Putting rural communities at the centre of health care

Rural communities need a healthcare system that is tailored to their unique situation. So how do you move these communities from simply being the end-user of a service to being a partner in the design of their own model of care?

NSW Rural Doctors Network (RDN) has been supporting access to health services in remote, rural and regional New South Wales for more than 30 years. We do this by supporting recruitment and retention of health practitioners, career pathways, provision of outreach services and the future workforce. Our vision is for improved health service access for all Australians – no matter where they live.

RDN has a longstanding methodology of putting the needs of rural communities at the centre of health service modelling and workforce planning. In 2022, we want to put the spotlight on community solutions through a unique program called Collaborative Care. The program will develop and test community-led models of care in five rural locations.

The premise is to enable local communities to inform and influence the design of their healthcare service models. This method is grounded in the principles of community development and encourages local innovation.

It is a similar concept to a healthcare provider who puts the patient at the centre of their care. Instead, we are looking at the model of care that services a whole community, or several connected communities.

Health care is a complicated sector, so this presents obvious challenges. Service providers need to intentionally collaborate around identified priorities using a framework that draws the local community into the solution.

RDN is currently partnering with Local Health Districts and Primary Health Networks in the New South Wales regions of Far West, Murrumbidgee and Western NSW to implement a trial of this approach.

To achieve this, the coordinating organisations guide these communities through five steps of community-led planning.

1. Investigate the need

The first step is to do your homework and find out what community needs have already been identified and reported. The last thing a frustrated community wants is to be asked the same questions they have answered 10 times before.

2. Engage with local stakeholders

Too often we hear stories about solutions that were formulated before anyone talked to the community. Community engagement should never be a tick-the-box exercise. We need to listen to the lived experience of rural communities and let them shape their priorities.

3. Co-design the model of care

No single group or organisation delivers rural health care. If the desired result is an integrated model of service delivery, then community solutions need to be designed by multiple organisations in partnership. This step should occur after local priorities are identified through community engagement.

4. Implement in partnership with communities

Innovative models of care will break new ground. This can deliver value to a community quickly, but solutions need to be regularly tested by local stakeholders. It helps to embrace an agile approach to implementation. This approach will deliver small wins more quickly which may help build community confidence in the process.

5. Reflect and learn together

Look at what is working well and where improvements can still be made. These improvements aren’t just about the project, but also the methods of collaboration between stakeholders and communities. And don’t forget to share any findings with the broader health sector.

These five steps are adapted from research by the Collaborative Care Program partners: Collaborative care: primary health workforce and service delivery in Western New South Wales — A case study. They are simple guiding principles to help communities work together more effectively and can be adapted to suit the local context.

The Collaborative Care Program received funding through the Australian Government and is supported by Far West Local Health District, Murrumbidgee Local Health District, Western NSW Local Health District, Murrumbidgee Primary Health Network, Western NSW Primary Health Network and NSW Rural Doctors Network.

For more information visit our online community portal: https://nswrdn.engagementhub.com.au