Primary care Rural Integrated Multidisciplinary Health Services

The National Rural Health Alliance (the Alliance) has been advocating for a new model of primary care funding and service delivery that will support and sustain the healthcare workforce to provide essential primary care to rural communities. The Alliance has developed this model to work where markets are thin, failing or have failed. It was previously known as rural area community controlled health organisations. While this term was well recognised, there may have been some confusion with Aboriginal Community Controlled Health Organisations (ACCHOs). To ensure that there was no ongoing confusion or ambiguity, the Alliance has changed the name to Primary care Rural Integrated Multidisciplinary Health Services (PRIM-HS).

The Alliance has been working with a number of primary care organisations and grass roots individuals to develop and refine the PRIM-HS model of care. This has included updated costings of the model, governance, employment strategy, collaboration and portability. The Alliance has put forward a pre-Budget submission to the Treasurer and Ministers for Health and Aged Care and Rural Health, to advocate for immediate funding of these identified communities and others, where the model can work and add value to the region.

The Alliance will undertake further promotion and advocacy for PRIM-HS as a long-term, sustainable solution that will: 

• link local entities and experts to work together and add to existing services
• support clinicians and staff
• provide ongoing (at least five years) block funding, not rely fully on outdated Medicare patient subsidies that do not meet the actual cost of services
• provide a one-employer model that ensures stability, transferability and ongoing financial parity between those employed in local health services and those in urban centres
• not rely on expensive and unsustainable fly-in fly-out models
• enter a social contract to support the 30 per cent of Australia’s population who have added to our economy and from which all Australians reap the benefits
• build on findings and recommendations from various workforce, Medicare and other reforms, reviews and enquiries. The recently released Strengthening Medicare Taskforce recommendations support the case for the PRIM-HS model, at least at a high level.

The Alliance believes this model can support the rural workforce in a number of ways including to:

• provide a hub for professional development to support interprofessional understanding and enable all professionals to work to their full scope of practice
• ensure a critical mass of health practitioners to support sustainable on-call and after-hours demand
• provide a base for visiting non-GP medical specialists and other visiting health professionals, as well as a location for supported patient-end services for telehealth
• provide certainty of income and employment for health professionals considering rural practice
• remove the need for health practitioners, particularly early-career professionals, to have the skills to establish and operate a financially viable rural practice, which is a significant disincentive for working rurally
• overcome the perception that rural practice means professional isolation and lack of peer support, through the key PRIM-HS principle of a multidisciplinary team
• assist staff with relocation expenses and provide local, up-to-date information on accommodation, education, employment opportunities for partners, and social and recreational activities
• provide a multidisciplinary-team employment model that provides opportunity to provide holistic care and better patient outcomes, thus increasing job satisfaction.

Our work together as an Alliance, as partners and supporters of rural and remote Australians – who significantly and per capita add value to the country’s economy and society – believe this model is part of the picture to support the rural health workforce into the future.