Recruiting, retaining and supporting General Practitioners (GPs), Nurses and Allied Health Professionals in rural New South Wales, Australia

About RDN

The NSW Rural Doctors Network (RDN) is a not-for-profit and non-government organisation, and is designated by the Australian Government as the Rural Workforce Agency (RWA) (for health) in New South Wales (NSW).

RDN aims to ensure that the highest possible standard of healthcare is provided to rural and remote communities through the provision of a highly skilled and continuing medical and health workforce in remote and rural NSW.

RDN is a membership organisation numbering more than 1,500 with 1,032 registered Medical Practitioners as Primary Members and 502 Associate Members who, although not eligible for Primary Membership, wish to support the aims and objectives of the Network.

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Programs & Services

RDN offers a range of services, programs and activities across NSW that:  

  • Assist rural communities and rural General Practices to find suitably skilled and qualified General Practitioners (GPs) to work in their towns
  • Assist suitably skilled and qualified GPs, nurses and allied health professionals to find employment in rural NSW (this includes both Australian and International Medical Graduates/Overseas Trained Doctors)
  • Support existing rural doctors through the provision of Continuing Professional Development (CPD) activities and Succession Planning 
  • Assist in finding locum support for rural and remote GPs
  • Deliver a wide range of Health Outreach services to rural towns
  • Support rural medical partners and families
  • Provide a range of scholarships, support and information for students studying medicine or health related degrees in NSW.

RDN also:

  • Works with local communities, governments and rural Local Health Districts on medical workforce matters
  • Works with University Medical Faculties to promote rural medicine
  • Works with rural NSW PHNs to support rural GPs
  • Works with Aboriginal Community Controlled Health Services to support health services for Indigenous peoples
  • Influences government policy to support rural medicine
  • Maintains a comprehensive rural health workforce database.

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Partnerships

While RDN provides services and programs for rural health, its major input is facilitating other organisations in working together to fill workforce gaps, provide a cohesive approach to health services, and to innovate to expand access to healthcare for people living in remote, rural and regional NSW.

RDN achieves its objectives by working collaboratively with rural PHNs, the Rural Doctors Association of NSW, the Australian College of Rural and Remote Medicine, the Royal Australian College of General Practitioners, Rural Training Providers, the Australian Medical Association, the University Medical Faculties and Departments of Rural Health, the Aboriginal Health and Medical Research Council, State and Federal Departments of Health, rural Local Health Districts, local government and other key stakeholders.

Conceptually, RDN can be seen as being at the centre of a pentagon, harnessing the efforts of:

  1. Policy makers (governments and departments)
  2. Health providers (medical and other health practitioners)
  3. Health service organisations (e.g. rural Local Health Districts, PHNs, Aboriginal Medical Services, hospitals and other local health services)
  4. Communities
  5. Academics.

 

Further, RDN has had influence over the years on health service developments and policy at state, national and international levels through participation in committees, research collaborations and submissions to government inquiries.

RDN helps to improve patient care and health status in rural NSW communities through these strategic partnerships.

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Operating Context

As the RWA in NSW, RDN works within a large and complex environment that involves stakeholders such as doctors, nurses, allied health practitioners, medical practices, health service organisations, educational institutions, governments and community groups. Much of RDN’s work is with the following communities:

Rural Medical and Health Practitioners*

  • 2,038 rural NSW GPs excluding registrars
  • 2,520 rural NSW GPs including registrars working in 637 rural practices in Australian Standard Geograpahical Classification - Remoteness Area (ASGC-RA) 2-5
  • 701 rural NSW GPs who are Visiting Medical Officers (VMOs) in rural hospitals ASGC-RA 2-5
  • 231 GP vacancies registered with RDN in rural towns
  • 54 nurses through the Rural Health Professionals Program (RHPP)
  • 145 allied health workers through the RHPP
  • 58 dentists through the Dental Relocation and Infrastructure Support Scheme (DRISS)
  • More than 600 urban and regionally based medical specialists, nurses and allied health practitioners who provide health outreach services to rural towns, supported by RDN and its partners.
  • RDN communicates with around 400 urban, rural interstate and overseas doctors who are interested in locum work in NSW and facilitates more than 70 locum placements each year.

In recent decades, rural NSW GPs have remained in rural practice longer than in any other Australian state or territory. Despite an increase in the numbers of rural GPs, average hours of patient contact has declined as a result of more doctors working part-time, and a gradual reduction in the traditionally long hours of work undertaken. The number of rural GP vacancies has steadily grown over the same period. A concern is the number of GPs aged over 55 years, which currently stands at 700*. The need to replace these doctors as they retire or leave rural practice poses a significant challenge, not least because this cohort of doctors take an active and critical role in training registrars and medical undergraduates.

Health Organisations*

  • Seven PHNs serving rural NSW.
  • Seven rural and three urban Local Health Districts.
  • All Aboriginal Community Controlled Health Services (ACCHS) and several ACCH-related services.
  • Eight medical schools and their associated rural campuses.
  • 17 rural referral hospitals.
  • 125 RDA Settlement Package hospitals.
  • One state-based NACCHO affiliate.

Governments*

  • The NSW Ministry of Health (MoH) has funded RDN since 1988.
  • The Australian Government Department of Health (DoH) funds RDN activities through the Rural and Remote General Practice Program (RRGPP), Health Outreach programs, RHPP and DRISS.
  • The RDN region spans 88 rural local government bodies (Shires or Councils), 14 of which provide funds to RDN to administer medical student Bush Bursaries in their towns.

*At 30 June 2016

Operating Principles

RDN operates, and has operated, on the principles of:

  1. Action, through RDN doing what is best done at a state-wide (rural) level
  2. Support for other organisations to do what is best done at a regional or local level
  3. Facilitating and coordinating activity across the state to achieve greater cohesion and less duplication in implementation
  4. Recognising areas where new strategies are needed or can add value, and developing those strategies. Where appropriate, those strategies may be implemented by other organisations at a regional or local level.

1. Action at a state level includes such activities as:

  • Assessment of and assistance to Overseas Trained Doctors (OTDs)
  • Orientation training courses and support for doctors new to remote, rural and regional NSW
  • Workforce data and information management
  • Relocation and education grants
  • RDN Rural Locum Service
  • Workforce planning
  • Research to better inform the attraction, recruitment and retention of rural GPs, nurses and allied health practitioners
  • Relationships with state level organisations
  • Managing scholarships for medical students to increase their exposure to rural medicine
  • Clinical, professional and social orientation through education, information and support planning services
  • State-wide health service planning for health outreach services
  • Free medical and health vacancy promotion through the RDN website for organisations in RA 2-5 areas
  • Maintenance of rural medical and health workforce skills through the provision of CPD conferences and events
  • Contributing to the future rural workforce through the administration of the NSW Rural Resident Medical Officer Cadetship Program for Indigenous and non-Indigenous medical students.

2. Support at a regional or local level includes such activities as:

  • Providing support and funds to individual doctors to assist them in their preparation towards gaining
    Fellowship of the RACGP and ACRRM
  • Assisting rural communities seeking doctors, nurses and allied health practitioners
  • Providing direction, workforce data analysis and support to local health groups’ succession planning activities
  • Local management, by LHDs, rural PHNs, ACCHSs and other rural health organisations, of the health outreach programs administered by RDN.

3. Facilitation and coordination at a state-wide level:

Given the size and complexity of rural medicine in New South Wales, this is a major part of RDN's activities, aimed at achieving cohesion in rural health programs and minimising duplication of activities across the various organisations' activities. It includes such activities as:

  • Chairing and hosting the Rural Medical Training Forum (RMTF) - all stakeholders involved in rural medical education and training
  • Chairing and hosting the Rural Medical Support Forum (RMSF) - PHNs, local government, state and federal health departments, rural GPs, young rural doctors, Aboriginal Health and Medical Research Council (AH&MRC), rural community representatives (e.g. Country Women’s Association, Rural Medical Family Network), RDN Management and RDN Board member
  • Chairing and organising monthly teleconferences and annual face-to-face meetings of all rural NSW PHNs
  • Meetings and discussions with a wide range of organisations, including politico industrial bodies, medical colleges, governments and communities on attracting, recruiting and retaining rural GPs, nurses and allied health practitioners
  • An MOU and partnership with the AH&MRC to increase the health and medical workforce in ACCHSs.

4. Development:

Over the last 28 years RDN has been involved in developing many innovations in the medical and health workforce. Examples include the development of GP Entities and their extension into integrated primary care, a program of medical specialist outreach to Aboriginal communities, a quantitative tool to assess the vulnerability of rural towns to loss of medical services, a web-based system to facilitate devolved management of a wide range of health outreach services to more than 120 towns, and an online learning facility to support rural health professionals and general practice staff.

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Governance

The basic framework through which RDN operates is under a thirteen member Board of Directors headed by an elected Chair and Vice Chair who are both in rural general practice. The Board is responsible for setting the strategic direction for RDN, for developing policy and planning priorities, and for ensuring that the RDN meets its contractual agreements and obligations.

The RDN Board comprises individuals nominated by RDN members (two), Rural Doctors Association (RDA (NSW)), Australian Medical Association (AMA (NSW)), Aboriginal Health and Medical Research Council (AH&MRC), Royal Australian College of General Practitioners (RACGP) and the NSW Ministry of Health (MoH) (two). Note: The makeup of the RDN Board is currently under review by a Governance Sub-committee of the Board.

The Rural Medical Support Forum (RMSF) is the major committee of the RDN and advises the Board on policy issues and RDN management on operational issues. The forum includes local government, state and federal health departments, rural GPs, young rural doctors, the AH&MRC, rural community representatives (CWA, RMFN), RDN Management and RDN Board members.

The Rural Medical Family Network operates (RMFN) as a committee of RDN. The network has its own membership (currently 881*) of spouses of rural GPs, its own elected committee. RDN remains accountable for all activities, including financial, of the RMFN.

*At 30 June 2016

RDN Board

The Board of Directors is responsible for determining overall policy and priorities of the organisation, and for ensuring that RDN meets funding agreements and contractual obligations.

2017 RDN Board (appointed at the November 2016 Annual General Meeting)

  • Dr Ros Bullock (Chair), Elected GP
  • Dr Lee Jeffery (Deputy Chair), co-opted NSW Rural Doctors Network Board member
  • Dr John Curnow (Treasurer) NSW Rural Doctors Association
  • Dr Rose Ellis (Secretary), co-opted NSW Rural Doctors Network Board member
  • Dr Lauren Cone, Elected GP
  • Ms Christine Corby, Aboriginal Health and Medical Research Council
  • Dr John Kramer, Royal Australian College of General Practitioners
  • Dr Geoff White, NSW Australian Medical Association
  • Ms Jill Ludford, NSW Ministry of Health (Senior Executive)
  • Dr William Lancashire, NSW Ministry of Health (Director of Primary and/or Community Services or Director of Medical Services)

RDN Constitution

The RDN is a public company limited by guarantee under the Australian Corporations Act 2001. Download the RDN Constitution (2015).

Rural Medical Support Forum

The Rural Medical Support Forum (RMSF) provides advice to RDN on initiatives to improve the attraction, recruitment and retention of GPs to rural NSW.

The RMSF comprises representatives with expertise and experience in rural medical workforce issues from a range of organisations in NSW. Together these representatives plan workforce strategies for a range of GPs - including students, graduates, proceduralists and overseas trained doctors - to improve the sustainability of GP health services in the bush.

The RMSF reports and makes recommendations to the RDN Board.

2017 RMSF Committee

  • Mr Richard Colbran, NSW Rural Doctors Network (Chair)
  • Dr Lauren Cone, NSW Rural Doctors Network Board
  • Dr Ros Bullock, Rural GP
  • Vacant, NSW Local Government & Shires Association
  • Ms Robyn Wright, Country Women’s Association
  • Dr Anna Keedwell, Rural GP Registrar
  • Ms Barbara Newton, Community Representative
  • Vacant, Aboriginal Health & Medical Research Council
  • Ms Kim Sanazzaro, NSW Rural Medical Family Network
  • Dr Ian Kamerman, Rural Doctors Association (NSW)
  • Ms Linda Macpherson, NSW Ministry of Health
  • Ms Lisa LaRance, Australian Department of Health
  • Vacant, Rural Junior Medical Officer
  • Dr Rose Ellis, NSW Rural Doctors Network
  • Ms Christine Roach, NSW Rural Doctors Network

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Funding Sources

RDN receives core and project funding from the NSW Government Ministry of Health (MoH) through its Non-Government Organisation Program, and infrastructure and project funding from the Australian Government Department of Health (DoH).

RDN also receives annual funds from DoH to develop and administer the Rural and Remote General Practice Program (RRGPP) in NSW. This program aims to attract, recruit and retain general practitioners in rural and remote communities.

Importantly, RDN receives funds to deliver a wide range of Health Outreach services across more than 120 rural NSW towns.

Several rural local governments, community and industry organisations also contribute funding for RDN activities.

In 2012 RDN added the recruitment of nursing and allied health professionals to its suite of services under the Australian Government’s Rural Health Professionals Program.

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History

Since its beginnings as the Rural Doctors Resource Network (RDRN) in 1988, RDN has continued to have a history of innovations that have shaped NSW and national rural health programs and policy.

RDN was established as a Company Limited by Guarantee in 1998 by combining the structure of the RDRN, established in 1988, with some functions of the NSW Rural Divisions Coordinating Unit (RDCU), established in 1993. The 1990s saw the emergence of rural health as an issue in its own right in Australia so RDN’s establishment and achievements are important in the relatively recent history of rural health issues in Australia.

RDN has expanded over the years from a focus on Locums and rurally based Continuing Medical Education (CME) to include GP recruitment and retention, nursing and allied health recruitment and retention, outreach services, GP locum service, support for families of rural medical and health practitioners, and rural NSW health workforce data services.

While RDN provides services and programs for rural health, its major input is in facilitation to ensure other organisations work together to fill workforce gaps, provide a cohesive approach to health services, and to innovate to expand access to healthcare for people living in remote, rural and regional NSW.

Further, RDN has had influence over the years on health service developments and policy at state, national and international levels through participation in committees, research collaborations and submissions to government enquiries.

In 2013 RDN celebrated 25 years (with predecessor organisation RDRN). An overview of highlights and achievements during that time can be viewed in the RDN Annual Report 2012-13 under Corporate Reports and Plans.

Additional information about RDN’s history and the journey of rural health in NSW are published by RDN in:

  • The Rural Road Travelled - History and Achievements of the New South Wales Rural Doctors Network, November 2006 (ISBN 0-9581728-9-7)
  • The 1987 NSW Rural Doctors’ Dispute -The Dispute that Changed the Face of Rural Medicine, November 2007 (ISBN 978-0-9803026-4-6).

These publications are available online under RDN History or in print, free of charge, by emailing your request or phoning 02 4924 8000.

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