Flexible work locations

Description

The Australian allied health workforce, as with other health professions, is maldistributed and in short supply in rural and remote areas. Continuing allied health workforce insufficiency affects many rural services and communities. Service delivery to rural and remote communities is further complicated because relatively small numbers of people in need are dispersed over large geographic areas, while allied health professionals tend to be located in large regional centers. Considerable time and distance costs are incurred by health professionals who travel to people in need, and by those people who travel to access services. These issues are amplified in the case of people with disabilities, their carers, and those who provide specialist support services.

Medium hard to implement: may take some organizational change to implement.

An innovative recruitment strategy would enable practitioners to choose where they live, rather than moving to a town in which the position was nominally located, provided they agreed to deliver outreach services to surrounding areas. The strategy, anecdotally, has resulted in increased recruitment and greater retention of professionals in the region.

  • Develop a local area plan for utilising the expertise of practitioners across organisations
  • Recognise the need for practitioners working for different organisations, in rural and remote areas, to collaborate, both in terms of peer support, and service delivery.

Success factors

Managers in rural and remote locations realise the potential of the National Broadband Network (NBN) to improve internet connection and speed, thus making use of web-based technology a more reliable and sustainable option for the future.

Allowing practitioners to operate from flexible work locations may avoid relocation, particularly if there are families involved. Greater use and development of web-based technology will also enable greater flexibility and reach.

Challenges

Rural professionals need to be skilled because they will be going into areas where there is potentially limited support. Local knowledge is very important, especially when working with Indigenous people. There is a sense in these communities that the residents don't want fly-in fly-out services, they want people on the ground, and someone they can trust. You need to have respectful communication in place.

How can we be sure that our service model best meets the needs of our population, provides the most cost-effective solutions, and leverages advances in technology? The service model must best meet the needs of the population, and metrics are required to monitor the effectiveness of the service model. In addition to understanding the population’s
service needs, a strong body of evidence suggests that, especially in rural and remote environments, the most successful health-service models are explicitly tailored to the local environment.

Making a move to a rural or remote community, relocating and building a life there is a major consideration. Prospective employers want to reach recruits with more than just a job advertisement; it must be easy for target recruits to access any information that would influence them in making this major life decision. Professionals may have families including a spouse who needs to find work, and children requiring education and activities.

Ensuring that the new employee and their family is made to feel welcome in the community, and supported to become integrated in community recreation and other activities, is a key factor in ensuring a positive start and long stay in the community. This can mean involving community partners in meeting with the new recruits and their families, giving tours of the town, health services, and schools to ensure they are able to register in recreational and other programs.

Another important support that is often thought to be too complex to address is spousal employment. Lack of work opportunities for spouses is known to be a key barrier in the recruitment of professionals to rural locations. Dedicating resources to assisting spouses to learn about work opportunities is a good start to addressing this barrier.

In rural remote communities, professionals often work in isolation, without access to specialist support that they may have enjoyed in previous urban roles or in their training. Rural and remote health leaders who report that they have overcome challenges in recruitment and retention of professionals typically report that they consider supporting team cohesion to be a major part of their role. They involve their team of professionals in decisions on who to recruit to the team, they create opportunities for their team to socialize and learn together, and offer them some control over their work environments (shift scheduling, strategic planning, creation of leadership roles among professionals, such as regional professional development lead).

Supporting your professional teams to access professional development that is relevant to their rural and remote work environment can be a significant factor in enhancing the quality of services in your community and in retention of employees. A mixture of well designed “at distance or “technology enhanced” education programmes together with some “face-to-face” education and training should be offered.

Developing an academic/training mandate for an organization, and potentially seeking funds to allow professional teams to dedicate time to training the professionals of the future will lead to a strong return on investment. There is a clear and substantial body of evidence which confirms that offering health professional training in rural and remote environments leads to increased retention of those professionals. Furthermore, training and rural and remote environments ensures that professionals have the unique skills that are needed for rural practice.

methods

Department of Health and Ageing. Report on the audit of health workforce in rural and regional Australia. Canberra, ACT: Commonwealth of Australia, 2008.

Battye K. Workforce shortages or dysfunctional service models? In: Proceedings, 9th National Rural Health Conference; 7-10 March 2007; Albury, NSW, Australia; 2007.

Veitch C, Dew A, Bulkeley K, Lincoln M, Bundy A, Gallego G, Griffiths S.  Issues affecting therapist workforce and service delivery in the disability sector in rural and remote New South Wales, Australia: perspectives of policy-makers, managers and senior therapists . Rural and Remote Health(Internet) 2012; 12: 1903. Available: http://www.rrh.org.au/articles/subviewnew.asp?ArticleID=1903

Kehlet K, Aaraas IJ.  'The Senja Doctor': developing joint GP services among rural communities in Northern Norway. Rural and Remote Health(Internet) 2015; 15: 3101. Available: http://www.rrh.org.au/articles/subviewnew.asp?ArticleID=3101