THE CHALLENGE
A life-threatening challenge grips rural healthcare in Australia. Rural and remote residents face dire health outcomes compared to their metropolitan counterparts, with premature mortality rates notably higher. The escalating burden of chronic conditions coupled with an aging population has pushed the rural healthcare system to its limits.
Among the most pressing issues is the severe maldistribution of the healthcare workforce, notably General Practitioners (GPs), across Australia. In 2019, urban areas boasted 121.4 GPs per 100,000 population, while rural regions suffered shortages, with figures plummeting to as low as 69.4 per 100,000 in very remote areas. Despite prior government efforts, the Western NSW PHN identified that 41 towns would be at risk of GP shortages within a decade. If unaddressed, this crisis will lead to a cascade of adverse effects, from lost medical records to increased hospital admissions, exacerbating the strain on the healthcare system.
THE OUTCOME
Evohealth developed a forward-looking Model of Service Delivery (MoSD) that would ensure sustainable access to general practice across the region. Considering both existing, and predicted future, workforce challenges the digitally enabled MoSD, included hybrid capability of face to face and telehealth services, as well as efficient utilisation of virtual administrative services across the entire region.
The robust, co-designed MoSD was coupled with a comprehensive Business Case tailored to secure the critical buy-in of both Commonwealth and State Governments.
OUR APPROACH:
Evohealth conducted a collaborative co-design process with key stakeholders, recognizing the indispensable expertise of healthcare providers and community leaders in Western NSW. Stakeholders, including the Western NSW PHN Board, regional GPs, Local Health District (LHD) representatives, NSW Rural Doctors Network (RDN), and a community pharmacist actively contributed to the development of the MoSD.
The model was developed using various inputs, including agreed design principles, feedback from stakeholder consultations and co-design workshops, empirical evidence on rural primary healthcare delivery, and insights from successful models elsewhere. It represents an innovative and comprehensive solution to the pressing challenges faced by the region.
Key Features of the MoSD:
- Integrated Care Models: Led by GPs and centred around the community, the model provides patient-centred care through a multidisciplinary team comprising general practice, allied health, nursing, and pharmacy services.
- Virtual Primary Health Centre (VPHC): Operationalized by a virtual administrative centre, the VPHC ensures strategic and clinical governance, as well as day-to-day operations, supported by digital solutions enabling remote work.
- Network of Healthcare Practitioners: The model fosters a network of healthcare practitioners delivering care as close to the patient as possible, following established clinical pathways and guidelines, with an opt-in approach for existing practitioners.
- Continuity of Care: Ensuring seamless care, the MoSD facilitates a common medical record accessible by all practitioners, promotes continuity of practitioner where feasible, and leverages telehealth and digital health technologies as needed.
- Blended Funding Model: Supported by a blended funding approach directed through the VPHC, the model ensures financial sustainability, resource allocation based on need, care integration, and equitable access to primary healthcare.
- Right Care, Right Place, Right Time: Above all, the MoSD aims to deliver appropriate care to all residents of Western NSW, ensuring access regardless of location or circumstance.
