Maintaining resilience in a not-for-profit remote health service provider

Evelyn Edwards
Evelyn Edwards
North and West Remote Health

As the CEO of a remote health service delivery organisation I often wonder how other not-for-profit organisations manage in an environment of constant change, reduced funding, increased reporting requirements, environmental challenges and continual staff turnover.
In this new age of fierce competition, remote service providers are tasked with continually monitoring for service and cost efficiencies, quality improvement and accreditation; building and maintaining relationships; and providing services that are relevant and connected to their communities.
I have come to the conclusion that the cornerstones for resilience in these organisations are: an attitude of flexibility; a commitment to help communities; a passion for service delivery; and sound relationships.

Queensland-based North and West Remote Health (NWRH) commenced operations in 1994 as a support agency for General Practice in a couple of rooms co-located with likeminded organisations with a passion for rural health. Starting as an initiative of the Federal Government it has progressed through four name changes (including an amalgamation and two business restructures), a number of health reforms and a sharp growth in service delivery and capacity. It is now a substantial primary health care organisation, servicing 14 Local Government Areas and 39 communities across a geographic area of over 600,000 kilometres of remote Queensland.

While it is not unique for a not-for-profit organisation to have gone through this growth, the way in which services are funded is changing dramatically. The ageing population and reduced funding to provide health services means we must provide value for money and achieve improved health outcomes.

Retaining a workforce that provides client support and clinical services in a remote area needs constant management. To address a workforce shortage NWRH has a commitment to deliver services through a combination of a locally based and an outreach workforce. This is only possible through the development and maintenance of local relationships and a commitment to deliver culturally appropriate and respectful services.
The challenging and rewarding experiences encountered by our workforce drove us to develop an in-house Organisation Learning Framework leadership program to build the capacity and cultural competency of the middle and senior management team. This allowed us to focus on the specific requirements of our business to ensure we are consumer focussed.

At NWRH our continuous quality improvement ethos and flexibility to roll with the reform changes have helped us to stay focussed on maintaining service continuity to remote communities. We have been through ten accreditation and quality audit visits in the last financial year. In addition we have conducted a number of internal efficiency projects to improve referral processes and telecommunications and operational systems to and from our remote sites.  

We have reinvented ourselves a number of times and I’m sure will continue to do so as future reforms require. We continually evaluate our capacity to deliver and have resisted being at the mercy of the multiple changes in our sector.  

Not-for-profit and community organisations offer a point of difference that larger corporate organisations can’t. They have: connectedness and a true understanding of what their communities need and want; flexibility to deliver services with a minimum of fuss; and a greater efficiency and commitment to achieve better health outcomes for remote communities.

NWRH is just one of those many not-for-profits and this is our story.

For more information on North and West Remote Health, visit

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