How can optimal skill mix be effectively implemented and why?
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The aim of this policy brief is to develop key messages to support evidence-informed policy-making.
Key messages
Skill-mix initiatives focus on changing professional roles – directly and indirectly. They change roles directly through extension of roles or skills, delegation, and the introduction of a new type of worker; they change them indirectly through modifications of the interface between services – that is, where care is provided.
Skill-mix initiatives may be motivated both by qualitative considerations (such as quality improvement, professional development and quality of work-life concerns) and quantitative considerations (such as shortages, maldistribution and cost–effectiveness).
Policy instruments that support the effective implementation of skill-mix initiatives include:
- modifying or introducing new professional roles through the development of different organizational and regulatory arrangements, including regulating professional scopes of practice and overcoming institutional barriers;
- supporting new or enhanced professional roles through collective financing and altered financial incentives; and
- ensuring the educational foundations (competence and capacity) for the new and expanded professional roles.
