responsible for ascertaining and allocating placement opportunities in accordance with their
service agreement and HHS capacity in response to education provider requests. HHSs provide access,
orientation, resources, and opportunities to engage in immersive clinical teaching and training,
including clinical supervision and assessment for students in the healthcare environment.
Department
of Health
Contract
management
Policy framework
to enable
placements
Reference point for
clinical placements
program
Education
provide
A
anging and
administering
clinical placements
on behalf of their
students
Ensuring students
are prepared for
the clinical learning
environment
Liaison and
negotiation with
HHS
Hospital and
Health
Service
Assessing and
allocating
placement
opportunities
Operational
elationship
management with
education provide
Access, tasks, and
supervision to
assist students to
achieve learning
objectives
Student Ready for learning
Ready for
experiencing a
clinical
environment
Administratively
eady for clinical
placement
Private
providers
Support for
student learning
outside the public
system
Support for
development of
health workforce
equired outside
the public system
Clinical Placements Strategic Review - Discussion Paper Page
Clinical placements occur in fully operational public health facilities, so the range of experiences and
variety of learning opportunities is unique to each placement. Opportunities are made available to
students as required to achieve the learning objectives and assessment outcomes agreed with the
education provider. In their supervisory role, HHSs must support students to fulfil their responsibilities
while undertaking the placement and take necessary steps to manage any failure to fulfil these
esponsibilities through feedback and learning support, through to proposed termination of the
placement, where required.
Students are responsible for completing the Student Deed Poll and fulfilling all obligations, such as
ackground checks and mandatory training, as outlined on the Student Orientation Checklist, prior to
placement. It is the responsibility of students to be prepared for learning and to participate in the
operational clinical environment, following the direction of their allocated supervisor.
While the clinical placements framework does not specifically cover private health service providers,
these stakeholders form part of the
oader network of clinical education and training of the existing
and emerging workforce.
Other clinical placements programs
Clinical placement programs operate across Australia and share the objective of supporting health
workforce development and sustainability through clinical education and training. The governance and
operating models are
oadly consistent across the jurisdictions, including Queensland, in that some
form of agreement for clinical placements is developed centrally for use by health services and
education providers, supported by specifications for student compliance. These typically include
equirements for matters such as criminal history checks, mandatory training, and vaccinations. The
alance of relative obligations of education providers and the health services providing placements, are
generally similar across Australia.
In some jurisdictions, a dedicated clinical education and training area oversees the clinical placements
program. In Western Australia, the Clinical Training Network performs this role from within the WA
Department of Health.4 In New South Wales, the Health Education and Training Institute (HETI)
functions as a statutory health corporation within NSW Health, delivering an extensive program of
training and education opportunities for NSW Health staff.5
The
oad consistency of approach in the management of clinical placements across Australia has
several advantages. It supports the cross-jurisdictional enrolment and movement of students and
enables education providers to more readily establish relationships with health agencies in other
jurisdictions. It is noted that almost two-thirds of Queensland’s Deeds are with inter-jurisdiction
education providers. Although these providers may not represent a high proportion of the total
placements in Queensland, the Deed enables them to seek out Queensland-based placements for their
students.
4 Government of Western Australia (Department of Health) 2020, WA Clinical Training Network, Government of Western Australia
(Department of Health), viewed 30 June 2020,
.
5 New South Wales Government (Health Education Training Institute) 2020, Health Education and Training, New South Wales
Government, viewed 30 June 2020, < https:
www.heti.nsw.gov.au/about-heti/our-organisation/vision-purpose-mission>.
Clinical Placements Strategic Review - Discussion Paper Page
Clarity in governance a
angements
The governance structure for the clinical placements program, while generally functional and
transparent, reflects the
oader complexities of the Queensland Health system and is multi-layered.
Existing legislative and contractual a
angements between the Department of Health and HHSs provide
the backdrop for the allocation of responsibility for the strategic and operational aspects of the clinical
placements program.
The legal instruments for the clinical placements program necessarily reflect program requirements
within the existing governance mechanisms. The existence of two Deed types (Group A and Group B for
universities and registered training organisations respectively) is a result of historical legislation and
funding a
angements.
The cu
ent Student Placement Deed structure allocates the overarching responsibility for
management of the clinical placements program to the Department of Health but requires HHSs to
negotiate the a
angements for specific cohorts of students via the Schedule to the Deed. This
governance framework formally divides and assigns responsibility and aligns with the HHS’s role in
clinical placements according to the service agreements. It also gives HHSs some level of flexibility to be
able to customise the operational aspects of the clinical placements to the local setting. HHSs are a
legal party to the Deed through the Schedule, as an attachment to the Deed.
The contrasting profiles of Group A and Group B education providers suggest that combining the two
groups with one Deed may not have any added value. Retaining distinctive Deeds not only supports
tailoring to the groups’ differing funding, accreditation, and legislative parameters, but also recognises
the tendency for less turnover among Group A Deed holders. It is noted, however, that as tertiary
providers respond to the changing funding and student learning environment, the distinction between
course types may become less apparent.
Given the complexity of existing governance a
angements, ensuring clarity within the clinical
placements program about the responsibilities of each party is imperative.
Summary of issues for consideration
Considerations and desired features Focus area : Strategic Governance
Multiple governance
mechanisms
Service agreements provide the framework outlining
oad
expectations of HHSs in relation to clinical placements. The
Student Placement Deed, including the Schedule, provides
operational detail about how the placements operate, providing
the opportunity for HHSs to tailor clinical placements to their local
equirements.
Effective governance may be provided by multiple mechanisms
however these should be streamlined, devoid of overlaps and gaps
and operate with maximal transparency.
Clinical Placements Strategic Review - Discussion Paper Page
Considerations and desired features Focus area : Strategic Governance
Structure and contents of
existing legal instruments
The existing Student Placement Deed, Schedule and Deed Polls
work together to assign accountability and manage risk in the
operation of the clinical placements program.
Legal instruments should be efficacious while being as user-
friendly as possible.
The operationalisation of the legal instruments should be as
streamlined and transparent as possible, within commercial-in-
confidence parameters.
Allocation of responsibility The existing Student Placement Deed, Schedule and Deed Polls
allocate responsibility across the Department of Health, HHSs,
education providers and students.
Responsibilities should be appropriate, transparent, and clearly
communicated.
Consultation questions
Questions for stakeholders Focus area : Strategic Governance
. Do the governance a
angements for the clinical placements program need to be strengthened or
streamlined and how would this be best achieved?
. Do the existing legal instruments provide a useful source of guidance for how the clinical
placements program should operate, and if not, how could these be improved?
. Do you consider that the responsibilities of all participants in the clinical placements program are
clear, reasonable, and taken to the point of action and, if not, which aspects require attention?
Clinical Placements Strategic Review - Discussion Paper Page
Focus area : Resourcing
Immersive clinical education and training represents a genuinely shared investment by the Queensland
Government, Commonwealth Government, HHSs, education providers and students in nurturing and
developing the future healthcare workforce. As an essential component of healthcare training
programs, the increasing demand6 for pre-entry clinical placements and competition between
education providers, puts pressure on the workforce and infrastructure resources of HHSs. This section
of the discussion paper considers various resourcing and program access issues.
Program management
Overarching program management is the responsibility of the Workforce Strategy Branch within the
Strategy, Policy, and Planning Division of the Department of Health. Program management includes,
ut is not limited to, enquiries and advice to education providers, HHSs, and students; applications for,
and establishment of, new Deeds, including confirmation of insurances, registrations, course
accreditations, and business checks; usual contract management responsibilities (including
enegotiation of new Deeds prior to expiry); and, at times, in-depth consideration of new initiatives or
strategic matters (e.g. clinical placements management system, criminal history positions of other
jurisdictions, clinical education and training reporting of hours to Australian Government).
Historically, the program was supported by up to . FTE. The development of comprehensive online
information for key stakeholders and the alignment of student deed expiry dates as well as changing
priorities over the last - months, have seen resource allocation for this function fluctuate between
. FTE and . to . FTE for specific program-related projects, as required. Program management is
undertaken within the core FTE and budget of the Branch.
Operational placement management occurs in HHSs under varied models. Some HHSs have dedicated
placement coordinators per profession; others have dedicated staff to coordinate placements across all
professions and in multiple sites; others are managed by the supervisor. Variations in levels of
esourcing are as diverse as the models themselves.
Program communication and engagement
Cu
ent communications protocols for program-specific information from Queensland Health to HHSs
is through HHS Chief Executives, and from Queensland Health to education providers is through Chief
Executive Officers or company Directors. Day-to-day queries regarding the program come from varied
sources across all stakeholders