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Collaborative Care Workforce Models for Remote and Rural Communities

The Collaborative Care Program is a community-centred approach to addressing the health care challenges in rural and regional NSW. These challenges include the recruitment and retention of health practitioners, financial sustainability of health services, and continuity of care.

The Program is coordinated by RDN and is funded by government to work with other local, state, and national stakeholders to provide rural communities with the tools and support they need to solve complex health challenges, with a focus on multidisciplinary care for chronic disease management. 

The Collaborative Care approach is an extension of RDN’s town-based health planning approach which has proven successful for more than 35 years. The Program works with local health professionals and communities to create a primary healthcare access model that fit their needs. It does this by bringing communities from neighbouring areas together to develop shared priorities and solutions. 

 

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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

Phase

In Plain English

1. Investigate

  • Research existing evidence of needs and primary health care workforce data to provide context for discussions.

Do the homework: What do we already know about the primary health care needs in these communities?

2. Prioritise needs

  • Community representatives look at the needs that have been identified and create a list of priorities.
  • Priorities should be supported by multiple sources of evidence, such as community feedback, advice from local health practitioners, and secondary research.

Choose your focus: Which of these needs should we tackle first?

3. Co-Design

  • Work together on a plan of action that will better address the needs of local communities.
  • Consider any tools or resources that are currently available.
  • Set a realistic timeline and budget to begin implementing these changes.

Make a new plan: Decide together how primary health care services could be shared among local communities.

4. Implement

  • Support health practitioners to work collaboratively across communities.
  • Communicate any changes to health services with local communities and organisations.

Get started: Put the plan into practice and make sure communities know what to expect. 

5. Reflect & Learn

  • Analyse how the new model of care is working and identify key learnings.
  • Compare the current evidence of primary health care needs against the needs that were identified at the start of the project.

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.

For more information, contact Justyn Walker, Project Lead - Collaborative Care, on jwalker@nswrdn.com.au or 02 4924 8066.