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< Previousnsw rural doctors network annual report | 2020-2110 rdn service pillars KNOWLEDGE • Service strategy • Health workforce and service needs • Evaluation methodology • Research and publications • Policy ENGAGEMENT • Workforce • Community • Regional • Health employers • Sector • Industry • Government MEMBERSHIP • RDN member services • Rural Health Pro • Events and networking CLINICAL ADVANCEMENT • Clinical quality and governance • Expert Advisory Pool • Education and training OPERATIONS • Program delivery • Project management • Contract management and acquittal • Product offerings • Customer service GOVERNANCE • RDN Board • Company Secretary • Business governance • Internal committees CORPORATE SERVICES • Corporate Affairs • Communications • People and Culture • Finance • ICT and Security • Administration Another key aspect of our governance approach is to clearly define our streams of service to our stakeholders, as represented in the graphic below. It is important to remember that our service pillars do not represent our organisation chart because we are customer-orientated and show our customers’ offerings aligned to our customer needs. 11 Grafton, NSW, Gumbainggir Country.nsw rural doctors network annual report | 2020-2112 CONCEPTS AND ENABLERS RDN has evolved in response to the changing health landscape with evidence-informed approaches and contemporary solutions to support the broader multidisciplinary rural health workforce. This complex undertaking is compounded by systems and workforce challenges at national, state, regional and local community levels. RDN has built its programs and advocacy strategies on data intelligence and implementation methodology. RDN has also committed to knowledge creation and dissemination through its Knowledge Mobilisation Unit in partnership with communities, service providers and government. One component of RDN’s knowledge mobilisation activities was to describe the critical concepts RDN has found to be imperative in the creation and sustainability of health access models and approaches in remote and rural communities. RDN has embarked on evidence and dissemination programs for each of these concepts and has embedded them within RDN’s program logics and methodologies. Further, a set of operational enablers were developed to test and support these concepts. Emmaville, NSW, Ngarabal Country. To ensure that community is at the centre of every decision and outcome, RDN’s community organising concept aims to bring about positive change by supporting communities to take coordinated, collective action; and the concept of health workforce literacy to strengthen the understanding communities have about their health workforce and enablers that affect positive experiences of rural practice, recruitment and retention. 13 1. HEALTH WORKFORCE LITERACY RDN believes that improving literacy about health workforce will improve, in particular, rural health workforce recruitment, retention and capability. Martiniuk, A., Colbran, R., Ramsden, R. et al. Hypothesis: improving literacy about health workforce will improve rural health workforce recruitment, retention and capability. Hum Resour Health 17, 105 (2019). https://doi.org/10.1186/s12960-019-0442-9 2. HEALTH WORKFORCE CAPABILITY A global reality is that rural health services, and the workforces that provide those services, are under unprecedented pressure. RDN posits that improving a rural health practitioner’s capability could help to retain them working rurally for longer. RDN’s research into this concept has provided insight into the factors that maintain or build health workforce capability, important considerations when designing capability support and key features of health apps or digital tools to support the capability of the rural health workforce. Understanding the factors that make up a health professional’s capability and the motivations or cues to act to build or maintain their capability may have a positive effect on their retention in a rural location. Martiniuk A; Colbran R; Ramsden R; Edwards M; Barrett E; O’Callaghan E; Bullock R; Lowe E; Karlson D; Curnow J; Gotch B; Kramer J; Bagnulo S; Rothnie I; Hardaker L; Turner N; Wotherspoon A; Russell C. (2020). Capability ... what’s in a word? Rural Doctors Network of New South Wales Australia is shifting to focus on the capability of rural health professionals. Journal for Rural and Remote Health. 3. MEANDERING STREAM OF WHOLE OF LIFE AND CAREER While Australia has continued to invest in policies and strategies aimed at improving rural health service provision, many communities still confront a disproportionate share of the rural workforce shortage. RDN suggests that reframing retention to consider a life stage approach to careers will guide more effective targeting of rural health policies, workforce planning, collaborative approaches and allocation of incentives. An understanding and acceptance of modern lifestyles and career pathways, and a celebration of career commitment to serving rural communities, is necessary for successful recruitment and retention of Australia’s future rural health workforce beyond the training pipeline. RDN also suggests the term meandering stream more accurately describes the non-linear post training career pathway and provides a lens through which to consider ways to encourage health professionals to stay working rurally throughout their career. Colbran R; Ramsden R; Edwards M; O’Callaghan E; Carlson D. (2020). Beyond the workforce training pipeline: embracing the meandering stream of “whole of life” and career to strengthen the retention of health professionals rurally. Journal of Integrated Care ahead-of-print.10.1108/JICA-04-2020-0022. Peer reviewed articles on RDN’S concepts include:nsw rural doctors network annual report | 2020-2114 BOARD, EXECUTIVE AND CLINICAL ADVISORS A/Prof John Kramer OAM, Chair Royal Australian College of General Practitioners (NSW Faculty) Dr Lauren Cone, Director Elected GP Ms Christine Corby OAM, Director Aboriginal Health and Medical Research Council Dr Tom Douch, Director Board elected member Ms Jill Ludford, Director NSW Ministry of Health (Senior Executive) Dr John Curnow, Deputy Chair NSW Rural Doctors Association Dr Peter Finlayson, Treasurer NSW Ministry of Health (Director of Medical Services) Dr Costa Boyages, Director NSW Australian Medical Association Dr Ros Bullock, Director Elected GP BOARD The Board of Directors is responsible for determining the overall policy and priorities of the organisation, and for ensuring that RDN meets funding agreements and contractual obligations. The 2021 RDN Board appointed at the November 2020 Annual General Meeting is: Dave Karlson is Company Secretary appointed by the RDN Board.15 Mr Richard Colbran Chief Executive Officer Mr Mike Edwards Director Service Delivery Ms Kerrie Hamilton Director Corporate Services Mr Dave Karlson Director Business Governance Dr Rose Ellis Director Health Service Development EXECUTIVE TEAM The RDN Executive team is responsible for implementing the policy and priorities of the organisation as determined by the Board of Directors and ensuring that funding and contractual obligations are completed as agreed. RDN Board members, RDN staff, Minister for Regional Health, the Hon Mark Coulton MP, and the National Rural Health Commissioner A/Prof Ruth Stewart, in Canowindra for a Board meeting, March 2021.nsw rural doctors network annual report | 2020-2116 CLINICAL ADVISORS RDN engages medical, clinical and non-health advisors to enable contemporary and best-practice decision making. We acknowledge and thank RDN’s significant clinical advisors. Dr Kate Armstrong B Med, DCH, MPH, FAFPHM, DrPH Candidate Medical Advisor, NACCHO Founder and President, CLAN Dr Natalie Klees B Med, MD, PGCertSc (Imaging), MHM, FRACMA Medical Advisor/ Deputy Director, Borders Policy Team, COVID-19 Public Health Response Branch, NSW Ministry of Health Medical Advisor for the Office of the Chief Health Officer, NSW Ministry of Health Dr Rick Newton MB; BS; B Sc; Master of Public Health; Dip. Ed. Telehealth medical practitioner in Western NSW Past Chair NSW Rural Doctors Network Dr Shannon Nott MBBS, MHM, MPH Rural Director of Medical Services, Western NSW Local Health District Retrieval and Primary Care Medical Officer, Royal Flying Doctors Service Dr Elizabeth Barrett MBBS, MPH, FAFPHM (RACP) Locum Director of Medical Services Dr Grahame Deane AM MBBS; FRACGP; FACRRM; DRANZCOG(Adv); JP Lake Cathie Medical Centre Director HNECC PHN Small Town Remote Telehealth Service to NENW NSW Monthly Locum service to Manilla Dr Mirna Hunter BMedSci (Hons), MD, MBA Deputy Chief Clinical Officer for Chris O’Brien Lifehouse Clinical Reference Lead for Australian Digital Health Agency Start Up Founder for ‘Eliot’ (Hospital Solutions Software) BOARD, EXECUTIVE AND CLINICAL ADVISORS continued17 2020-212019-202018-192017-182016-172015-16 Revenue $35.258m$34.072m$32.791m$27.422m$27.143m$25.311m Expenses $35.308m$34.232m$32.816m$27.175m$26.888m$24.383m Surplus-$0.050m-$0.160m-$0.025m$0.247m$0.295m$0.928m table 1 RDN financial performance from 2015-21 REVENUE Overall revenue in 2020-21 continued the increasing trend RDN has experienced in recent years, with a $10m, 39.3 per cent increase over five years. This year saw a half-year funding of Collaborative Care, as well as full year funding of the Rural Generalist Support Program. The RDN-administered outreach program saw continued expansion, as did joint ventures with other rural stakeholders. The funds to be rolled forward into 2021-22 have increased by $3.1m as the impact of COVID-19 limited the ability to deliver services, particularly the outreach programs and More Doctors for Rural Australia Program (MDRAP). EXPENSES Expenses increased 3.1 per cent as RDN continued its response to the ongoing disasters impacting rural NSW. Embedding Rural Health Pro as a networking tool for rural professionals, initial implementation of a CRM system that will enhance RDN’s capability and the expansion of RDN’s workforce to implement new programs, many of whom are now in rural locations, have all contributed to the increase. FINANCIAL PERFORMANCE 2020-21nsw rural doctors network annual report | 2020-2118 Wagga Wagga, NSW, Wiradjuri Country. In rural Australia, rates of poor mental health and suicide are higher than comparable populations worldwide, and this has been attributed to the compounding impact of drought and climate change acceleration. Curtin M; Brooks R; Verdon S, Crockett J; Hodgins G. (2020). The impact of bushfire on the wellbeing of children living in rural and remote Australia. Med J Aust 2020; 213 (11 Suppl): S14–S17.19 RDN drives the development and use of qualitative and quantitative data to inform health workforce and service planning, quality improvement and develop evidence-informed and scalable health workforce solutions that respond to local need and enhance access to care. The 2020-21 Primary Health Workforce Needs Assessment (HWNA) is the fourth in this current series of needs assessments that applies a framework developed by RDN to focus on needs in the three priority areas of access, quality and sustainability. This latest publication provides quantitative, qualitative and thematic insights to needs and the state of the NSW rural health workforce as well as a summary of trends, all of which are essential planning tools for RDN’s activity investments and impact evaluations. It also provides a foundation to inform RDN’s state and national partners, stakeholders, governments and policy decisions. Workforce priorities in the 2020-21 HWNA continue to focus on the availability of GPs, GP Visiting Medical Officers (VMOs), GP Proceduralists, nurses and midwives, allied health, Aboriginal health, mental health and aged care health professionals. New analysis includes the impact of natural disasters and COVID-19 on the rural health workforce, the impact of technology connectivity on the rural health workforce and health service access, and insights from Rural Health Pro members. RDN’s HWNA would not be possible without links to a wide range of data and information sources, and insight provided by the many dedicated individuals, organisations and forums who share their knowledge and experience of rural health with RDN’s needs assessment processes. 2021 HWNA key findings include: Continuing GP shortages The mental health and wellbeing of the rural primary health workforce continues to be an area of focus and coordinated support is required to counter rural professional and personal isolation Natural disasters and emergencies in recent times have put pressure on the system and signified the need for changes Large gaps in access to allied health and social services Poor or limited access to culturally appropriate services for Aboriginal and Torres Strait Islander populations and poorer health outcomes for Aboriginal people Technology and connectivity remain issues in rural locations Need to recognise the large impact informal carers have on the healthcare system and understand their needs The health needs for the 65+ aged group place increasing demand on the GP workforce. The full report is available at www.nswrdn.com.au/needs-assessment PRIMARY HEALTH WORKFORCE NEEDS ASSESSMENTNext >