Abstract
BackgroundThe challenges of providing and accessing quality health care in rural regions have long been identified. Innovative solutions are not only required but are also vital if effective, timely and equitable access to sustainable health care in rural communities is to be realised. Despite trial implementation of some alternative models of health care delivery, not all have been evaluated and their impacts are not well understood. The aim of this study was to explore the views of staff and stakeholders of a rural health service in relation to the implementation of an after-hours nurse practitioner model of health care delivery in its Urgent Care Centre.MethodsThis qualitative study included semi-structured individual and group interviews with professional stakeholders of a rural health service in Victoria, Australia and included hospital managers and hospital staff who worked directly or indirectly with the after-hours NPs in addition to local GPs, GP practice nurses, and paramedics. Thematic analysis was used to generate key themes from the data.ResultsFour themes emerged from the data analysis: transition to change; acceptance of the after-hours nurse practitioner role; workforce sustainability; and rural context.ConclusionsThis study suggests that the nurse practitioner-led model is valued by rural health practitioners and could reduce the burden of excessive after-hour on-call duties for rural GPs while improving access to quality health care for community members. As pressure on rural urgent care centres further intensifies with the presence of the COVID-19 pandemic, serious consideration of the nurse practitioner-led model is recommended as a desirable and effective alternative.
Highlights
The challenges of providing and accessing quality health care in rural regions have long been identified
These rural demands challenge the sustainability of the General practitioner (GP)-led mode of care in rural areas
Transition to change Participants revealed that a period of change had occurred during which clinical staff, stakeholders, and the community were adapting to the presence of after-hours nurse practitioner (NP) in the urgent care setting
Summary
The challenges of providing and accessing quality health care in rural regions have long been identified. The provision of on-call afterhours medical services in addition to a typical GP working week is a major burden on work-life balance, is a known barrier for recruiting GPs to rural communities, and a reason for leaving rural communities [6,7,8]. These rural demands challenge the sustainability of the GP-led mode of care in rural areas
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