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
Sharon James
Dr Sharon James is an experienced primary healthcare nurse who completed her PhD about lifestyle risk-factor communication in 2020. She currently works as a research fellow and project manager with Monash University in the Department of General Practice on the Australian Contraception and Abortion Primary Care Practitioner Support Network Project. Her other interests include communication, preventive care, chronic disease management and nursing roles in primary health care.
A network supporting long-acting reversible contraception and medical abortion: the AusCAPPS protocol
Background: Utilisation of long-acting reversible contraception (LARC) (intrauterine devices and implants) by Australian women remains very low, despite guidelines recommending increased use. In addition, expanding the numbers of primary care practitioners willing to provide early medical abortion (EMA) (using mifepristone followed by misoprostol to end an early pregnancy up to nine weeks), which is a more accessible and less invasive option than surgical termination that can be provided in primary care settings, has proven challenging. Very few general practitioners (GPs) provide these services and there remains great inequity in access, particularly for young and rural and remote women.
Methods: To address these issues we will establish, deliver and evaluate the Australian Contraception and Abortion Primary Care Practitioner Support (AusCAPPS) network – a multidisciplinary, interactive online community of practice supporting GPs, practice nurses and pharmacists working in primary care to deliver and support the provision of LARC and EMA services. The network will provide peer connection, case discussion and ‘ask an expert’, as well as access to resources and education and training.
Our four-year mixed-methods national knowledge translation project is a partnership between Australian and international researchers in contraception and abortion from the NHMRC Centre of Research Excellence for Women’s Sexual and Reproductive Health in Primary Care (SPHERE) and relevant key industry, national and state-based professional, government and non-government organisations. Our primary objective is to increase the availability of LARC and EMA services in Australian primary care. Secondary objectives are to: increase the number of GPs certified to prescribe EMA; increase the number of pharmacists certified to dispense EMA; increase the rates of prescription of IUDs, implants and EMA; and improve primary care practitioners’ knowledge, attitudes and provision of LARC and EMA.
The AusCAPPS community of practice will run for two years. Surveys will assess the knowledge, attitudes and practices of the three professional groups pre- and post-implementation. LARC and EMA provision will be assessed through analysis of Pharmaceutical Benefits Scheme and Medicare Benefits Schedule data. A process evaluation will analyse utilisation of the online community of practice, and involve interviews with network participants.
Results: The anticipated increase of GPs and pharmacists prescribing/dispensing will in turn support increased availability and accessibility of LARC and EMA throughout Australia.
Conclusion: The AusCAPPS network will increase access to much-needed practice support, resources, and education and training; provide regional peer-networking opportunities; drive innovation; and coordinate sustainable improvements in access to and equity of these services nationwide.
Achieving equitable access to abortion: recommendations from the SPHERE Women’s Health Coalition
Aim: Improving access to abortion services is a priority of the National Women’s Health Strategy 2020–2030. However, inequitable availability of abortion services persists across Australia. Obtaining an abortion is especially difficult for women living in rural and remote areas, where services are not readily available and women have to travel long distances and incur increased cost to access care. In response to these issues, the SPHERE Women’s Sexual and Reproductive Health COVID-19 Coalition aimed to develop and disseminate a Consensus Statement outlining recommended approaches to addressing inequitable access to abortion in Australia.
Methods: A Working Group of the SPHERE Women’s Sexual and Reproductive Health COVID-19 Coalition was convened to draft the Consensus Statement. This was ratified by members of the Coalition (organisations and representatives from peak bodies and eminent Australian and international clinicians, researchers and other stakeholders) in November and released in December 2020.
Results: Key recommendations outlined in the Consensus Statement included that abortion services should be recognised by federal and state governments as an essential healthcare service (Category 1); that publicly funded abortion services are accessible, affordable and available; that where complications arise in provision of abortion in community settings, accessible and equitable treatment is available in publicly funded hospitals; that services which receive public funding or engage in training future health professionals are mandated to provide medical and surgical abortion services; that statewide information and referral centres are available for all women requesting an abortion; and that, as part of the National Women’s Health Strategy 2020–2030, the Minister for Health reports on the proportion, location and names of services engaged in publicly funded abortion services.
Relevance and conclusion: All services that receive public funding (including hospitals, primary care and community-based services) have a duty of care to provide both medical and surgical abortion care. Publicly funded health services are essential for training the future healthcare workforce and ensuring sufficient numbers of skilled practitioners to provide abortion care and manage complex cases. This is particularly crucial for rural and remote areas where the number of providers of medical and surgical abortion is minimal and access is limited. Access to abortion is a reproductive right and it is critical that it be readily accessible and affordable to all women.
Consensus Statement on implementation and monitoring of the National Women’s Health Strategy
Aim: The National Women’s Health Strategy 2020–2030 is the second women’s health strategy to be developed in Australia. It outlines a national approach to improving health outcomes for women and girls in Australia, including increasing access to maternal, sexual and reproductive health information and services in rural and remote areas. However, it is unclear what progress has been made in women’s health since the last strategy nor how the impact of the current strategy will be measured. The SPHERE Women’s Sexual and Reproductive Health COVID-19 Coalition aimed to develop a Consensus Statement regarding the need for implementation and monitoring of the National Women’s Health Strategy, with a focus on the ‘Maternal, sexual and reproductive health’ priority area.
Methods: A Working Group of the SPHERE Women’s Sexual and Reproductive Health COVID-19 Coalition was convened to draft the Consensus Statement. This was ratified by members of the Coalition (organisations and representatives from peak bodies and eminent Australian and international clinicians, researchers and other stakeholders) and released in May 2021.
Results: The Consensus Statement calls on government to: undertake a national consultation process with government and non-government representation from all states and territories to inform the development of an implementation plan and set of key performance indicators (KPIs); publish the implementation plan and KPIs; allocate funding to support the achievement of the key outcomes of the National Women’s Health Strategy; allocate funding for a formative evaluation process that focuses on timely and disaggregated data collection and monitoring against each KPI and enables future research on priority areas; and publish an annual progress report, reporting at both state/territory and national levels on outcomes and KPIs.
Relevance and conclusion: There is a need for a transparent implementation and monitoring plan for reporting progress against the National Women’s Health Strategy 2020–2030, a clear evaluation plan to measure impact and success, clarity on the level and nature of funding being made, and stronger communication and engagement with consumers and stakeholders. These elements will be crucial to inform service provision and promote equitable access to services, monitor change and impact, ensure accountability and transparency, and promote optimal outcomes for women and girls in rural and remote regions of Australia.
Emma Jamieson
Emma Jamieson resides in the Southwest region and is a Research Fellow with the Rural Clinical School of Western Australia. She has a personal interest in diabetes research and clinical management, and over 15 years’ laboratory experience in type 1 diabetes research and pancreatic islet transplantation models at both St Vincent’s Institute in Victoria and Harry Perkins Institute of Medical Research in Perth. Since 2014, Emma has been the Southwest coordinator for the ORCHID study. Emma recently submitted her PhD investigating alternative biomarkers to improve detection of gestational diabetes mellitus in rural and remote antenatal patients. Her focus is on translational research, aimed at improving birth outcomes and preventing or delaying progression to type 2 diabetes in mothers and babies.
Optimisation of screening for diabetes in pregnancy in rural and remote Australia
To optimise birth outcomes, universal screening for gestational diabetes mellitus (GDM) by 75g oral glucose tolerance test (OGTT) is recommended at 24–28 weeks gestation and earlier for women with GDM risk factors. Women from regional Western Australia (WA) have increased risk for GDM compared to urban women, yet poor OGTT acceptability and non-adherence to pre-analytical laboratory standards results in significant underdiagnosis. Early pregnancy measurement of glycated haemoglobin (HbA1c) and implementation of tubes (FC) to stabilise OGTT samples may improve screening outcomes.
Prospective study
Participants: Twenty-seven regional WA clinics recruited 694 pregnant women, >16 years of age, without confirmed diabetes (2015–18). Clinicians reported maternal characteristics and GDM risk factors. Birth outcomes were recorded from hospital discharge summaries. Study HbA1c was offered early (<20 weeks gestation). Clinician requested OGTT results were corrected for estimated glucose loss due to pre-analytical glycolysis.
Outcome measures: Uncorrected and corrected GDM incidence; ROC curve optimal early HbA1c threshold for corrected GDM (≥90% specificity); and relative-risk for large-for-gestational-age (LGA) newborn.
Results: Pre-analytical glycolysis resulted in 62% underdiagnosis of GDM (uncorrected 10.8% v corrected 28.5% [20.8-29.5%], P<0.001) and underestimation of risk for LGA newborn (RR 1.12 [0.51-2.47]). Early HbA1c ≥38 mmol/mol (≥5.6%) was highly predictive (71.4% [47.8-88.7]) for GDM diagnosis in Aboriginal women (129) and increased risk overall (466 with HbA1c) for LGA newborn (RR 2.04 [1.03-4.01], P=0.040).
Validation and Translation: Kimberley Aboriginal Community Controlled Health Services (ACCHSs) implemented universal early HbA1c and FC-tubes for OGTT in 2017 and 2019, respectively. Preliminary analysis of ~1000 electronic medical records for Kimberley ACCHS antenatal patients (2018–21) showed 13.9% had an early HbA1c ≥38 mmol/mol and trend towards higher LGA newborn (22.7% v 13.6%, P=0.118). GDM incidence increased 2.5-fold after implementation of FC-tubes (37.4% v 14.8% standard-tube, P<0.001) with most GDM (77.5%) diagnosed at fasting OGTT sample. Concomitant increases in maternal booking BMI and LGA newborn in the FC-tube period (coinciding with initial COVID-19 restrictions) confounded birth outcome analysis (median [IQR] BMI (kg/m2) 26.5 [22.1-31.9] v 24.8 [21.0-29.8], P=0.001; LGA 16.7% v 10.0%, P=0.028).
Discussion: Universal early pregnancy HbA1c ≥38 mmol/mol likely identifies Aboriginal women with apparent prediabetes and elevated risk of LGA newborn. When glycolysis is minimised, universal fasting glucose at 24–28 weeks gestation identifies most GDM that develops later in pregnancy. Both approaches could lead to more comprehensive screening coverage, reduce the number of OGTTs and expedite management of hyperglycaemia to improve birth outcomes. The potential COVID-19-related increase in LGA newborn warrants national analysis.
Nicole Jeffery-Dawes
Dr Nicole Jeffery-Dawes is a psychologist who has lived and worked remotely since 2012. She has provided FIFO and DIDO services in Cape York and the Kimberley region. In her spare time she was an active member of the Volunteer Fire and Rescue Service. Nicole consulted to CRANAplus to develop training and resources for the Mental Health and Wellbeing Training Project and is now consolidating her experience in the position of Senior Psychologist for CRANAplus, supporting the mental health and wellbeing of the remote and isolated health workforce.
Promoting wellbeing for health professionals in drought- and bushfire-affected communities
Background: Following the summer bushfires of 2019–20 and on the doorstep of the COVID-19 pandemic, CRANAplus received an Australian Government grant to develop and deliver mental health and wellbeing workshops for health professionals in drought- and bushfire-impacted areas across rural and remote Australia. CRANAplus had to quickly adapt to meet the ever-changing needs associated with the pandemic.
Method: Initial phases involved consulting with peak bodies, primary health networks (PHNs) and local health organisations, as well as holding virtual consultation workshops to understand the context and key areas of need. The project developed a series of online resources including 12 pre-recorded webinars, four podcasts and resources on the CRANAplus website covering a variety of topics in support of health professionals in the targeted communities.
Following this initial phase, four key topics were developed:
- stress reactions and helpful responses
- secondary trauma and burnout
- resilience and self-care strategies
- increasing confidence with conversations about mental health.
Over a year, the project delivered 80 online or face-to-face workshops to over 800 participants across five states. To address local needs, the project utilised whatever online platform the local health service preferred: their own or the CRANAplus Zoom platform. Workshops ranged from 30 minutes to three hours, as one-off sessions or as series of workshops.
Face-to-face sessions were conducted throughout fire-affected Victorian and New South Wales alpine and coastal areas, South Australia, Tasmania and drought-affected Queensland.
Results: Evaluation data indicated that the workshops were well-received with the average rating from evaluations 4.4/5 (where 1=Not Useful at all and 5=Extremely Useful). The below comment from a workshop participant was commonly reported:
‘I found this workshop very engaging and, unlike other workshops, I could have sat and listened longer.’
A range of resources (Helpful Hints) were also developed in response to requests from workshop participants and are available on the CRANAplus website.
Critical to the success of the project was the ability to collaborate with other agencies (such as PHNs, RFDS, Phoenix, This Way Up) to facilitate use of established networks and share expertise and evidence-based resources.
Conclusion: Health workers are exhausted and find it challenging to prioritise time for their own mental health, wellbeing and self-care. Key to the project’s success was its ability to engage participants (health services) by providing flexible, targeted workshops responsive to local needs, including the innovative use of technology.
Heather Jensen
Ms Heather Jensen is an occupational therapist and academic. She teaches into the Flinders Remote and Indigenous Health postgraduate program, including topics in remote allied health delivery and disability in remote and Indigenous Australia. She has extensive experience working as an occupational therapist in Central Australia, including on the Ngaanyatjarra, Pitjantjatjara and Yankunytjatjara (NPY) Lands and for the ‘Purple House’ (Western Desert Dialysis) in Alice Springs.
She has led the development of a web-based app, Talking Disability, aimed to support Aboriginal interpreters and others working in the disability field.
Her research interests include allied health service models, disability and dementia for people living in remote communities. She was CI on a recently completed ARC-funded project which investigated ‘What makes a good life for people with a disability on the NPY Lands’ and is currently involved in a project investigating the NDIS planning process in rural and remote Australia. She has been an active member of Services for Australian Rural and Remote Allied Health and Occupational Therapy Australia. She is currently a board member of Disability Advocacy Service in Central Australia.
Planning a better life under the NDIS in rural and remote Australia
Aims: This Australian Research Council funded project aims to Identify the experiences and expectations of Aboriginal and non-Aboriginal people in rural and remote areas who are working with NDIS-approved Planners and Local Area Coordinators (LACs). The project team is a multi-university team with partner organisations in Western NSW and Central Australia.
The outcomes will be used to determine the current skills, expertise and attributes of the NDIS-approved Planners and LACs as well as ascertain the approaches, knowledge, values and skills required to develop high-quality plans that are appropriate in a rural or remote setting. These research findings will inform recommended resources and training programs for National Disability Insurance Agency (NDIA) staff working in the rural and remote environment as well as resources for other workers in the field.
Methods: Semi-structured interviews, focus groups and yarning circles were conducted with NDIS participants (aged over 18 years) and carers, as well as with NDIA planning staff, advocates (and guardians) who assist with planning processes. Recruitment was through the partner organisations using a snowball approach. Data analysis uses a constant comparative thematic approach, using NVivo software. Local implementation (service providers) and advisory (participants) groups in each region were established to assist in participant recruitment and will advise on recommendations and knowledge translation.
Results: At the time of writing this abstract, data collection was almost complete, with the number of participants interviewed close to targets in both regions. Data analysis has commenced but is not yet completed. Results will be available to be presented at the conference.
Challenges: Data collection was delayed at the beginning of the project due to COVID restrictions with face-to-face interviews. There were also some difficulties in gaining approval for the project from the NDIA, while maintaining control of the research outputs.
Jenny Job
Dr Jenny Job is a research fellow at the University of Queensland – Mater Research Institute’s Centre for Health System Reform and Integration. Jenny has a strong interest in the implementation of remotely delivered health services, and diet and physical activity interventions. Her PhD focused on a digitally delivered intervention with evaluation of outcomes important to informing translation into practice. In addition, Jenny is an experienced accredited practicing dietitian and has worked in maternal and child health, and chronic disease management in public hospitals, private settings and community sectors.
A virtual integrated practice model to support rural primary care: a proof of concept
Background: Rural and remote communities of Australia often experience poorer health outcomes comparative to metropolitan populations. There exist unique barriers to health and health care in rural and remote locations, such as insufficient health workforce supply and stability. Despite initiatives to recruit and retain health workforce in these areas, a concerning inadequacy remains, particularly in primary care settings where there is a great potential to prevent adverse health outcomes. Access to a sufficient and stable primary health workforce is important to care continuity and quality in rural and remote communities.
Response to the coronavirus pandemic has transformed healthcare delivery in Australian primary care settings. Most notable has been the rise in patient access to virtual healthcare options, which have long been advocated to improve access to care in rural and remote Australia. With virtual primary care now a reality, new opportunities exist to address the health workforce shortages impacting rural and remote communities. In our proof of concept, primary healthcare professionals based in urban or regional areas will be recruited as virtual team members of rural primary care services to provide ongoing care to patients.
Aim: Our study aims to conduct and evaluate a virtual integrated practice model utilising a continuity-of-care approach in rural primary care settings. We will assess the impacts of the intervention on practices, providers and patients; identify the barriers and facilitators to broader translation of the intervention into practice; and identify costs and potential funding models.
Methods: A co-creation approach will be used to develop the intervention and evaluation plan for the proof of concept. Working in partnership with Health Workforce Queensland and the Western Queensland Primary Health Network, the intervention will be implemented across three private, rural primary care settings in western Queensland. Data collection will be undertaken prior to, during and at the conclusion of the intervention period, which will extend for 18 months. To achieve the research aims, we will collect data predominantly through surveys, interviews and focus groups, with data on costs of delivery collected separately. Data collection is expected to begin early in 2021.
Implications: This study will explore an innovative model of care to overcome health workforce shortages in rural primary care settings. Findings from the proof of concept will be used to inform a pilot study and broader translation of the model into practice.
eConsultant implementation in western Queensland: outcomes and qualitative feedback from providers
Background: Limited local availability of specialist access means rural and remote patients in Queensland travel long distances to access specialist services. In addition, with increasing demand for specialist care across Australia, delays to specialist input are increasing, linked with subsequent deterioration in health. Our eConsultant model, an asynchronous general practitioner (GP) to general physician communication over secure messaging, provides a formalised, efficient and documented method for GPs to access specialist support for rural and remote patients. Reduced wait times for specialist input and avoidance of face-to-face hospital visits are established outcomes of this approach in North America. The model aims to provide specialist input within three business days for adult patients who would otherwise require an outpatient department (OPD) referral. GPs send a request for advice (RFA) to the general physician (eConsultant) and advise patients to schedule a timely follow-up appointment to discuss the eConsultant advice.
Aims: In partnership with Western Queensland Primary Health Network (WQPHN), eConsultant has been implemented in eight rural/remote GP practices. This research aims to understand the context in which implementation is occurring and the determinants of implementing the program. Barriers and facilitators will inform the strategies to support ongoing implementation.
Method: A retrospective review of RFA data was performed. Qualitative interviews and surveys will be conducted with the GPs to understand the variations in implementation between GPs, and to determine the barriers and facilitators to implementation of the eConsultant model of care in Queensland GP practices.
Findings: To date, RFAs have been generated for 57 rural patients, with a mean age of 58 years and an average of 1.5 comorbidities. The GPs mean time to response by the eConsultant was 1.7 (SD 1.2) days and patients mean time to specialist input (initial GP to GP follow-up appointment) was 12.9 (SD 11.9) days (a mean turnaround time that is less than average waiting times for OPD appointments). RFAs predominately related to management/diagnosis of general medicine and endocrine conditions. There were no quality/safety concerns identified by the GPs/eConsultant. Findings from the qualitative interviews and surveys will be presented.
Implications: Our eConsultant model is feasible in Australia and provided GPs and patients timely access to specialist input. eConsultant provides GPs with a reliable, auditable record of advice given by specialists, an opportunity for GP practice capacity building and more direct partnership with specialist colleagues. Findings will inform implementation of the eConsultant model of care into routine practice.
Genevieve Johnsson
Genevieve is currently employed in the role of Practice Leader (Innovation) at Autism Spectrum Australia (Aspect) and is an honorary Senior Research Fellow with the Centre for Disability Research and Policy at the University of Sydney. Since 2015 Genevieve has overseen the development and delivery of Aspect’s telepractice programs. This includes webinar training and online consultation programs for service providers, as well as teletherapy for families in rural and remote areas.
Genevieve completed her PhD at the University of Sydney investigating models of technology-based training and support for rural and remote professionals. Genevieve is passionate about bringing services to underserved areas, and will be continuing her research with the University of Sydney Centre for Disability Research and Policy, focusing on the delivery of allied health and behaviour support services via telepractice, allied health assistant models of practice, and professional development for rural and remote disability support staff via telepractice.
Therapy assistants in the disability sector: a growing workforce
There are significant workforce shortages under the National Disability Insurance Scheme (NDIS), particularly in the allied health professions. These shortages are further exacerbated in rural and remote areas and other thin markets. To address these shortages, innovation in service design is required to augment local services. The therapy assistant model is one such emerging model. Collaboration between an allied health practitioner and a locally based therapy assistant, including the use of telepractice, is a model that has great potential to increase timely access to therapeutic supports in rural and remote locations.
Based on the literature and a modified delphi approach, our research aimed to identify the aspects of therapy assistant models that are important in implementing it within the disability sector and differentiating it from a medical model of service delivery. We further investigated the delivery of a newly developed therapy assistant service to NDIS participants in four rural communities – Broken Hill, Deniliquin, Norfolk Island and north-west Tasmania – using a mixed-methods design including experience sampling, photovoice and qualitative interviews. A sustainability and cost-effectiveness evaluation were also undertaken.
This presentation will explore our key findings related to the development of a disability-specific therapy assistant framework, as well as the impacts and sustainability of a therapy assistant model of service delivery from the perspective of NDIS participants, therapy assistants, therapists and managers.
The major impact of this research is that the broader disability sector can build an evidence base to understand the successful application of the therapy assistant model which includes telepractice. This may increase therapeutic supports delivered to NDIS participants and their local support team in regions that are currently poorly served with traditional outreach models of service delivery. The research captures goal-oriented outcomes and participation in the community for NDIS participants as part of their engagement with therapy assistants. We will present practice frameworks, guidelines and business insights for upscaling the application of this model in many rural and remote locations.
Liz Jones
Liz Jones has, for 20 years, worked across health, government, community/not-for-profit and commercial sectors. During this time, she has held senior roles delivering digital transformation of the health and non-profit sectors to improve outcomes for Australians.
Leading consumer engagement for the expansion of the My Health Record system in 2018–19 led her to recognise that some people in Australia were more at risk of being left behind and further disadvantaged by lack of access to digital tools and the skills to use them.
Liz is now part of the leadership team at social change charity, Good Things Foundation, developing partnerships and programs to ensure that everyone in Australia can benefit from digital technology, particularly for the benefit of their health and wellbeing.
Bridging the digital health divide for consumers living in rural Australia
Whether looking up health information online, having telehealth consultations, accessing electronic prescriptions and referrals, or using health and wellbeing mobile phone apps, digital health is more widely used these days, particularly driven by COVID-19. However, the lack of access, income, skills and confidence to affordably maintain and use digital technology means that already socially disadvantaged groups are at risk of being further marginalised through poor access to health services.
Despite some improvements in access in recent years, in 2020 the ‘capital–country gap’ was still evident across all areas of digital inclusion. There is also a gap in usage, with only 24 per cent of people living in regional Australia being high users of digital media, compared to 38 per cent of their metro peers. This presentation will discuss this gap in digital inclusion and the impact this has in terms of barriers interacting with an increasingly digitised society, including health services and managing their health and wellbeing using technology.
The presentation will highlight how the digital health divide is a critical equity issue in the rapid expansion of digital technology in our health system. The populations affected by the digital divide are the same populations experiencing higher rates of chronic disease and worse healthcare outcomes. People particularly at risk of poor digital literacy include older people, Aboriginal and Torres Strait Islander people, people living in rural and remote areas, and people with disability. These people are more likely to be in the lowest socioeconomic groups and fare the worst in all health measures, such as higher incidences of chronic health conditions and mental health issues, and higher mortality rates (AIHW 2020). As services shift to greater digital delivery methods, digital health literacy is beginning to be recognised as a new social determinant of health (Jercich K 2021).
It will also present the approach and impact of our basic digital skills and digital health literacy programs we have led across Australia over the past four years, with hundreds of rural community partners, which aim to bridge this digital divide for people living in rural areas and others at risk of being left behind. Independent evaluations show that these programs have increased digital participation through improved digital and digital health skills and confidence, contributing to social connectedness and a reduction in loneliness, and enhancing social and economic inclusion.
Matt Jones
Matt’s healthcare management career has been devoted towards improving health outcomes through improved access, quality and equity of health care in regional, rural and remote communities across Australia.
In addition to working throughout regional, rural and remote Australia, Matt has acquired extensive healthcare management experience in several healthcare sectors and environments. Matt has held executive and management positions in public health, Indigenous health, acute health, public service and primary healthcare coordination. Matt has also obtained a Master of Public Health and Tropical Medicine from James Cook University.
Prior to his current position as Chief Executive Officer (CEO) with Murray Primary Health Network (PHN), Matt held the position of CEO of Loddon Mallee Murray Medicare Local for its three years of operation. Matt previously worked as a CEO within the Division of General Practice Network for seven years, including his final two years employed simultaneously as the CEO of both Murray-Plains Division of General Practice and Central Victoria General Practice Network.
Before these roles, Matt worked for several years in healthcare management in Aboriginal communities in remote Northern Territory and Western Australia (WA); Aboriginal health in Townsville, Queensland; public health in the Pilbara, WA; senior policy development at the Department of Health and Human Services in Melbourne and acute health management in rural Victoria.
Matt is currently Chair of the PHN Cooperative Regional, Rural and Remote Strategic Working Group.
Integrated Health Networks: future-proofing primary health care in rural areas
Improving health outcomes for people in rural areas requires a new way of providing primary health care. To meet the needs of the rural communities in our region, Murray PHN has begun working with a range of stakeholders across government and health sectors on stronger integration and better coordination of care, as part of a partnership approach. The Integrated Health Network (IHN) is an aligned network of multidisciplinary health providers across communities within a region, working together to improve access to primary care and deliver coordinated care for patients with complex or ongoing conditions.
The combined variables of increasing burden of disease, ageing populations and growing demand for care closer to home, have exceeded local capacity to provide multidisciplinary care for complex needs; further impacted by the challenges of scale, volume and distance typically faced by healthcare providers in dispersed rural communities.
Three adjacent rural local government areas face considerable primary healthcare provision challenges. In addition to an ageing population presenting with significant health needs, this sub-region is also trying to cope with an ageing general practitioner (GP) population in small or solo general practices and lack of access to allied and medical specialists. There are 11 general practices in the area with 71 per cent of GPs aged over 55.
To address this increasingly challenging primary healthcare access crisis, a collective of health and government stakeholders have joined forces since early 2020 to further develop the IHN concept.
This presentation describes the process that Murray PHN has undertaken to enable collaboration and innovation across a dispersed rural area to address this crisis, including:
- the IHN concept elements
- the service and workforce employment model
- establishing a collaborative leadership platform
- project progress update and learnings.
Monika Jones
Dr Monika Jones PhD is the Manager, Health Workforce Planning and Reporting, at Rural Workforce Agency Victoria (RWAV). She is responsible for strategic workforce planning, the data strategy and reporting for all of RWAV’s programs and services. She has extensive experience in analytics, creating solutions to diverse and complex problems, and growing partnerships with key stakeholders.
With over 11 years’ experience in medical/health data management, statistics and research, Dr Jones is passionate about improving excellence and equity in health care, ‘one statistic at a time’. Her former employers include the Royal Australasian College of Surgeons (RACS), the Royal Australian College of General Practitioners (RACGP), RMIT and La Trobe University.
Dr Jones has an industry-based PhD in applied statistics from the Industry Doctoral Training Centre, where she applied item response theory to general practitioner assessment data to address workforce and capacity issues. Her education includes a bachelor’s, honours and master’s degree in mathematical and statistical sciences (both pure and applied).
She enjoys continual professional development, the occasional hack-a-thon and her volunteering ventures.
Findings from the new Rural Health Workforce Census: lessons learnt in Victoria
Timely data should underpin solutions to enhance healthcare access based on local needs of rural communities and rural health professionals. Having an up-to-date, contextual snapshot of the health workforce within rural settings is critical but can be challenging.
The new 2021 Rural Health Workforce (RHW) Census, deployed in late 2021 by the Rural Workforce Agency Victoria (RWAV), provides an innovative yet practical approach to data collection and timely data-driven decisions in a Victorian context. Formerly known as the Regional Victoria GP Workforce Survey, the RHW Census has been significantly redeveloped and expanded to achieve a range of new outcomes. The target audience includes general practitioners, specialists, allied health and practices.
This presentation aims to highlight important findings from the 2021 RHW Census. We present our key insights to help influence innovative workforce strategies which address place-based needs. We will provide practical tips that you can apply in your future data collections, so you can continue supporting rural community health needs.
Cathryn Josif
Cath is a registered nurse with a clinical, management, education and research background across both acute and primary care settings in regional and remote Australia. She has experience in health services research, qualitative and evaluation methods, and participatory action research. Cath was part of the ‘1+1 = A Healthy Start to Life Project: targeting the year before and year after birth in Aboriginal children in remote areas’, recognised by the NHMRC in its Ten of the Best Research Projects 2014. Cath obtained a Churchill Fellowship (2016) to improve dementia services for remote-dwelling Aboriginal people. She is currently a Senior Lecturer in the Faculty of Medicine, Nursing, Midwifery and Health Sciences at the University of Notre Dame Australia.
Aged care and telehealth across COVID-19 borders in the Kimberley
The state government of Western Australia (WA) has enforced border closures within and into the state at various times since the beginning of the COVID-19 pandemic. Between March and June 2020, strict travel restrictions were imposed across WA’s Kimberley region to circumvent the virus entering the vulnerable, remote Aboriginal communities in the region. Kimberley health services face many unique challenges in care provision. During a pandemic, stretched services potentially struggle further to meet community and staff needs.
This project examined the key learning outcomes from the delivery of aged care and telehealth services amid these restrictions. Specifically, the research team explored the barriers and enablers to providing care, impacts upon staff delivering care, and effectiveness of providing care and preventing social isolation for the Kimberley’s older population during COVID-19.
Given the diversity of providers and workforce in the Kimberley region, the research team deemed the case-study approach the most appropriate and rigorous method to achieve the research outcome. To develop the case study, a convergent mixed-method approach was employed with quantitative and qualitative data collected concurrently and results blended to create a more complete, in-depth exploration of the research. Approximately 30 study participants completed a survey and/or interview with the research team.
The unexpectedness of pandemics such as COVID-19 means it is imperative to develop planned strategies that work effectively across sectors and service providers in the future. This project uncovered key elements of delivering care during health crises and better ways to provide culturally safe care to older Aboriginal Kimberley residents. The findings will assist in preparing for future pandemics among this and similar populations throughout remote Australia.