Collaborative Care Workforce Models for Remote and Rural Communities
The Collaborative Care Program is a community-centred approach to addressing the primary health care challenges in remote and rural NSW. These challenges include the provision of services, recruitment and retention of health practitioners, financial sustainability of health services, and continuity of care for patients. The Program received funding through the Australian Government in March 2021 and is scheduled to run until June 2024.
The Program works with local health professionals and communities to create a primary health care access model that fits their needs. It does this by bringing communities from neighbouring areas together to develop shared priorities and solutions. The Collaborative Care Program is an extension of RDN’s town-based health planning approach, which has proven successful for more than 30 years.
Collaborative Care projects
The Program will develop and test unique approaches to sustainable primary health workforce models in five locations, or 'sub-regions', across remote and rural NSW:
- The 4Ts (Tottenham, Tullamore, Trangie, and Trundle)
- Canola Fields (Canowindra and surrounding towns)
- Lachlan Valley (Condobolin, Forbes, and Parkes)
- Snowy Valleys
- Wentworth Shire.
These projects integrate with existing Australian Government and NSW Ministry of Health initiatives.
Who is involved?
The Collaborative Care Program is the result of an ongoing collaboration between RDN and our partner agencies that cooperatively administer these projects:
- Far West Local Health District
- Murrumbidgee Local Health District
- Western NSW Local Health District
- Murrumbidgee Primary Health Network
- Western NSW Primary Health Network.
The Program is being coordinated by RDN and has received funding support from the Australian Government Department of Health and Aged Care. We also work with many other local, state and national stakeholders to achieve a holistic, community-centred approach.
Beyond June 2024, we hope to broaden these partnerships as the findings of the Collaborative Care Program become available to other areas of remote and rural Australia.
Further information about the collaborative care program and trial sites can be found here.
The Collaborative Care Program addresses primary health care needs in remote and rural communities.
Primary health care is generally the first point of contact you have with the health system. Typical examples are your local GP, or an allied health professional such as a dentist, physio or speech pathologist. Your local pharmacist is another primary health care provider, and so is a nurse or a midwife. These health practitioners provide continuing care to patients and coordinate any specialist care the patient may need.
Primary health care may be provided in the home or a community setting such as a private practice, community health centre, or Aboriginal Community Controlled Health Service.
Primary health care does not relate to the care you receive in a hospital. This is known as acute care and the Collaborative Care Program does not address this. However, a well-functioning primary health care system will reduce the overall need for specialist services and hospital visits.
The Collaborative Care Program will not solve every primary health care need, but it will help communities to address these needs together.
One example is a location in Western NSW that had a shortage of doctors, resulting in an over-reliance on temporary practitioners, known as locums. Short-term locums are paid a higher salary, so this was expensive to staff. It also disrupted the continuity of care, with patients having to see many different doctors.
Collaborative solution: The Local Health District (LHD) worked with the communities and with GPs, nurses and a practice manager, to share doctors among the neighbouring towns. The doctors are rotated between the town practices by one practice manager, a new way of working.
These communities now have better access to primary health care and greater continuity with their health practitioners.
The Collaborative Care Program adopts a step-by-step approach to community-led planning. The coordinating organisations form a project team that guides their communities through the five planning phases shown below. Community engagement and empowerment should be at the core of each phase of the project.
The Five-Step Approach
In Plain English
Do the homework: What do we already know about the primary health care needs in these communities?
2. Prioritise needs
Choose your focus: Which of these needs should we tackle first?
Make a new plan: Decide together how primary health care services could be shared among local communities.
Get started: Put the plan into practice and make sure communities know what to expect.
5. Reflect & Learn
See how it’s working: Look at what is working well and where improvements can still be made.
These five steps are adapted from research by the Collaborative Care Program partners: Collaborative care: Primary health workforce and service delivery in Western New South Wales — A case study. They are meant as guiding principles of good collaboration to help communities work together more effectively.
The goal of the Collaborative Care Program is to develop sustainable solutions that will bring long-term benefits, and this will take time. It is important to note the Collaborative Care Program is not about additional funding for health workers or infrastructure. It is about communities coming together to share their resources in a way that provides better primary health care access to everyone.