Working Group Report to Hwnz Submissions Analysis

HEALTH SCIENCE AND TECHNICAL WORKFORCES WORKING GROUP REPORT TO HEALTH WORKFORCE NEW ZEALAND SUBMISSIONS ANALYSIS

Executive summary Health Workforce New Zealand (HWNZ) was established by the New Zealand Government with a mandate to lead and co-ordinate the planning and development of New Zealand’s health and disability workforce. HWNZ aims to ensure that we have a fit-for-purpose, high quality and motivated health workforce that keeps pace with clinical innovations and the growing needs and expectations of the New Zealand public. The science and technical workforce is an integral part of our health workforce. In line with its mandate and aims, HWNZ established a working group to consider and prepare a report on what we want our science and technical workforce to look like in the future. The working group’s report was released in March 2012. The intention of releasing the report was to gain information about:

the co-ordination of workforce planning across the health science and technical workforce

identification of the health science and technical professions

sector views on the key aims and principles that should underpin any health science and technical workforce education, training and workforce planning framework. The sector feedback on the report supports HWNZ’s view that further work should be carried out in relation to workforce planning co-ordination across the health science and technical sector. In general terms, the overarching aims and principles on which any model for co- ordination should be based set out in the report were acknowledged as reasonable, although many respondents suggested additional aims and principles. The report and subsequent feedback from the sector provide a good framework on which to build the next phase of HWNZ’s project to improve co-ordination across the health science and technical workforce in relation to education, training and workforce planning. The sector feedback also provides some useful information about, and examples of, co- ordinated approaches to education and training that are already occurring or being developed within the health science and technical sector. Progressing this project will require a careful and methodical approach, looking at profession-specific education programmes as well as workplace skills and competencies for each profession. This exercise will also require wide sector discussion led by key professionals within each profession or professional group and their related training institutions.

Background Health Workforce New Zealand (HWNZ) was established by the New Zealand Government with a mandate to lead and co-ordinate the planning and development of New Zealand’s health and disability workforce. HWNZ aims to ensure that we have a fit-for-purpose, high quality and motivated health workforce that keeps pace with clinical innovations and the growing needs and expectations of the New Zealand public. The science and technical workforce is an integral part of our health workforce. This workforce comprises over 20 occupational groups of regulated and unregulated professions. Many of the science and technical occupational groups are small, and many often work in isolation. New Zealand’s ability to meet future demand for science and technical workforces is compromised by the size and the level of training required for some professions and by the exclusion, in some cases, of the relevant science and technical professions from the development of service delivery plans. In line with its mandate, HWNZ established a small working group, for around four months, to consider and report on:

what we want our science and technical workforce to look like in the future

how workforce planning might be improved across the science and technical professions and in relation to workforce planning in other health professions.

The Report The Health Science and Technical Workforces Working Group’s (the Working Group’s) Report to the Health Workforce New Zealand Board (the report) was compiled from September to December 2011. The report was intended as a starting point for discussion in the health and health education sectors and gaining information about:

identification of the health science and technical professions sector views on the key aims and principles that should underpin any health science and technical workforce education, training and workforce planning framework. The report was released on 6 March 2012, with a set of related questions. The report was emailed to approximately 150 individuals and organisations (eg District Health Boards, regulatory authorities, professional associations, and tertiary education institutes). The report was also released on the Health Workforce New Zealand (HWNZ) website. The closing date for providing comments to HWNZ was 14 May 2012. HWNZ agreed to the latest date for submissions as 24 May 2012. Those who requested extensions were also encouraged to send their comments to HWNZ even if it was later than 24 May 2012 because, although we might not have been able to incorporate comments in this analysis paper, the comments could still be used in any further work relating to the health science and technical workforces. As at 24 May 2012, HWNZ had received 29 responses to the report. While a higher response rate would have been desirable, the low response rate is not unexpected given that the report dealt with largely with general principles in line with the intention to gauge the health and health education sectors’ views on the need for change. Analysis As at 24 May 2012, HWNZ had received 29 responses to the report. Appendix 1 provides a list of submitters. Respondents were asked to identify whether they were a health science and technical professional, from a professional association, District Health Board (DHB), regulatory authority, tertiary education organisation, college or other group. Respondents could identify as being in more than one of these categories. The respondents included: 11 from the health science and technical professionals 10 from DHBs 6 from professional associations 4 from regulatory authorities 8 from tertiary education institutes 1 from a health science and technical profession college 1 from a health science and technical workers union. Respondents who indicated that they belonged to, or were employed by, a particular organisation, were not necessarily responding on behalf of that organisation. With a few exceptions, this paper provides a summary of the sector comments for each question on which feedback was sought and HWNZ comments on the feedback. The exceptions are explained as they arise in this paper. In addition, where respondents provided comments under one question that seem to relate more to another question, those comments have been incorporated under the question to which they are more appropriate. Each of the sector comments includes a number either the text or in brackets following the comment to indicate the number of respondents who made similar comments. With just 29 responses, these numbers have not been calculated as percentages as percentages may give a misleading picture of the level of support for a single idea.

Question 1 Is there a need for better co-ordination of workforce planning for the science and technical workforce? Why or why not? Sector comment Most respondents (27) commented that there was a need for better co-ordination of workforce planning for the health science and technical workforce. A range of reasons was provided for why there should be better co-ordination of workforce planning was provided. Respondents’ reasons for this need included:

To provide an overall view of the health science and technical workforce, giving a clearer understanding of the number of professionals in this sector, and highlighting vulnerabilities in the science and technical workforce (7). To improve co-ordination and links between service providers and training providers (4). To achieve more effective workforce planning between larger and smaller DHBs (4). To reduce costs associated with training (3). To raise the profile of the health science and technical workforce, provide clear career pathways, and, in turn, attract more people into the sector (5). Respondents also raised some questions they felt were important to consider in relation to workforce planning in the health science and technology sector. These included:

Should co-ordinated workforce planning include the private as well as the public sector? (1). Should co-ordinated workforce planning include both the regulated and non- regulated health science and technical workforces? (1). Is the quality of science, technology, engineering and mathematics education at secondary school suitable for students moving into health science and technical profession education and training programmes? (1). HWNZ comment The responses to the report indicate that there would be support in the health and health education and training sector for better co-ordination of workforce planning across the health science and technical workforce. The reasons given largely confirm HWNZ’s view, based on informal communication with the sector in recent years, of the reasons for, and potential benefits of, developing a coordinated workforce planning model for this sector (eg aligning service providers and education and training providers, to provide a clear overview of the whole sector, to share the responsibility more effectively between larger and smaller DHBs, and to raise the profile of the health science and technical professions as an attractive career). With regard to the questions raised by respondents, HWNZ’s view is that any model for coordinated workforce planning for the health science and technical workforce should include the public and the private sectors, and both regulated and non-regulated professions. HWNZ acknowledges that it may be necessary to implement any model in phases. The phasing-in timetable may be determined by the public / private and regulated/non-regulated divisions, but the end goal should be for all these groups to be included. As we look at different ways to meet demand, such as shifting some tasks to other professions, extending scopes of practice, and implementing new models of care, it will become increasingly important that we have a good overview of all workforces in the health sector. To exclude some will simply shift the current lack of coordination from one place in the health sector workforce spectrum to another place on that spectrum. HWNZ is aware of the impact of secondary school education on school leavers’ career choices, and on their preparedness for tertiary education. There is a range of activities under way in New Zealand to promote health science and technology careers. HWNZ supports these activities and is aware that this is an issue that will raise its head across much of HWNZ’s work to try to ensure we have a health workforce that is fit-for-purpose. The sector feedback supports further work in relation to workforce planning co-ordination across the health science and technical sector. The debate is around how we can achieve better co-ordination of health science and technical workforce planning. Question 2 Keeping in mind that any definition of the health science and technical professions is likely to have its exceptions, do you think the proposed definition provides a reasonable guide to defining science and technical professions? Are there any changes you would make to the proposed definition? The definition developed by the working group as a starting point and guide was: Professions that primarily provide technical and scientific expertise to support the diagnosis, monitoring, management and treatment of health conditions independently or in conjunction with other health professionals to ensure safe, effective, quality patient care. Sector comment Just over half the respondents (16) felt that the definition proposed by the Working Group was reasonable. Two respondents felt the proposed definition was not suitable. Respondents suggested a number of ideas that they felt should be incorporated into an overarching definition of the health science and technical workforce. These include:

Research and test development aspects of the health science and technical workforce (3). Wellness testing, because it is an increasing role in some professions (2). Allow for the inclusion of activities relating to future role extensions, such as clinical interpretations (clinical scientists) (2) The emphasis on the scientific and technical aspects may not suit those professions with a greater degree of direct patient contact (eg Dental Hygienists) (1). The legislative frameworks for regulated professions within the health science and technical sector (2). One respondent commented that the definition may be too broad and able to be applied to too many other professions (eg surgeons, nurses). The respondent suggested that, rather than define the science and technical workforce, it may be better to limit the list to those professions likely to benefit from any proposed model for co-ordinating health science education, training and workforce planning. Another respondent felt it was less important to agree on an overarching definition of the health science and technical professions than to agree which professions should be included in any model developed for this sector. HWNZ comment The Working Group definition was suggested as a guide and a starting point. HWNZ’s view is that any definition of such a broad range of professions will only ever be a guide. For this reason, HWNZ is not overly concerned that there is no clear agreement across the majority of respondents about exactly what a high level definition should be. HWNZ agrees with the respondent who believes it is more important to determine which professions should be categorised as science and technical for the purposes of developing and implementing a workforce planning and education and training model. However, we recognise that some people prefer to have a definition, despite its potential limitations, as a general guide to help them determine where a particular profession sits. Therefore, HWNZ recommends that the definition developed by the Working Group be retained, subject to regular, ongoing reviews and amendments.

Question 3 Do you think that the list of science and technical professions in Appendix 3 of the report is basically accurate? Sector comment Fifteen respondents stated that they believed the list of professions in Appendix 3 of the report was acceptable. Five respondents believed the list was not accurate. Respondents from both groups then identified any professions they believed should be added to, or removed from, the list (refer questions 4 and 5). HWNZ comment The list of professions likely to sit within the health science and technical workforce provided in the report was not intended to be the definitive list. In fact, it is unlikely there will ever be a definitive list because the health sector workforces are continually changing as new models of care, science and technological advances and emerging roles are implemented. HWNZ is satisfied that the list of professions provides a reasonable starting point that can be reviewed and amended as necessary as the project progresses.

Question 4 Are there any professions you believe should be added to the list? Why? Sector comment Some respondents provided additional professions and descriptions of those professions. Below is the list of suggested additional professions. The descriptions of these professions have been included under Question 6.

Allied health professions (3) Ophthalmic science (1) Newborn hearing screeners (2) Vision science (1) Clinical exercise physiologists (3) Orthoptists (1) Cardiac technicians (1) Ophthalmology assistants (1) ICU technicians (1) Vascular technicians (1) NICU technicians (1) Physiology technicians (1) Pharmacists (2) Health informatics (3) Pharmacy assistants (1) Cytogeneticists (2) Critical care technology (1) Nutritionists (1) Podiatrists (1) Physician assistants (1) Opticians (1) Clinical coders (1) Health record managers (1) Respiratory technicians Paramedics (1) Phlebotomists (1) The primary reason given for adding a profession was that it fell within the health science and technical group and/or was closely related to one or more professions already on the list. HWNZ comment The list of professions is likely to need constant reviewing and refining as work to develop a health science and technical workforce planning and education and training model continues. Therefore, at this time, HWNZ has no set view on the inclusion or exclusion of any of the professions listed above. In addition, long-term, the list will be a ‘living document’ so that new and emerging professions can be included. Aside from the individual professions listed above, three respondents believed that the list should include all of the allied health professions. The allied health workforce is a priority for HWNZ, but HWNZ decided to focus this particular project on the science and technical workforce primarily because the science and technical workforce comprises a large number of professions. Including the allied health professions would add to an already large number of professions. HWNZ anticipates that whatever model is developed for the science and technical professions is likely to also be suitable for the allied health professions. HWNZ views the science and technical professions as a ‘subset’ of the wider allied health, science and technical workforce. Therefore, we certainly want the allied health professions to be involved in the science and technical workforce project as part of the wider group.

Question 5 Are there any professions you believe should be removed from the list? Why? Sector comment The following professions were suggested for removal from the list of professions provided in the report. Genetic associates Cardiac sonographers Audiology Cytogeneticists Pharmacy technicians / assistants The primary reason given for removing a profession was that it did not fall within the health science and technical group. HWNZ comment As noted in Question 4, the list of professions will need further review and refinement over the course of this project, as well as regular review in the long-term. There is no clear consensus on which professions should be included on, or excluded from, the list and, even if there was a consensus among the respondents, 29 respondents would be too small a proportion of the health science and technical sector from which to decide a definitive list. Question 6 Please provide any suggested amendments to the profession descriptions in Appendix 3 of the report. Sector comment The individual profession description amendments provided by respondents are not included in this paper. They will be used as part of the ongoing review and refinement of the list of health science and technical professions. Revised lists will generally be circulated with any future requests for feedback as this project progresses. Aside from the profession-specific description amendments, some more general comments were made by respondents. These comments were primarily around ensuring there was consistency about where the profession descriptions were derived from professional associations and regulatory authorities, from internationally recognised definitions, or from Multi-Employer Collective Agreements (MECAs) (8). HWNZ comment HWNZ agrees that descriptions of individual professions should, wherever possible, come from the same type of source. At this point, HWNZ believes that profession descriptions should come from the relevant professional association and regulatory authority. HWNZ would be reluctant to use MECAs as the description source because not all professions now, or in the future, will be covered by a MECA. Additionally, not all health science and technical professionals are DHB employees and the MECA description may not fit the non-MECA professional. Question 7 Do you agree with the aims and principles set out in sections 4 and 5 of the report? Why or why not? Sector comment Approximately half of the respondents (15) agreed with the aims and principles set out in the report. Only one respondent stated that they did not agree with the aims and principles. The more general comments relating to the aims and principles reflected those made in response to Question 1 (Is there a need for better co-ordination of workforce planning for the science and technical workforce?) Other comments in response to Question 7 related to individual aims and principles. The key points are:

A set of core education and training courses may be possible for some groups of science and technical professions, but each profession has its own set of skills and competencies that will limit the level of commonality that can be achieved (5) The reference to allowing easier movement between professions needs further defining. Movement between some professions, even if the professions are related, will not work because each has its own set of specialised skills, and there is nothing to suggest that professionals want to move between professions (3) A system that aims to enable an individual professional to work across two or more related professions may lead to a lower quality of care (1). The aims and principles should include patient safety, responsiveness/timeliness and quality (2). This section of the report also raised the question of the merits of having a single entity to oversee health science and technical workforce planning. The report also raised the question of whether the regional training hubs might be well suited to this role in the long term. No respondents stated that they did not support the idea of a single co-ordinating entity for workforce planning across the health science and technology sector. However, some respondents had reservations.

This sector may be too large and diverse for a single entity approach to be viable (2). Further discussion about how a single co-ordinating entity might work (ie how individual professions would be represented, how the legislative requirements for regulated professions would be recognised, addressing issues of accreditation) (2). The regional training hubs are not yet fully operational and their focus is on medical graduates in their first and second postgraduate years (3). HWNZ comment HWNZ accepts that the aims and principles are generic to the health science and technical sector as a whole. There is no expectation that every aim and principle will be applicable for every individual profession. However, it is necessary to have some aims and principles to guide workforce planning and development activity across the sector. Where an individual profession deviates from the overarching aims and principles, we need to be clear about the rationale for that deviation. HWNZ notes the concern that some of these aims and principles will lead to a reduction in patient safety and lower the qualification, skills and competency requirements for the health science and technical professions. HWNZ is very clear that patient safety and professional qualifications, skills and competencies must underpin any education and training model developed. However, this does not mean there are not ways to do things differently without compromising public safety and professional and educational standards. Despite the reservations, there seems to be general acknowledgement that the idea of a single co-ordinating entity for workforce planning in the health science and technology sector is worth discussing. Also worth discussing is whether the regional training hubs might be well placed to take this role on in the future, in line with the intention to gradually extend their focus to professions other than doctors. HWNZ will facilitate further discussion on the single co-ordinating entity as this project progresses.

Question 8 Could you please provide information on any existing multi-disciplinary education and training between different science and technical professions? If possible, please provide a contact name and phone number or email address for who could be contacted about this. NB The names and contact details provided by submitters have been excluded from this paper but will be used by HWNZ as required as this project continues. Sector comment While there are a number of multi-disciplinary education and training initiatives between different science and technical professions around New Zealand, the following specific examples were identified in the responses to the report:

Vision and hearing screening – this is a single qualification; the newborn hearing screening qualification has been modelled on the vision and hearing qualification and half the unit standards are common to both, allowing people to move from one to the other without too much difficulty (1). Medical laboratory science – the first year of medical laboratory science degrees offered in New Zealand comprises basic biological sciences which are common to pharmacy, physiotherapy, dentistry and medicine. There is also some overlap with various other disciplines which focus on biological (rather than physical) sciences. In the second year, there is some overlap in that most of these degrees include anatomy, physiology, microbiology, and biochemistry (4). Clinical physiology – clinical physiology combines cardiac and sleep physiologist education in the first year of undergraduate academic study. The postgraduate Certificate and Diploma in Medical Technology has shared learning across the three clinical physiology disciplines: cardiac, respiratory and sleep; gaining the academic qualification in one area allows a person to practise in any of the other two roles without the need for further academic qualifications, as long as the full-time equivalency and practical certification of the relevant group is achieved (2). Medical radiation technologists, MRI imaging technologists, nuclear medicine technologists, sonographers, medical physicists and bioengineers – Auckland University is intending to offer courses catering for these professions in 2013. There will be shared learning, but each profession will need to meet any regulatory authority requirements relevant to an individual profession or scope of practice (1). Audiology – previously co-taught some material with speech-language therapists, but this no longer happens because the audiology and speech-language professions each found it difficult to meet the specific needs of both professions without ‘wasting’ time and other resources teaching skills that were only needed by one profession (2). Multi-disciplinary model – has been established at Auckland University of Technology and is now in the process of being established at Unitec. Unitec is also in discussion with Australasian stakeholders for training New Zealand orthoptists and prosthetists, and with the Health Information Association of New Zealand about training for clinical coders and health record managers. Unitec’s BSc in medical imaging will be incorporated into the multi-disciplinary model in 2013 (1) HWNZ comment This question was intended as an information gathering exercise about examples of multi- disciplinary education and training already happening in the health sector. HWNZ is pleased to receive this information, and the contact details for those involved with these programmes and activities. More detail on these programmes will be sought as this project progresses. Question 9 Where should there be more multi-disciplinary education and training for the science and technical professions in the health sector? Sector comment In response to this question, six respondents commented that they were not convinced that more multi-disciplinary education and training for the health science and technical professions was possible and / or desirable, or that only relatively limited common training in the basic sciences would be possible. Of those respondents who expressed a view on where more multi-disciplinary education and training should occur, the following comments were made:

Multi-disciplinary education should generally occur in tertiary education for assistants or at years 1 and 2 of some professions requiring generic sciences (2). There was more scope for some multi-disciplinary education for technicians, who required a less complex, more generally applicable level of training, but less scope at the scientist level, where professions-specific skills were required (2). Multi-disciplinary should include, or be focused on, post-qualification (ie as part of continuing professional development) (3). Cultural competency, ethics, human anatomy, physiology, and national standards in English and communication were all areas that would suit multi-disciplinary education (3). HWNZ comment Sector feedback generally supports the view that there is some scope for multi-disciplinary education and training in the health science and technical workforce, and with other health professions. Not surprisingly, the level of support for multi-disciplinary education decreased as professional specialisation increased. Exactly where the line should be drawn to achieve the optimum balance between multi-disciplinary education and profession-specific education will need to be determined for each profession and group of professions as this project progresses. This will require a careful and methodical approach, looking at profession- specific education programmes as well as workplace skills and competencies for each profession. This exercise will also require wide sector discussion led by key professionals within each profession or professional group and their related training institutions.

Question 10 What do you believe are the barriers to achieving more multi-disciplinary education and training for the science and technical professions in the health sector? Sector comment The most frequently mentioned barrier related to funding and other resources, such as backfilling teacher/supervisor positions, and time (13). Other barriers included: Sector or profession resistance (7) Similarities between professions is a perception rather than a reality, non- transferable skills and training (6) Legislation, and the mix of regulated and non-regulated professions within the sector (2) HWNZ comment The sector feedback provides an accurate indication of the potential barriers to increasing multi-disciplinary education and training in the health science and technology sector. However, HWNZ does not consider these barriers to be insurmountable. In the current economic environment, funding and other resources will be one of the most challenging obstacles. But, it should be noted that some of these resource barriers are problems that already exist (eg backfilling teacher/supervisor positions). Rather than being seen as barriers to developing and implementing a new approach to health science and technical education and workforce planning, these existing problems should be viewed as things any new approach should try to improve. Sector resistance will also be an important area to keep in mind. Wide sector involvement as the project progresses will minimise sector resistance, although there will always be some element of resistance to change. HWNZ is clear that its mandate is to work towards ensuring New Zealand has the health workforce it needs to meet future demand. While sector support is certainly desirable, and HWNZ will do everything it can to gain sector support, HWNZ is aware that it may be necessary to make decisions that are not widely popular if New Zealand is to work towards having a health workforce that supports and reflects a clinically led, more convenient and people-centred health system.

Question 11 Where should the balance lie between a generalist and a specialty focus in education and training? Sector comment The sector comments provide no clear consensus on where the balance between generalist and specialist should lie in education and training. However, where a view was expressed, it reflected the views on the level at which multi-disciplinary education could be appropriate: the early stages of an education programme (eg the first year of a two or three year programme), and programmes for less specialised professionals (eg assistants rather than scientists) was where generalist education was most likely to be possible (7). Two respondents followed a similar view but suggested that the division should, with occasional exceptions, be that pre-registration and undergraduate programmes should be seen as generalist and post-registration and postgraduate programmes as specialist. HWNZ comment Where to draw the line between generalist and specialist education was something many respondents seemed uncomfortable commenting on at this point, particularly beyond the progression from generalist to specialist that already exists in each profession’s education programme. Again, this was not a question that HWNZ anticipated a definitive answer on. It serves as a starting point for further discussion, which will include defining ‘generalist’ and ‘specialist’, and how those definitions translate into multi-disciplinary education and training programmes. Professions, regulatory authorities, tertiary education organisations and the Tertiary Education Commission will all have a role to play in defining these terms and in aligning the required generalist/specialist level of skills and competencies with education programmes.

Question 12 Please include any other relevant comments not covered in the above questions. Sector comment The sector responses to this question can be divided into two categories: the concept of developing a new approach to education, training and workforce planning for the health science and technical workforce and the report itself. In relation to the concept of developing a new approach to education, training and workforce planning, most comments have already been referenced in response to questions 1 to 11. Therefore, this paper will focus on the comments made about the report itself. Broadly speaking, there were three matters raised about the report:

There was insufficient consultation on the matters raised in preparing the report, and this will need to be undertaken for any future work (5). The report needed to be more specific in its conclusions and proposals (2). More detail about the health science and technical workforce (eg workforce data and career pathways) is needed in the report and no decisions should be made until this information is available (3). HWNZ comment HWNZ notes the three concerns. HWNZ intended the report as a mechanism to begin to gain information about:

identification of the health science and technical professions

sector views on the key aims and principles that should underpin any health science and technical workforce education, training and workforce planning framework. The report was not intended to be a detailed proposal. HWNZ is satisfied that the report achieved the two aims listed above. The next phase will begin to look at how an education, training and workforce planning model might look for New Zealand’s health science and technical workforce, how each profession might sit within the model by mapping each profession’s current education and training programmes and workplace skills and competencies, and clearly identifying any professions that will not sit within the education and training model, but need to be included in any moves towards co-ordinated workforce planning. Appendix 2: List of submitters Name Category Details David Robiony- Professional Australian & NZ Society of Respiratory Science Rogers organisation Juergen Meyer Professional college NZ Branch, Australasian College of Physical Scientists & Engineers in Medicine

Fiona Iowen DHB; profession Waitemata DHB; Medical Laboratory Science

Alex Wheatley DHB Lakes DHB (Information Officer) Glynne Morressey DHB; ITO; profession Northland DHB; Careerforce; Vision & Hearing Technician; Co-ordinating assessor for VHT qualification Dr Jerry Shearman ITP (training CPIT, Academic Manager organisation) Russell Simpson DHB Hutt Valley, science & technical professions

Belinda Buckley DHB; profession Auckland DHB; Charge Cardiac Sonographer

Sue Camoutsos; DHB; profession Canterbury Health Laboratories; Medical Kirsten Beynon; Laboratory Scientists & Technicians Kevin Taylor; Tony Burns; Greg Devane; Ken Beechey Mike Legge University Otago University, Medical Laboratory Science

Dr Mary Nulsen University Massey University, Medical laboratory Science

Susan Beggs Regulatory authority Physiotherapy Board Christine King DHB Capital & Coast DHB; Director of Allied Health, Science & Technical Michele Peck Professional NZ Anaesthetic Technicians Society association

Group Professional Cardiac Physiologists & Cardiac Physiology association Technicians; Society of Cardiopulmonary technology (NZ)

Ken Beachey Professional; NZ Institute of Medical Laboratory Science professional association

Grant Searchfield Profession; University University of Auckland

Gloria Crossley DHB; professional Medical laboratory science Jeanine Doherty Professional NZ Audiological Society association; profession Jonathan Grady; University University of Canterbury Rebecca Kelly- Campbell; Greg O'Beirne; Michael Robb; Donal Sinex Regulatory authority Medical Sciences Council of NZ

Union APEX; medical laboratory workers Wendy Horne University Unitec Institute of Technology Kim Fry; Hentie DHB Whanganui & MidCentral DHBs Cilliers Regulatory authority Medical Radiation Technologists Board of NZ

Barbara Moore Regulatory authority Pharmacy Council of NZ Andrew Hamer Professional NZ Cardiac Network Penny O'Leary University UCOL Claire Bornfather DHB, professional Taranaki DHB