“Beyond workforce”: a systemic solution for health service provision in small rural and remote communities

Abstract

Successful, “innovative” primary health care (PHC) models exist that have adapted to the specific circumstances of their rural and remote context. A typology of discrete, integrated, comprehensive and outreach rural and remote services exists rather than a “one coat fits all” PHC health service model. Successful models are characterised by macro‐scale environmental enablers (supportive health policy, federal–state relations, and community readiness) and five essential service requirements (workforce organisation and supply; funding; governance, management and leadership; linkages; and infrastructure). Service sustainability depends on ensuring that key systemic service requirements are met at the local level in ways that accord with, and are supported by, the broader macro‐scale environmental enablers. Based on these principles, these model types are amenable to generalisation and evaluation in other regions.

Optimizing Implementation of Obesity Prevention Programs: A Qualitative Investigation Within a Large‐Scale Randomized Controlled Trial

“…It would also bring together various skill sets, perspectives, and resources to optimize program implementation . The findings from this study are consistent with theoretical models developed to support the rural workforce, focusing on developing supportive health policies, collaborations, workforce capacity, funding, leadership, and infrastructure provisions . Ensuring the rural workforce feels valued has also been demonstrated in previous literature, revealing the importance of providing recognition to maintain the rural workforce interest and motivation to implement evidence‐based programs .…”

Bringing evidence to bear on policy processes: the challenge of the Australian Primary Health Care Research Institute

“… Chronic disease management ( Cranston et al, 6 Dennis et al 7 ); Integration, coordination and multidisciplinary care ( Jackson et al, 8 Mitchell et al, 9 Powell Davies et al 10 ); Innovative models for comprehensive primary health care delivery ( McDonald et al, 11 Naccarella et al, 12 Humphreys et al 13 ); Innovative models for the management of mental health in primary health care settings ( Griffiths and Christensen 14 ); Children and young Australians, health promotion and prevention ( McDonald et al, 15 Hearn et al 16 ); and Workforce (focus on competency‐based training) ( Glasgow et al 17 ). …”

“…The number of hits suggested the resources have been useful, and, interestingly, it seems the full reports are most often visited rather than the one‐ or three‐page summaries. Anecdotal accounts suggest that the recent Australian Government intervention in the Northern Territory has resulted in much use being made of the reports by McDonald et al 15 and Humphreys et al, 13 although this can not be corroborated through analysis of APHCRI website activity. Anticipating future policy challenges in an explicit and timely fashion allows for a repository of relevant research information to be developed 20 …”

How do small rural primary health care services sustain themselves in a constantly changing health system environment?

“…In this study the enablers of, and threats to, sustainability are considered within a comprehensive framework of PHC service requirements [15,16]. These inter-dependent sustainability requirements (workforce organisation and supply; funding; governance, management and leadership; service linkages; and infrastructure [15,17]) have been validated previously across a range of different primary health service models in different rural and remote contexts [16]. Sustainable PHC services also depend on several external environmental enablers, including a supportive policy environment, clearly-articulated Federal-State governments' roles and responsibilities, and strong community involvement.…”