Improving Healthcare through the Skills Mix of the Workforce.

The latest definition of skill mix refers to changes in tasks, skills, competencies or roles within and between healthcare professionals and healthcare workers in three areas: Task shifting, role expansion and multi-professional collaboration. There is evidence of the effectiveness of many changes in the skill mix - particularly in the areas of health promotion and disease prevention, chronic disease management and care of vulnerable populations. The implementation of skill-mix approaches begins with interprofessional education, which emphasises collaborative practice aimed at fostering working relationships between two or more health professions. The evidence for the effectiveness of many skill mix changes should not be understood as a resource-neutral intervention. Changes in skill mix have implications for the structure of labour shortages, as workload shifts or increases. In addition, education and training interventions require time and resources and therefore considerable joint effort from the stakeholders involved.