Program
A PDF version of the program is now available here:
Keynote speakers

Lara Fuller
Associate Professor Lara Fuller, MBBS (Hons), FRACGP, GCME, AMusA, is Director of Rural Medical Education and the Rural Community Clinical School at Deakin University, Victoria. As an academic general practitioner, her teaching and research interests are in curriculum design for rural medical education, learning in longitudinal integrated clerkships, rural clinical training pathways and rural workforce outcomes. She is an active member of the Federation of Rural Australian Medical Educators (AusFRAME) and the International Consortium of Longitudinal Integrated Clerkships (CLIC).
Portland District Health services a community of almost 20,000 people. Compared to the rest of Victoria, Portland has greater socioeconomic disadvantage, a higher proportion of people of Indigenous status, and higher rates of hypertension, smoking, alcohol consumption, obesity and psychological distress.
The hospital has 69 registered inpatient beds with a 24-hour, seven-days-a-week Urgent Care Centre (UCC). The UCC is deemed one of the busiest in Victoria, per population.
On 14 June 2018, Professor Paul Worley, the then National Rural Health Commissioner, visited Portland. Portland’s shortage of general practitioners (now critical) was a familiar issue confronting him.
As a result of this visit, Portland decided to ‘grow its own’ rural workforce using the already existing infrastructure, beginning with longitudinal medical student training and ending with advanced skills training posts, eventually producing rural generalist general practitioners to meet the needs of the community.
With the hospital adversely affected, with limited access to International Medical Graduate Hospital Medical Officers due to the COVID-19 pandemic, the timing was opportune.
The outcome of this process is an innovative and collaborative rural generalist pathway with the achieved steps as follows:
- Novel longitudinal internship program. In 2021, interns commenced working for six months in ‘medicine’ and six months in ‘surgery’, but each week begins with a day in the UCC and finishes with a day in general practice. The intern may see a patient in UCC with a FACEM on Monday, follow up care in the general ward Tuesday to Thursday with a physician or surgeon and review or admit patients in general practice with their GP supervisor on Friday.
- PMCV accreditation for a Rural Generalist Year 2 stream. The program comprises a six-month blended community paediatric and obstetric experience, with placements within the hospital, general practice and Aboriginal Medical Service, followed by six months in UCC with support to enrol in ACEM Emergency Certificate and Anaesthetic experience in a JCCA-approved training position.
- Advanced skills training posts in anaesthetics and paediatrics accredited and in emergency currently under development. Partnerships established with Barwon Health and Western Health and South West Healthcare.
- The development of posts that facilitate rural generalist consolidation for each of the above disciplines
The significant beneficiaries of this integrated approach to rural generalist pathways will be the Portland community.

Margaret Garde
In 1985 Margaret Garde arrived in Portland, Victoria, to join her partner, now husband. Being the only female GP, and the youngest by at least 10 years, brought with it a sense of professional isolation.
The disciplines in which she worked included family planning, occupational health, Aboriginal health, public health, forensic medicine, adolescent health and mental health. Now she has a strong interest in teaching and supporting students and doctors who wish to live and work in a rural location, with a strong emphasis on giving them the preparation they need to feel confident and secure.
Thus followed the hosting of a string of medical students, John Flynn Scholars, and cousins, children of friends or anyone else who was remotely interested in medicine as a career.
As is now well recognised, none of these wonderful people returned to Portland to work.
In 2012 the opportunity to work in Portland’s GP SuperClinic presented and, together with this, the ability to host Deakin University students from a rural background who reside in Portland for their 12-month placement.
This, together with a visit from Paul Worley, the then National Rural Health Commissioner, provided the inspiration for our longitudinal rural vocational experience.
Portland District Health services a community of almost 20,000 people. Compared to the rest of Victoria, Portland has greater socioeconomic disadvantage, a higher proportion of people of Indigenous status, and higher rates of hypertension, smoking, alcohol consumption, obesity and psychological distress.
The hospital has 69 registered inpatient beds with a 24-hour, seven-days-a-week Urgent Care Centre (UCC). The UCC is deemed one of the busiest in Victoria, per population.
On 14 June 2018, Professor Paul Worley, the then National Rural Health Commissioner, visited Portland. Portland’s shortage of general practitioners (now critical) was a familiar issue confronting him.
As a result of this visit, Portland decided to ‘grow its own’ rural workforce using the already existing infrastructure, beginning with longitudinal medical student training and ending with advanced skills training posts, eventually producing rural generalist general practitioners to meet the needs of the community.
With the hospital adversely affected, with limited access to International Medical Graduate Hospital Medical Officers due to the COVID-19 pandemic, the timing was opportune.
The outcome of this process is an innovative and collaborative rural generalist pathway with the achieved steps as follows:
- Novel longitudinal internship program. In 2021, interns commenced working for six months in ‘medicine’ and six months in ‘surgery’, but each week begins with a day in the UCC and finishes with a day in general practice. The intern may see a patient in UCC with a FACEM on Monday, follow up care in the general ward Tuesday to Thursday with a physician or surgeon and review or admit patients in general practice with their GP supervisor on Friday.
- PMCV accreditation for a Rural Generalist Year 2 stream. The program comprises a six-month blended community paediatric and obstetric experience, with placements within the hospital, general practice and Aboriginal Medical Service, followed by six months in UCC with support to enrol in ACEM Emergency Certificate and Anaesthetic experience in a JCCA-approved training position.
- Advanced skills training posts in anaesthetics and paediatrics accredited and in emergency currently under development. Partnerships established with Barwon Health and Western Health and South West Healthcare.
- The development of posts that facilitate rural generalist consolidation for each of the above disciplines
The significant beneficiaries of this integrated approach to rural generalist pathways will be the Portland community.

Christine Giles
Chris Giles is a senior executive with considerable experience leading and managing regional, rural and remote health services.
Chris has a strong clinical background as a nurse then midwife, which has proven very valuable in her recent executive roles. These executive roles include working in healthcare organisations in Western Australia, Victoria and Queensland.
Most recently, Chris has worked as the Chief Executive Officer of Portland District Health in south-west Victoria. Prior to this she spent three years living in the Torres Strait, working as a District CEO for Queensland Health.
Chris has a passion for finding solutions to wicked problems, often challenging the normal by finding innovative solutions to improve health service access and quality for rural and remote communities. Some of these solutions include extending scope of practice for clinicians, training cohorts of nurse practitioners and using technology such videoconferencing and electronic health records to overcome distance.
As a sideline, Chris is on the Board of the local catchment management authority, keen to ensure land and water resources are managed to ensure future generations can enjoy them as we do.
Portland District Health services a community of almost 20,000 people. Compared to the rest of Victoria, Portland has greater socioeconomic disadvantage, a higher proportion of people of Indigenous status, and higher rates of hypertension, smoking, alcohol consumption, obesity and psychological distress.
The hospital has 69 registered inpatient beds with a 24-hour, seven-days-a-week Urgent Care Centre (UCC). The UCC is deemed one of the busiest in Victoria, per population.
On 14 June 2018, Professor Paul Worley, the then National Rural Health Commissioner, visited Portland. Portland’s shortage of general practitioners (now critical) was a familiar issue confronting him.
As a result of this visit, Portland decided to ‘grow its own’ rural workforce using the already existing infrastructure, beginning with longitudinal medical student training and ending with advanced skills training posts, eventually producing rural generalist general practitioners to meet the needs of the community.
With the hospital adversely affected, with limited access to International Medical Graduate Hospital Medical Officers due to the COVID-19 pandemic, the timing was opportune.
The outcome of this process is an innovative and collaborative rural generalist pathway with the achieved steps as follows:
- Novel longitudinal internship program. In 2021, interns commenced working for six months in ‘medicine’ and six months in ‘surgery’, but each week begins with a day in the UCC and finishes with a day in general practice. The intern may see a patient in UCC with a FACEM on Monday, follow up care in the general ward Tuesday to Thursday with a physician or surgeon and review or admit patients in general practice with their GP supervisor on Friday.
- PMCV accreditation for a Rural Generalist Year 2 stream. The program comprises a six-month blended community paediatric and obstetric experience, with placements within the hospital, general practice and Aboriginal Medical Service, followed by six months in UCC with support to enrol in ACEM Emergency Certificate and Anaesthetic experience in a JCCA-approved training position.
- Advanced skills training posts in anaesthetics and paediatrics accredited and in emergency currently under development. Partnerships established with Barwon Health and Western Health and South West Healthcare.
- The development of posts that facilitate rural generalist consolidation for each of the above disciplines
The significant beneficiaries of this integrated approach to rural generalist pathways will be the Portland community.

Stan Grant
Stan Grant is the International Affairs Editor for the Australian Broadcasting Corporation (ABC), a multi-award-winning current affairs host, an author and an adventurer.
Well known for having brought the former Prime Minister Malcolm Turnbull to tears when interviewed about Indigenous affairs on The Point, Stan’s keynotes are insightful, engaging, always professional and, at times, controversial.
Stan’s Aboriginal heritage has shaped his dynamic, resilient personality. Born in Griffith in south-west New South Wales (NSW) in 1963, Stan Grant’s mother is from the Kamilaroi people and his father is of the Wiradjuri.
Stan spent most of his childhood on the road living in small towns and Aboriginal communities across outback NSW. His father was an itinerant saw-miller who worked when and where he could. Stan moved so often he attended 12 different schools before he was in his teens.
The early travelling gave Stan a love of adventure and stories. He grew up listening to the tales of his grandfather and uncles and aunts. Despite poverty and an early sporadic education, the security of his family and the larger Aboriginal community gave him a strong platform for life.
After attending university, Stan won a cadetship with the Macquarie Radio Network, launching a career in journalism that has spanned more than 30 years and more than 70 countries. In that time Stan has travelled the world covering the major stories of our time from the release of Nelson Mandela, the troubles in Northern Ireland, the death of Princess Diana, war in Iraq, the second Palestinian intifada, the war on terror, the South Asia tsunami, the Pakistan earthquake and the rise of China.
Stan has hosted major news and current affairs programs on Australian commercial and public television. He has been a political correspondent for the ABC, a Europe correspondent for the Seven Network based in London and a senior international correspondent for the international broadcaster CNN based in Hong Kong and Beijing.
Returning to Australia in 2013, Stan continued to cover international events for Sky News Australia and reignited his passion for telling the stories of his own Indigenous people. He has worked as the Indigenous editor for The Guardian Australia, managing editor for National Indigenous Television and international editor for Sky News. In 2016 Stan was appointed as special adviser to the then Prime Minister Malcolm Turnbull on Indigenous constitutional recognition.
Stan has won many major awards including an Australian TV Logie, a Columbia University Du-Pont Award (the broadcast equivalent of the Pulitzer Prize) and the prestigious United States Peabody Award. He is a four-time winner of the highly prized Asia TV Awards including reporter of the year.
Stan has written The Tears of Strangers and Talking To My Country (Harper Collins), and has published numerous articles and opinion pieces for The Sydney Morning Herald and The Australian.
Stan Grant is passionate about justice and humanity. His years of international reporting have given him a deep understanding of how the world works. He is deeply immersed in the politics and history of Asia and the Middle East. He can link the importance of leadership and the impact of history and, above all, believes in the power and resilience of people.
Stan is married to ABC Sports broadcaster, Tracey Holmes, and has four children. He lives in Sydney.
Booked through: Celebrity Speakers www.celebrityspeakers.com.au

Mark Howden
Professor Mark Howden is Director of the Institute for Climate, Energy and Disaster Solutions at The Australian National University.
He is also an Honorary Professor at Melbourne University, a Vice Chair of the Intergovernmental Panel on Climate Change (IPCC) and the Chair of the ACT Climate Change Council. He was on the US Federal Advisory Committee for the Third National Climate Assessment, was a member of the Australian National Climate Science Advisory Committee and contributes to several major national and international science and policy advisory bodies.
Mark has worked on climate variability, climate change, innovation and adoption issues for over 30 years, in partnership with many industry, community and policy groups via both research and science-policy roles. Issues he has addressed include agriculture and food security, the natural resource base, ecosystems and biodiversity, energy, water and urban systems.
Mark has over 420 publications of different types. He helped develop both the national and international greenhouse gas inventories that are a fundamental part of the Paris Agreement and has assessed sustainable ways to reduce emissions. He has been a major contributor to the IPCC since 1991, with roles in the Second, Third, Fourth, Fifth and now Sixth Assessment Reports, sharing the 2007 Nobel Peace Prize with other IPCC participants and Al Gore.

Gabrielle O'Kane
Gabrielle O’Kane is Chief Executive Officer of the National Rural Health Alliance, the peak body for rural health in Australia. She is an Adjunct Associate Professor with the University of Canberra and Charles Sturt University. Gabrielle has extensive experience in the private and public health sector, which has contributed to her deep understanding of the need for collaborative partnerships to support the rural health workforce and achieve positive health outcomes for rural communities. She promotes solutions to the Australian Government to address the needs of rural communities and health professionals, through her position on many pertinent steering groups and committees.

Roland Sapsford
The Climate and Health Alliance’s new Chief Executive Officer, Roland Sapsford, has been working to respond to the challenge of climate change and the task of reducing emissions through public policy and activism for much of his professional life.
This work has ranged from being involved in New Zealand’s first study of the impacts of carbon taxes and work on energy efficiency and home insulation policy, through to getting solar panels installed on a local community centre and campaigning against major road projects.
Roland once completed four years of a medical degree and was a senior manager in public health for five years. He has also studied economics and systems ecology to postgraduate level, and has a strong commitment to Indigenous rights.

Rabia Siddique
Rabia Siddique is a history-making humanitarian, best-selling author and multi-award-winning international keynote speaker. She is a sought after transformational coach and mentor and speaks English, French, Spanish and Arabic.
Current work
Rabia’s powerful and engaging presentations on leadership, resilience, equality and diversity draw on her personal story of strength, courage and forgiveness, in addition to her legal, military and psychology training. Surviving a hostage crisis in Iraq, Rabia garnered global attention for making the British military accountable for silencing her about her ordeal and role as a military lawyer in releasing captured Special Forces soldiers. Standing up for justice in the face of public ridicule, Rabia’s brave action in suing the British Government for sexism and racism became a catalyst for policy change to ensure a fairer workplace for women and cultural minorities in the British military.
Rabia is an expert commentator, regularly appearing in newspapers and magazines, and on television, radio and online media in Australia and around the globe, including The Guardian, 60 Minutes and ABC television.
With her best-selling memoir Equal Justice also the focus of a feature film, she is now writing her second book.
Rabia is an Ambassador for 100 Women, Angelhands, Esther Foundation, Inner Ninja (mental health support) and Ishar (multicultural health service). She is a Board Member of the International Foundation of Non-Violence, Museum of Freedom and Tolerance, Wesley College and Calan Williams Racing.
Previous experience
Law: Rabia’s extensive career as a criminal, terrorism, war crimes and human rights lawyer has taken her to Europe, the Middle East, South America, South East Asia and Australia.
Military: Her military career includes serving as a British Army officer in England, Northern Ireland and the Middle East. Rabia was one of England’s first Armed Forces Employment Law Officers – a role which took her to Royal Military Academy Sandhurst where she ran equality and diversity training. Among her charges was Prince William, the Duke of Cambridge.

Keith Suter
Dr Keith Suter is considered one of Australia’s most influential global futurists and media commentators in national and foreign affairs. He has also held many strategic leadership roles. Dr Suter is an experienced, professional and awarded presenter renowned for explaining complex global and business issues in a way his audiences can digest and understand. He is in demand as an MC and conference facilitator. Keith’s tailored keynotes, workshops and facilitated sessions are entertaining, highly compelling and always captivating.
In 2019 Keith was proudly appointed as a Member (AM) of the Order of Australia (General Division), for significant service to international relations and to the Uniting Church in Australia.
Previous experience
Academic expert: Dr Keith Suter has achieved three doctorates. The first of these was about the international law of guerrilla warfare (University of Sydney), the second about the social and economic consequences of the arms race (Deakin University) and a third doctorate on scenario planning (University of Sydney).
Leadership roles: He has been appointed to many prestigious roles throughout his career, including Chairperson of the International Commission of Jurists (NSW), Director of Studies at the International Law Association (Australian Branch) and Managing Director of the Global Directions think tank. After 25 years, Keith recently retired from the role of Chairperson of the International Humanitarian Law Committee of the Australian Red Cross (NSW).
Global recognition: He has also been a member of the prestigious Club of Rome since 1993. The Club is ‘an informal association of independent leading personalities from politics, business and science, men and women who are long-term thinkers interested in contributing in a systemic, interdisciplinary and holistic manner to a better world. The Club of Rome members share a common concern for the future of humanity and the planet.’ The club has only 100 members, with Mikhail Gorbachev among them.
Keith is a Life Member of the United Nations Association of Australia in recognition of his service. At various times from 1978 to 1999, he served as the National President of the organisation and took on the roles of WA and NSW State President.
Strategic roles: Keith was the President of the Centre for Peace and Conflict Studies (1991–98) at the University of Sydney, and was a consultant on social policy with the Wesley Mission for 17 years. In addition, he served as a consultant for a number of other organisations with a focus on local and international issues. He is also an active member of the Australian Institute of Company Directors.
Media roles: He frequently appears on radio and television discussing politics and international affairs. He has been, for many years, the foreign affairs editor on Channel 7’s Sunrise program.
Renowned author: Among Keith’s many books are All about Terrorism: Everything you were afraid to ask, as well as Global Order and Global Disorder: Globalization and the Nation-State and 50 Things You Want to Know About World Issues … But Were Too Afraid to Ask.

Susan Wearne
Susan Wearne is a general practitioner (GP) and senior adviser to the Australian Government Department of Health and Aged Care regarding rural health and health professional education. She trained at Southampton University in England and completed general practice training in Northamptonshire and back home in Cheshire. She owned a practice in York, England, and worked at the Aboriginal Medical Service in Alice Springs and for the Royal Flying Doctor Service at Ayers Rock Medical Centre. She has extra qualifications in child health, women’s health, family planning, primary health care and medical education and now works as a GP in Canberra.
Susan is a Clinical Associate Professor at Australian National University and has published over 40 peer-reviewed articles on general practice and medical education. The fourth edition of her textbook Clinical Cases for General Practice Exams was published in 2019. She held educational leadership positions in the Northern Territory before taking on national roles for the Royal Australian College of General Practitioners and General Practice Education and Training. She works in the Health Workforce Division which manages general practice training and other programs that promote Australians’ access to qualified health professionals. She was medical lead for the soon to be released Australian National Medical Workforce Strategy.
Susan’s husband, Tim Henderson, is the eye surgeon at Alice Springs Hospital. Their daughter and her family live in England and their son works in Adelaide. Between flights home to Alice, Susan swims, makes clothes and enjoys the scenery on the lake as she learns to row.

Justin Yeung
Justin is a consultant emergency physician by training. He has had a number of leadership positions in WA Health – director roles in emergency medicine (Royal Perth Hospital, Albany Health Campus and WA Country Health Service) and medical services (Great Southern region of Western Australia). He is currently Medical Director of the WA Country Health Service Command Centre, which incorporates a number of 24/7 clinical streams in acute telehealth – emergency, inpatient medicine, mental health, obstetrics and midwifery, palliative care and acute patient transfer coordination. Justin splits his time between Perth and Albany, and still maintains clinical exposure working in the Emergency Telehealth Service and locums in regional Western Australia. To add some spice to the year, Justin has started postgraduate studies in health care leadership. He’s also an oft-stung beekeeper.
From humble beginnings as a limited-hours, weekend-only, single-doctor emergency consultation service for a handful of small country hospitals in Western Australia (WA), the WA Country Health Service Command Centre is approaching a 10-year milestone of providing specialist-led clinical consultation directly to rural patients using video-enabled technology. The Emergency Telehealth Service (ETS) has grown into a 24/7 virtual emergency department, managing more than 27,000 consultations in 2021. The range of clinical services available to support our regional clinicians using telehealth has expanded to include inpatient care (2018) and mental health (2019), obstetric and midwifery, palliative care and, most recently, transfer coordination (all commenced in 2022). We will present an overview of our 10-year journey, highlight areas of innovation and success, as well as outline challenges we have and continue to face.
Plenary sessions
Opening Session:
Julieanne Gilbert MP
Assistant Minister for Health and Regional Health Infrastructure, Queensland – Welcome to Brisbane
Emma McBride MP
Federal Member for Dobell, Assistant Minister for Rural and Regional Health
Plenary Session 1:
Russell Roberts
Australian Journal of Rural Health
Editor in Chief 2017–21 – AJRH 30 Years
Jason Waterford
HESTA Australia Ltd
Plenary Session 4:
Helen Haines MP
Independent Federal Member for Indi
Closing remarks:
Stephen Gourley
Deputy Chair, National Rural Health Alliance
Concurrent presenters
David Edwards
David Edwards is a Worimi man, raised in Turrbal and Yuggera country and now living in Widjabul-Wyabul country in northern New South Wales. David has science and health promotion qualifications and works from University of Sydney’s University Centre for Rural Health in Lismore, New South Wales, as Co-Director on the WellMob Indigenous wellbeing website, part of the national e-Mental Health in Practice project. David also works on a national Indigenous fathering project and his ‘Eco-Connections’ consultancy business delivering ecological and cultural heritage protection services.
WellMob: a digital library of online wellbeing resources for our deadly mob
e-Mental Health in Practice (eMHPrac) is a support service funded by the Australian Government to build digital mental health awareness and skills in primary care practitioners across the country. One of eMHPrac’s recent initiatives is the development of WellMob, a website that brings together online social and emotional wellbeing (SEWB) resources for Aboriginal and Torres Strait Islander people.
The WellMob website is this country’s first online library of over 200 videos, apps, podcasts and other websites on Aboriginal and Torres Strait Islander SEWB. It’s been designed to help our diverse health and wellbeing workforce to find and share online wellbeing resources with our mob. This includes school counsellors, youth workers, family support, D&A and NDIS workers, GPs, psychologists and other allied health professionals.
The website was designed for mob by mob. The website development process had Indigenous governance and leadership to ensure it was culturally safe and engaging, user friendly and accessible for both workers and community users. The project was led by Indigenous staff at the University Centre of Rural Health (part of University of Sydney) in collaboration with the Australian Indigenous HealthInfoNet.
The website layout and content is centred around a holistic model of Indigenous SEWB. It recognises that our connection to country, culture, community and kin are instrumental in our wellbeing and differentiates WellMob from more mainstream mental health websites.
Launching the WellMob website in mid 2020, amid the COVID-19 pandemic and associated lock-downs, was critical timing. Many counselling and community wellbeing services couldn’t be delivered out in the community and wellbeing workers had to rely on virtual forums to engage with clients, including recommending online resources that our mob could download on their mobile devices to integrate into their wellbeing practices.
The WellMob website has made it easy for workers and mob to find culturally relevant online resources that support our mental health and wellbeing. The WellMob team will present on the website demonstrating its functionality, showcasing some deadly resources and illustrating examples of how frontline workers and other health professionals can use it in their work with our diverse communities.
Mike Edwards
Mike Edwards is an experienced health service executive. He is the Director of Service Delivery at NSW Rural Doctors Network (RDN). Mike is passionate both personally and professionally in improving health access equity. Mike has 15 years of commercial experience in complex project development and management roles. Over the past ten years, Mike has significantly contributed to RDN and the sector’s health and service workforce planning methods and strategies. His strength in seeking integrity, using localised and objective evidence to inform best practice and innovation, and fostering genuine, respectful partnerships has helped lead to many sustainable workforce solutions for communities.
Building capability: using technology to bridge social distance
Background: It is well known that a high-quality, sustained health workforce contributes to a healthy population. However, health workforce retention continues to be an ongoing challenge for rural health. It is posited that improving a rural health practitioner’s capability could help to retain them working rurally for longer. With rapidly increasing access to, and use of, digital technology worldwide, there are new opportunities to build capability for those who are working in rural and remote areas.
Purpose: To explore important factors in building a health professional’s capability, including digital solutions to retain them longer in a rural location.
Method: In 2021, an evaluation of [name of platform], a popular digital platform that connects health professionals and organisations interested in rural health, asked members about the factors that impact on health workforce capability. Additionally, semi-structured interviews were conducted in rural NSW with 13 GPs and allied health professionals. Thematic analysis was used to analyse the data and themes identified were mapped to an overarching Framework.
Results: The ‘Framework for building Health Workforce Capability through using digital technology’ identifies elements of health workforce capability, cues to action, and benefits and barriers to using a technology solution to support rural health workforce capability. Whilst it could be assumed that low technology literacy would act as a barrier to the use of digital tools, this was not a significant factor in impeding participants’ willingness to adopt digital tools when social and professional networks weren’t available to them face to face. Capable people felt connected to others professionally and were recognised members of their community. They had access to education, training and supervision. Similarly, 56 per cent of the survey respondents said engagement with others on [name of platform] made them feel more capable in their role, suggesting this platform is an important part of the solution to building rural health workforce capability.
Challenges: That we understand what is needed in a digital or technology solution to help rural health professionals build or maintain their capability. To ensure rural health professionals are aware of digital for self-management when their rural circumstances prevent other forms of support.
Implications: The Framework may guide health workforce planners, HR professionals, policymakers and app designers in developing technical solutions. Understanding the factors that make up a health professional’s capability and the cues to maintain their capability may help to strengthen technical solutions to support health workforce capability.
Integration of Australia’s healthcare system: lessons learned
Background and aims: The Parliamentary Inquiry into Health outcomes and access to health and hospital services in rural, regional and remote New South Wales (the Inquiry) is examining the provision and availability of health services in non-metropolitan areas. Reporting and recommendations coming out of the Inquiry, as well as the submissions and associated transcripts, constitute a rich source of data for those working to support rural health. This study identified key themes to determine how they inform key collaborative initiatives addressing health access and equity across regional, rural and remote New South Wales from a health workforce perspective.
Method: [Organisation] selected 81 pieces of the most relevant data from the Inquiry (70 submissions, five transcripts and six sets of supplementary questions). These submissions were largely made by advocates (organisations, unions, government, peak bodies) and consumer groups. The main issues or recommendations in each transcript were themed and counted.
Results: Amongst other key themes that will be reported, a desire for health system integration at the local, state and federal levels, to help navigate Australia’s often fragmented health system, strongly emerged from the transcripts. It is also a draft recommendation in the Primary Health Reform Steering Group. Fragmented approaches reduce health workforce capability and the capacity of the health system to provide continuity of care, which leads to untimely access to care, the delivery of poor-quality services, duplication and inefficient use of resources.
We will present insights into how integration of parts of the health system and levels of government can be achieved through existing initiatives, such as the innovative Collaborative Care program funded by the Australian Government. This is a community-centred approach to addressing primary healthcare challenges in remote and rural NSW that can be implemented more broadly.
Challenges: To break down healthcare silos to address remote and rural workforce recruitment and retention, workforce capability, health service financial sustainability and continuity of care.
To create a system’s view and increase collaboration between governments and local stakeholders. This relies on learning the lessons from approaches that aim to bridge the social distance.
Implications: A strong commitment to collaboration and innovation is central to addressing the problem of our complex and fragmented health service. If we are to create better access to health services for rural communities, we must play a strong advocacy role in relation to policy, strategies and approaches that aim to break down the siloed approaches.
Jacqueline Emery
Jacqui Emery is Chief Executive Officer (CEO) of Royal Far West. She is an experienced leader in the media, education and not-for-profit sectors, with a broad skill set covering strategy, governance, transformation, operations, relationships, marketing and communications.
Prior to becoming CEO, Jacqui was the Director of Business, People and Culture at Royal Far West, and the executive lead on the development of the Bushfire Recovery Program, supporting the mental health and development of children directly impacted by the bushfire event of 2019–20 summer.
Jacqui has also held leadership roles in some of Australia’s most well-known organisations including the Australian Institute of Company Directors (AICD), the Australian Financial Review Group and Reader’s Digest.
Reducing developmental vulnerability in rural and remote areas
Aim: One in five Australian children start school with a developmental vulnerability, but these rates are higher in rural areas and almost twice as high in very remote areas, and this gap is widening. Health system challenges to access allied health services, including workforce shortages and resourcing, exacerbate this inequity. Thirty-two per cent of children in rural or remote New South Wales are unable to access the health services they need, impacting long-term health and wellbeing outcomes. The increasing prevalence of natural disasters in rural and remote areas create additional challenges for communities and can have long-term developmental health consequences for children.
This presentation will showcase [organisation name]’s approach to reducing developmental vulnerability in rural areas, through harnessing its specialist multidisciplinary workforce, innovating around telehealth and ensuring deep connection to and partnership with communities.
Methods: [Organisation name] has worked with community in three different ways to innovate and deliver services that close the access gap.
- Allied health Telecare into rural and remote schools – a whole-of-school approach: partnering with rural preschools and schools to provide screening, assessment, therapy and educator support via Telecare to address service gaps. Building on this, we have recently co-designed a whole-of-school model which builds the capacity of the whole school to identify and respond to children at risk of developmental vulnerability.
- Responsive and community-led models of care for children and families in very remote Aboriginal communities: working with Aboriginal community NGO Marninwarntikura Women’s Resource Centre to co-design and implement models of care and support for children in very remote Aboriginal communities, including the use of Telecare, in Fitzroy Valley, the Kimberley, Western Australia.
- A Bushfire Recovery Program for children: partnering with communities and recovery experts to combine Telecare and outreach services to deliver community needs-driven mental health and psychosocial supports for children impacted by the Black Summer Bushfires, including enhancing resilience and strengthening the support systems around children.
Results: All programs have been evaluated using clinical and user-satisfaction/self-report measures and results show strong outcomes for children and high levels of community engagement and support.
Conclusions: By engaging our deep relationships with communities, government, research and philanthropy we have been able to innovate and test in a systematic and evidence-informed way to fundamentally challenge longstanding access challenges for rural and remote communities, including during COVID-19 and other unprecedented natural disasters.
Kate Emond
Ms Kate Emond is the Head of Department for the Rural Department of Nursing and Midwifery, and mental health lecturer for postgraduate and undergraduate nursing and paramedicine degrees. Her research focus is mental health assessment in pre-hospital care. She has a background in comprehensive general and mental health nursing. Her interests include clinical decision-making, critical thinking, mental health triage, mental health presentations in emergency departments and pre-hospital care, crisis assessment and treatment, community mental health, service delivery and policy. Kate has previous experience as a senior psychiatric clinician and in management. Her research interests include clinical decision-making, mental health literacy, psychiatric and mental health crisis assessment, simulation and clinical education.
Characteristics in paramedics when managing mental health presentations
Mental-health-related presentations account for a considerable proportion of the paramedic’s workload in pre-hospital care. This cross-sectional study aimed to examine the perceived confidence and preparedness of paramedics in Australian metropolitan and rural areas to manage mental-health-related presentations. Overall, 1,140 paramedics were surveyed. Pearson chi-square and Fisher exact tests were used to compare categorical variables by sex and location of practice; continuous variables were compared using the non-parametric Mann–Whitney and Kruskal–Wallis tests. Perceived confidence and preparedness were each modelled in multivariable ordinal regressions. Female paramedics were younger with higher qualifications but were less experienced than their male counterparts. Compared to paramedics working in metropolitan regions, those working in rural and regional areas were generally older with fewer qualifications and were significantly less confident and less prepared to manage mental health presentations (p=0.001). Compared to male paramedics, females were less confident (p=0.003), although equally prepared (p=0.1) to manage mental health presentations. These results suggest that higher qualifications from the tertiary sector may not be adequately preparing paramedics to manage mental health presentations, which signifies a disparity between education provided and workforce preparedness. Further work is required to address the education and training requirements of paramedics in regional and rural areas to increase confidence and preparedness in managing mental health presentations.