Australia’s neurology workforce is already inadequate and would need to grow by nearly double over the next decade to meet patient need without other measures, researchers say.

The ANZAN working party behind the finding says GPs will need to be trained to take on diagnosis and management of neurological conditions including epilepsy, migraine and FNDs to make up for the shortfall, even with a dramatic expansion in the number of working neurologists by 2034.

They also argue:

• Referral and care pathways will have to be overhauled to improve efficiency
• The number of specialist neurology nurses, nurse practitioners and administrative support staff need to grow substantially to assist neurologists in meeting demand
• Expand telehealth, particularly for rural and regional patients

As with other specialties, the problem is most critical in regional and rural Australia, currently home to 31% of the nation’s population but just 4% of its neurologists, according to the researchers.

Based on an average consult duration of 46.9 minutes for an initial encounter and 23.6 minutes for a review, the current national shortfall equated to 121,000 initial consults and 207,500 reviews, they reported in BMJ Neurology Open (link here).

On current trends, the workforce was projected to expand from 620 neurologists in 2020 to 896 in 2034.

Nevertheless, this would leave a capacity deficit exceeding 154,000 initial encounters and 110,000 reviews by 2034, the researchers wrote.

Increasing the total number of neurologists to 1200 by that time could theoretically eliminate the deficit in total review encounters, although a shortfall would still remain outside the major cities, they calculated.

“These results indicate that unless more holistic efforts (incorporating increases to the workforce alongside improvements in systems of care) to improve neurology care in Australia are undertaken, the shortfalls in the availability of neurology care in Australia are likely to persist,” the authors wrote.

“This gap can be mitigated by sustainable increases in neurological workforce, but this is likely insufficient alone.”

“Thus, while efforts to expand the workforce should be pursued, including investment in the neurology training programme and subsidy of more neurology positions, especially in regional Australia, this should be undertaken in concert with other initiatives.”

Additionally, efforts to address the regional deficits may require “focused interventions” such as recruitment and retention incentives, they added.

Conducted on behalf of ANZAN’s workforce committee, the study’s senior author was Professor Tomas Kalincik of the University of Melbourne and Royal Melbourne Hospital.