There are many challenges involved in establishing a sustainable remote area health service. To meet these challenges, it is vital for service providers to have a thorough grasp of the issues which impact on their ability to deliver consistent quality care in remote areas.

Below are four factors identified by CareLynx which must be addressed when developing a model of service delivery for remote communities.

1. Global Workforce Shortages

The growing shortage of qualified health care professionals globally has been well documented. Remote health services are already experiencing difficulties filling positions, and this situation is only going to worsen. According to a World Health Organisation report, by 2035 there will be an estimated shortfall of 12.9 million health workers worldwide. This has serious implications for Australia, particularly in remote regions where staff shortages will be felt most keenly.

The WHO report pinpointed a number of reasons for the global shortage of qualified health care workers. These include an ageing workforce which is not being replaced at a sufficient rate to keep up with demand, inadequate training of new staff and an increase in chronic and infectious diseases which require more complex treatment methods.

These pressures on health care systems are being further exacerbated by the growing mobility of health care workers around the globe. While the migration of health care workers has obvious benefits in providing more staff to fill roles in remote areas, these workers often have little incentive to stay in communities for extended periods.

2. Disparity Between Urban and Remote Regions

The WHO has identified the unequal distribution of resources in urban and remote regions as a serious global problem.  This is borne out in Australia where poorer health outcomes, higher rates of mortality and decreased life expectancy in rural and remote areas indicate that much more needs to be done to address this disparity.

There is a direct correlation between higher incidences of chronic health problems such as cardiovascular disease and diabetes, and socioeconomic and lifestyle factors such as lower incomes, ageing populations and smoking which are more prevalent in remote areas. While people living in remote zones have comparatively greater health needs, their access to health services is restricted, and as a result they don’t receive the same level of care as people in metropolitan regions.

To help close the gap in health care between urban and remote Australia, it is vital for remote areas health care workers to receive training and support that is appropriate to their circumstances. For example, a higher proportion of care in these regions is provided by nurses due to a lack of GPs and specialists, indicating that remote nurses often need a wider skill set than their urban counterparts. The limited number of nursing home facilities for the elderly in remote areas also represents a major challenge to health care providers. 

3. Retention of Health Care Professionals

One of the key solutions to addressing the disparity between urban and remote areas is the retention of qualified and experienced health care workers. While remote health workers are very passionate and committed to providing the best service possible, staff retention is a serious issue.

One reason staff retention is low in remote areas is due to the tendency for jobs to be filled by new graduates who are seeking to gain experience and accreditation. Graduates often leave as soon as they have fulfilled their contracts, taking their valuable location-based skills and knowledge with them.

Established professionals who do a stint in remote areas are less likely to settle permanently in the region than those who have existing ties to the community. As previously mentioned, 457 visa holders can help to alleviate staff shortages, but these workers also tend to be more transient.

This lack of continuity in health care represents a real challenge for health service providers in remote areas because quality care depends on consistency. When experienced staff are frequently being replaced by recent graduates and visa holders, the standard of care suffers. Establishing relationships of trust between health care workers and clients is also very important in isolated areas, and it becomes harder to develop these relationships when staff turnover is high.

4. Ineffective Management Practices

All of the problems identified above are aggravated by inconsistent and ineffective management practices. Remote healthcare workers across a range of professions recently participated in a recent study published in Rural and Remote Health about what is required to develop a sustainable health service. These healthcare workers identified the following management practices as impacting on the quality of care in remote regions:

• Insufficient incentives and extrinsic rewards to retain staff in challenging environments
• Disparities between remuneration and incentives for different health professions
• Lack of leadership, communication and distance management skills amongst management
• Inadequate training, support and understanding of specific challenges faced by remote health workers
• Inflexible work patterns

As these issues indicate, management practices which are shaped by the specific needs of health staff and clients in remote areas, can play a major role in improving health services. Appropriate practices can do much to combat staff shortages and retention issues, which in turn will help to address the disparity in health care resources and outcomes between urban and remote areas. CareLynx has taken all of these challenges into consideration in its quest to provide a health care service which is cost-efficient and effective, in the process coming up with some innovative solutions of its own.