Delivering care in rural and remote areas
5 minute read…
Australia’s unique geography can present a number of challenges around our ability to provide effective health and social care support in remote communities.
Almost 30% of Australians live outside major cities, with almost 2% of the population living in rural and remote areas. According to a report by the Royal Flying Doctor Service, or RFDS, individuals living in isolated locations are more likely than their metropolitan counterparts to experience poor healthcare accessibility, workforce shortages, and an increased risk of illness and disease. These factors make overcoming barriers to care a priority for health and social care providers.
Challenges facing rural and remote settings
People living in rural and remote communities can experience a number of obstacles when accessing appropriate health and social care services:
1: Geographical barriers
Australia is the sixth largest country in the world with vast stretches of land that are sparsely populated. For individuals living in rural and remote communities, accessing care and support, such as Supported Individual Living (SIL) support, mental health services, and disability assistance, can often mean long travel times to the nearest provider. In some instances, individuals may need to travel hundreds of miles just to access the service they need.
2: Workforce shortages
One of the most pressing issues facing rural and remote areas is staffing shortages. Workforce issues were exacerbated by the Covid-19 pandemic and continue today. Research by the RFDS indicates that, by 2028, rural and remote settings will only have one twelfth of the number of physiotherapists required and only a third of the psychologists needed to ensure adequate care and support for those living in geographically-isolated communities.
Services based in rural and remote areas can sometimes struggle to recruit and retain staff in health and social care. Practitioners may be unwilling to relocate due to lifestyle preferences, infrastructure constraints, and limited career development opportunities. This can lead to frequent staff shortages and high turnover rates, both of which can adversely impact the quality of care provided.
3: Cultural considerations
Around 32% of the rural and remote population in Australia is Indigenous, including people of Aboriginal and Torres Strait origin. Often, Indigenous people can face both cultural and language barriers when trying to access the right care, and, as a result, may experience poorer physical and mental health outcomes. In fact, there is a 14-year life expectancy difference between Indigenous and non-Indigenous people in rural and remote settings, highlighting the importance of appropriate care and support for all communities.
4: Socio-economic factors
Many rural and remote communities face higher rates of socio-economic deprivation which can lead to poorer health outcomes. Against a backdrop of low-quality housing, high rates of unemployment, and limited access to primary healthcare, there may be a higher-than-average need for care and support in isolated areas.
Delivering effective care in rural and remote settings
Despite the indisputable challenges, there a number of steps we can take as health and social care professionals to ensure that we can deliver effective care to individuals living in rural and remote areas in Australia:
1: Provide ‘remote’ care
In situations where it is challenging to have health and social care professionals offering support in person, we can think about opportunities to deliver care remotely. Advances in technology mean that, in some instances, we can communicate with individuals via phone call or video conferencing platforms such as Zoom.
Of course, this is not practical or possible in all scenarios: some individuals with communication difficulties may not be able to access or use the technology required, and satellite links in rural and remote areas can be unreliable or, in some cases, non-existent. However, where possible, ‘tele-support’ can sometimes help to supplement in-person care.
Digital platforms and websites can also be a good source of support and information for individuals who are able to access them. Online resources can provide useful information around pertinent issues, and while they are not a substitute for in-person care, they can help to inform and support individuals.
2: Establish mobile support teams
Where there are no or few services in a remote area, setting up mobile support teams can be an effective way to deliver care and support to individuals. These teams might include professionals from across the social and health care sectors, all of whom can bring essential services and expertise directly to remote communities.
This outreach approach enables early intervention and removes the need for individuals to travel long distances to access vital help and support.
We may also want to consider integrating services around areas such as housing and employment. A collaborative care approach that combines a number of different services enables us to ensure that individuals are equipped with the tools they need to participate fully in their communities.
3: Promote culturally safe support
Many rural and remote communities are made up of Indigenous people, including Aboriginal and Torres Strait individuals. We must acknowledge cultural sensitivities and should work in partnership with Indigenous communities to deliver support that takes cultural differences into account.
Culturally safe support involves engaging positively with community leaders, recruiting Indigenous health and social care staff, providing language support, and acknowledging community values. This approach can help to build trust and connection, enabling us to provide support that meets individuals’ needs.
4: Prioritise workforce support and training
There is no doubt that choosing to work in a remote area is not without its challenges, so in order to recruit and retain the best health and social care practitioners, we need to prioritise workforce support and training.
We can think about areas such as travel and accommodation costs, and explore ways to ensure that staff members have access to high-quality, ongoing training and development. Practitioners in remote areas often need a broad range of skills and knowledge, given the wide range of needs they may be supporting. This makes continuing professional development even more important.
Establishing peer support networks enables staff to connect with other practitioners working in isolated areas, and to share their experiences, knowledge, and skills.
5: Upskill local community
Working closely with communities can be a powerful way to improve health and social care provision in rural and remote areas. This might involve cascading knowledge, sharing expertise, and training individuals locally so that care can continue when we are not there to offer in-person support.
Establishing two-way communication channels where we can all learn from each other helps to build mutual trust, increase cultural competency, and facilitate a sustainable approach to care and support that is rooted in the community.
Improving access to services in rural and remote areas
Everyone deserves fair and equal access to effective, high-quality health and social care, and this is no different for individuals living in Australia’s rural and remote areas.
By taking a creative, joined-up approach and working collaboratively with individuals and communities, we can begin to dismantle barriers to accessibility and ensure that we always offer the best care and support.