Health Workforce (GEN 2,7

The health of individuals and communities is poorer the further the distance from a metropolitan centre; holding positions of trust with patients, rural and remote GPs provide health care to the majority of people in the community in which they reside and have little day-to-day contact with others of their profession which often leads to a feeling of isolation and challenges in maintaining a healthy work-life balance. This is true also for other health professionals including nurses and allied health professionals. Retention of health professionals in rural and remote locations is an ongoing challenge requiring input from the whole community, state and Australian Government to resolve.

Identified Need

Health Workforce outcome of service needs analysis

Key Issue

There is a continued difficulty in attracting, recruiting and retention of GPs and allied health professionals to rural and remote areas ∙ All of the CSAPHN region except Port Augusta, Whyalla,

Gawler, Mount Barker and Victor Harbor are considered

GP distribution priority areas ∙ GPs often responsible for ED and acute hospital services as well as primary health care via general practice ∙ Many localities with limited or no services ∙ Rates of podiatrists, psychologists, registered nurses, optometrists and physiotherapists are below state averages in all CSAPHN regions, despite higher rates of chronic disease and mental illness ∙ Rates of GPs, pharmacists and dentists are below state averages in nearly all CSAPHN regions ∙ Long wait times to see a practitioner ∙ Ageing of the rural and remote health workforce. All of the CSAPHN region is considered a district of workforce shortage for medical specialists. Challenges in accessing business improvement and professional development opportunities for rural and remote practitioners. ∙ Leading issue in priority matrix ∙ HWA rates of health practitioners ∙ DoH distribution priority areas mapped via DoctorConnect ∙ Key theme in all stakeholder engagement and feedback ∙ NHSD and CSAPHN internal service mapping ∙ SA Health inpatient data ∙ HWA report: National Rural and Remote Health Workforce Innovation and Reform Strategy (HWA 2013) ∙ RDWA Medical Outreach programs by specialty and location (RDWA undated a, undated b, undated c)

Description of Evidence

Identified Need

Health Workforce outcome of service needs analysis - continued

Key Issue

Impact on prescribing practices and medication management, especially for patients with chronic and complex conditions. Lack of connection and communication between various health providers both within and between rural communities.

Difficulty of acquiring accurate, comprehensive service data around allied health – particularly level and quality of outreach services. see above…

Description of Evidence

Priority

Health Workforce (GEN – 2) opportunities, priorities and options

Possible Options

1. Local quality improvement in general practice and other local service providers through: ∙ Facilitation of service satisfaction and provider retention through provision of material support to general practice, community health services, ACCHOs, and allied health services, covering; ∙ Better business modelling and forward planning ∙ Practice sustainability ∙ After hours business modelling ∙ Strategy and improvements in data use and utilisation of technology, including promotion of data cleansing ∙ Participation in improvement programs ∙ Coordination of continuing professional development. ∙ Facilitating knowledge and skill development to build cultural awareness and cultural competency across the health workforce. ∙ General Practice, allied health and pharmacy, ACCHO’s and AMS achieve increased capacity to provide quality services. ∙ Evidenced improvement in financial capacity redirected to service provision. ∙ Evidence provided of increased quality of patient throughput and patient outcomes. ∙ Retention of providers improved through increased satisfaction with working environment. ∙ CSAPHN

Expected Outcome Potential Lead

∙ RDWA

∙ SA Health

∙ University sector ∙ General Practice

∙ GP peak bodies ∙ ACCHOs and AHCSA

2. Advocacy and support with relevant GP and other health professionals in workforce planning, recruitment and retention initiatives. ∙ Increased access to health service providers ∙ Improved patient access, experience and journey.

Priority

Health Workforce (GEN – 2) opportunities, priorities and options - continued

Possible Options

3. Support allied health providers to build business capacity through outreach and multi-modality service delivery options.

4. Support appropriate peak bodies in capacity building and sharing of information to pharmacy managers, general practitioners, and practice managers.

5. Recognise the RFDS as a general practice (albeit mobile) in all areas of practice support and support the development of business models that will capacity build

RFDS as an on-ground provider of services in remote communities.

6. Work with RDWA to integrate practice quality improvement initiatives as part of workforce placement and retention.

Identified Need

After Hours Access –outcome of service needs analysis 7. Engage with universities to promote student and new practitioner placements in rural areas.

Key Issue

∙ No/limited after hours sites in the Tatiara and upper

South East regions. ∙ Reliance on country hospital EDs for after-hours treatment in many country locations. ∙ Many country hospital EDs do not have a doctor on-site and available for consultation. ∙ PIP scheme inadequate to fully resource some practices for necessary after-hours operations. ∙ Difficulty in distinguishing need from service availability through MBS after-hours billing rates. ∙ CSAPHN internal service mapping database and listing of PIP practices. ∙ After hours clinics and hospital ED locations mapped ∙ Issue of importance in priority matrix ∙ Key theme in stakeholder consultations

Expected Outcome Potential Lead

∙ Improvements achieved in awareness of principles and practical application of principles for quality use of medicines.

∙ RFDS demonstrating enhanced provision of comprehensive services more widely across the region. see above…

∙ Functional partnership achieved with RDWA to tailor and adapt activities to the region according to evidence-based needs.

∙ Partnership achieved facilitating placement of students and new graduates in rural areas.

Description of Evidence

Priority

After Hours Access (GEN –7) opportunities, priorities and options

Possible Options

1. Provide material support to general practice to enable better business modelling for sustainable after-hours services.

2. Provide material support to key required allied health and or pharmacy to enable better business modelling for sustainable after-hours services as identified and required.

3. Work with the six regional Local Health Networks to identify options for improvements in after-hours primary health services to redirect or improve primary health after hours service demand.

4. Support a GP to RACF telehealth service.

Expected Outcome

∙ More timely attention to residents’ primary health care and less need for transfer to Emergency

Departments.

∙ Partnerships with identified providers according to community need and extension of services occasioned.

∙ Partnership with LHN focussing on better data intelligence on needs and sentinel activity achieved implementing alternative service provision in out of hours.

∙ Continuance for progression of existing CSAPHN work that facilitates increased uptake of simplified local telehealth platforms in small communities. Evidenced by, timelier GP ‘attendance’ to needs and reduced demand on hospital attendances.

Potential Lead

∙ CSAPHN

∙ Six regional LHNs ∙ Private Allied Health and

IPHCS Providers ∙ General Practice / ACCHOs ∙ Pharmacy ∙ RWDA