What is a sustainable remote health workforce? People, practice and place

Abstract

Introduction: In rural and remote regions, access to healthcare services is reliant on the availability of a competent workforce. The global challenge for the attraction and retention of health professionals in rural and remote regions is exacerbated by inconsistent management practices, as well as the disparity of distribution of health professionals between urban, rural and remote areas. This aim of this study was to examine how remote health professionals describe a sustainable remote health workforce and how they propose it could be achieved. This study contributes to the research in this field by examining how health professionals who are currently working in remote regions of Australia describe aspects of a sustainable remote health workforce. Methods: The findings from two data sources (interviews (n=24) and an online questionnaire (n=191)) were examined to identify the characteristics of a sustainable remote health workforce. A purposive sampling method was used to recruit interview participants, ensuring the sample contained managers and health professionals with longevity working in remote regions. In contrast, the online questionnaire was disseminated by eight health service providers resulting in a random sample of current health professionals. The interview and questionnaire participants were asked the same question: 'What is a sustainable remote health workforce?' A thematic analysis was conducted and the emergent themes from the interviews were used to guide the thematic data analysis for the questionnaire. Results: Examination of the characteristics of a sustainable remote health workforce, as described by health professionals currently working in remote areas, revealed that participants identified three extant themes: people, practice and place. Further analysis revealed that a sustainable remote health workforce is about an appropriate mix of health professionals with suitable personal characteristics and professional attributes to meet the remote populations' needs. Irrespective of geographical location, it seems that infrastructure, resources and community engagement together with the organisational systems influence the effectiveness of management practices. Hence, management practices influence the outcomes of many of the policy choices that can improve workforce sustainability. Conclusions: A sustainable remote health workforce is about an appropriate mix of health professionals with suitable personal characteristics and professional attributes to meet the remote populations' needs. Beyond person-fit, a sustainable remote health workforce requires an appropriate model of service delivery that provides continuity of health care through improved retention of competent health professionals. The solutions-focused approach of this study revealed opportunities for management practices that could positively influence the sustainability of future health workforces. Members of the current remote health workforce, experienced remote health professionals who know the landscape, propose that future health workforce sustainability is achievable with effective management practices focused on people, practice and place.