Rural Health Workforce Resources
The South Island Workforce Development Hub hosted a rural health workforce workshop in August 2018. The purpose of the day was to bring together a range of people with an interest in rural health and the rural health workforce. Participants came from DHBs; PHOs; education providers; St John; trust hospitals; College of Midwives; Health Workforce New Zealand; The purpose of the day was to identify issues/ vulnerabilities and gaps; showcase current initiatives underway or in development and to look at opportunities for regional collaboration. Since then a small group of people who attended the workshop have started to meet to progress this work.
The resources on this page have been shared to help inform these discussions as consideration is giving to issues such as retaining a rural workforce; what capability is required to work rurally; models of care; skill mix; support; generalist skills and training pathways fit for purpose.
For further information about rural health workforce activity underway across the South Island please contact: firstname.lastname@example.org
Shortages of health professionals persist in much of rural New Zealand despite a range of targeted university and professional college initiatives. In response to this a collective of universities, professional colleges and sector groups have put a proposal to Government for a National Interprofessional School of Rural Health. If adopted, this proposal would embed rural health professional education and research in rural communities around New Zealand, empowering them to organise the education that occurs in their community, in a coherent and coordinated way. What is being proposed is not a new or separate education provider but rather an ‘enabling body’ that would lever o_ the expertise and resources of the existing tertiary institutions, colleges and rural communities. It calls for an ‘all of systems’ approach that encompasses all the health professions that practise in rural areas, undergraduate education and postgraduate training, and rural health research. Although modelled on successful Australian rural clinical schools, it is a uniquely New Zealand solution that is cognisant of the New Zealand context and resources.
Nixon, G.H., Kerse, N. M., Bagg, W., Skinner, M.A., Larmer, P.J. and Crampton, P. (2018). Proposal for a National Interprofessional School of Rural Health. NZMJ, Vol 131 No 1485 pp67-75.
Read the article here.
There is an urgent need to create sustainable models for acute medicine in smaller hospitals. Too often, the knee-jerk reaction has been to try to close or downgrade these services rather than to develop solutions that better suit the needs of the local community. As a result, attempts to close these services have tended to fail, while the problems they were trying to address remain.
The Nuffield Trust was asked by NHS England to work with a group of clinical leaders, Royal College representatives and other experts to develop a better understanding of the problems associated with acute medicine in smaller hospitals and to find possible solutions. We reviewed the literature, looked at local and international examples and drew on our own extensive research in this area.
Vaughan, L., Edwards, N., Imison, C. and Collins B. (2018) Rethinking acute medical care in smaller hospitals – Research summary report October 2018. Nuffield Trust 2018. www.nuffieldtrust.org.uk/research
This research explores the views of health care executives, clinical leaders, and clinicians about health care in urban/suburban and rural settings. The survey explores the type of settings in which organizations provide care, the quality of services provided, a comparison of aspects of care for rural versus urban/suburban settings, the biggest barriers to providing excellent care, and the tools, models, and policies to improve care delivery. Completed surveys from 730 respondents are included in the analysis.
Compton-Phillips, A. and Mohta, N.S. (2018) Lessons Learned From and For Rural Health. NEJM Catalyst
SARRAH (Services for Australian Rural and Remote Allied Health) is working with health and education sector partners from across Australia on the allied health rural generalist pathway. The pathway is a strategy to build the capacity, value and sustainability of allied health services and multi-disciplinary teams in rural and remote areas. The components of an allied health rural generalist pathway are:
1. Service models that address the challenges of providing the broad range of healthcare needs of rural and remote communities,
2. Workforce and employment structures that support the development of rural generalist practice capabilities, and
3. an education program tailored to the needs of rural generalist practitioners.
for further information - https://sarrah.org.au/ahrgp
New Zealand has a rural population with unique healthcare needs. Traditionally, rural health care has been provided by medical general practitioners (GPs); however, as the number of GPs declines, the rural nurse specialist (RNS) role has emerged. The RNS is a registered nurse with advanced nursing skills that enable independent, autonomous practice within rural areas. The health needs of each rural community are specific to that area and the RNS role has been developed according to local healthcare needs. The purpose of this research was to provide a description of the RNS role in New Zealand.
Bell J, Crawford R, Holloway K. Core components of the rural nurse specialist role in New Zealand. Rural and Remote Health 2018; 18: 4260. https://doi.org/10.22605/RRH4260
Delegates at the 15th WONCA World Rural Health Conference New Delhi, India, April 2018 stated that as rural healthcare practitioners, they base our work on this understanding. They strive for the highest possible level of health for the communities they serve, with the goal of “Health For All Rural People”, identifying six priority areas to achieve this:
Read the full statement here.
Rural health workforce shortages are a global phenomenon. Countries like Australia, with industrialised economies, large land masses and broadly dispersed populations, face unique rural health challenges in providing adequate services and addressing workforce shortages. This article focuses on retention of early-career nursing and allied health professionals working in rural and remote Australia. Some of Australia’s most severe and protracted rural workforce shortages, particularly among early-career health professionals, are in public sector community mental health
(CMH), a multidisciplinary workforce staffed primarily by nurses and allied health professionals. This study investigated how employment and rural-living factors impacted the turnover intention of early-career, rural-based CMH professionals in their first few years of working.
Cosgrave C, Maple M, Hussain R. An explanation of turnover intention among early-career nursing and allied health professionals working in rural and remote Australia – findings from a grounded theory study. Rural and Remote Health 2018; 18: 4511. https://doi.org/10.22605/RRH4511
The NSW Health Professionals Workforce Plan 2012-2022 is a strategic framework that aims to address the long-term workforce needs of NSW Health. The Plan outlines strategies to grow the rural workforce, support rural education and training, improve rural workforce planning capacity and provide support to health professionals working in rural areas. The Plan is aligned with the NSW Rural Health Plan which includes a strategy focusing on enhancing the rural health workforce in NSW. The NSW Rural Health Plan recognises the role of all members of the workforce in enabling the delivery of services in rural communities, and supports initiatives to attract, retain and support health professionals in rural and remote areas. This includes supporting the Aboriginal health workforce, targeting recruitment and promoting development and training. Local health districts are developing workforce plans to support their service plans. These planning processes have been completed or are underway throughout NSW Health.
The lack of health workers in remote and rural areas is a worldwide concern. Many countries have proposed and implemented interventions to address this issue, but very little is known about the effectiveness of such interventions and their sustainability in the long run. This paper provides an analysis of the effectiveness of interventions to attract and retain health workers in remote and rural areas from an impact evaluation perspective. It reports on a literature review of studies that have conducted evaluations of such interventions. It presents a synthesis of the indicators and methods used to measure the effects of rural retention interventions against several policy dimensions such as: attractiveness of rural or remote areas, deployment/recruitment, retention, and health workforce and health systems performance. It also discusses the quality of the current evidence on evaluation studies and emphasizes the need for more thorough evaluations to support policy-makers in developing, implementing and evaluating effective interventions to increase availability of health workers in underserved areas and ultimately contribute to reaching the United Nations’ Millennium Development Goals.
Dolea, C., Stormonta, L. & Braicheta, J. (2010). Evaluated strategies to increase attraction and retention of health workers in remote and rural areas. Bull World Health Organ 2010; 88:379–385 http://dx.doi.org/10.2471/BLT.09.070607