Supporting older Australians to be cared for and die in the place of their choice requires a high-quality and well-prepared health workforce. The aged care industry comprises both health professionals and care workers. 
The aged care workforce is a significant workforce with 366,027 workers of which 240,317 have direct care roles.  The size of the residential aged care workforce being estimated at 235,764 workers of which 153,854 have direct care roles: 386 Nurse Practitioners (NP), 22,455 Registered Nurses (RN), 15,697 Enrolled Nurses (EN) and 108,126 Personal Care Attendants (PCA), 2,210 Allied Health Professionals (AHP) and 4,979 Allied Health Assistants (AHA).  The size of the home care and home support aged care workforce is estimated at 130,263 of which 86,463 have direct care roles: 53 Nurse Practitioners, 6,969 RNs, 1,888 ENs, and 72,495 Community Care Workers, 4,062 Allied Health Professionals and 995 Allied Health Assistants.  AIHW data reports that in 2012, there were 25,958 registered GPs. 
Enrolled nurses and care workers provide most direct care to older people. [1-3] Vulnerabilities in the employment structures and skills shortages can add to complexity around competencies and scope of practice. Careworkers often provide care at the intersection between professional and informal care. Many have limited training and feel inadequately prepared for their job.  There is increasing recognition of the importance of staff training and education and on their effectiveness as interventions that achieve outcomes for staff and for the people for whom they provide care. Tools to assess palliative care competency for careworkers are available but are limited in their suitability for those with language or literacy problems. 
Primary care professionals are seen as an important link in preventing people dying in hospitals.  However, they must be willing to manage the uncertainty around palliative and end-of-life care.  Effective collaboration and interprofessional working many assist in providing care to older Australians at the end-of-life.  Tools to identify people with palliative care needs do exist and should be used alongside clinical judgement. 
Nurse Practitioner role may also be a valuable addition to the palliative care/aged care workforce. 
Few reviews included prospective comparative interventions. Many dealt with analyses of surveys, interviews and workforce reports. The conduct of the reviews was adequate.
Page updated 22 May 2017