A novel strategy to address complex workforce problems

New ways to fix the rural health workforce maldistribution and shortage are needed. Strategies such as telehealth and outreach services are important ways to increase access. However, innovative and bespoke ways to improve the attraction and retention of healthcare professionals in rural places are urgently needed.

Governments in high-income countries, including Australia, have tended to consider the problem of a maldistributed health workforce primarily through an economics lens of demand and supply. This has led policymakers to concentrate on increasing supply to address unmet need in rural settings. Further, this economics-orientated framework has fed the popular narrative that the rural health workforce ‘problem’ is predominately a shortage of country doctors. In reality, the problem is far more complex than this narrative suggests, with communities needing healthcare professionals from multiple disciplines to support each other and the community’s healthcare needs. A novel approach is happening in some Australian states.

Community-level initiatives, underpinned by the principles of empowerment and asset-based community development, are gaining support and having positive outcomes. Attract Connect Stay is one such initiative. Attract Connect Stay is a community-led solution to address the difficulties experienced by rural communities across Australia with attracting, recruiting and, importantly, retaining healthcare professionals.

Underpinned by Dr Cath Cosgrave’s extensive program of research examining rural health workforce strengthening, Attract Connect Stay is inspired by the community of Marathon, Ontario, Canada. In 2009, they established a community-funded and managed Health Workforce Recruiter Connector position to assist with finding ‘good fit’ health professional candidates and then supporting them and their families to settle into the town, including finding partners employment.

In 2020, the Attract Connect Stay project was undertaken with support from Services for Australian Rural and Remote Allied Health and funding from the Foundation for Rural and Regional Renewal. Dr Cath Cosgrave, supported by a team of rural health researchers (Drs Moran, Malatzky and Waller), set out to trial a similar process in rural Australia and, from that, develop an evidence-informed blueprint for rural communities to use free of charge in establishing, managing and sustaining their own Rural Health Recruiter Connector position.

The Attract Connect Stay blueprint has now been developed, tested and implemented in a number of rural communities across Australia. In the Glen Innes community in New South Wales, the implementation of the program and the subsequent creation and recruitment of a Health Workforce Recruiter Connector (who has been in the role since August 2022) has seen at least seven healthcare professionals – two general practitioners (GPs), one pharmacist, one exercise physiologist, one diabetes educator, one nurse practitioner and one speech pathologist – and five family members supported to move and settle in within the first six months. This resulted in 70 patients being removed from GP waiting lists and equated to 224 hours of additional in-place clinical care. Full evaluation findings are available on the Attract Connect Stay website.

The Attract Connect Stay blueprint is now publicly available at attractconnectstay.com.au. The blueprint can be used initially by rural communities to critically appraise their readiness to undertake the solution and, from this point, be supported to either develop this readiness, or move forward in the process. The ability of initiatives like Attract Connect Stay to produce positive change for rural communities evidences the potential of future investment in alternative approaches to rural health workforce issues that attend to the social determinants of rural health workforce retention and the importance of place and belonging in decisions to stay or go.

For more information, please follow the link to Cath Cosgrave’s website cathcosgrave.com.