A report by the Regional Australia Institute has indicated that more millennials (20–35 years old) are likely to look for opportunities in regional areas. The report classes regional areas as anything except the capital cities and indicates that approximately 1.2 million people moved into and around regional Australia based on data from the 2016 census. The primary drivers for young families to move to regions were identified as housing affordability, career advancement and better lifestyle opportunities. The report also noted that such movement contributed to the building of human and social capital within regional communities. Younger families moving into regional Australia also have expectations of adequate local medical services. Obstetrics and gynaecology form a central platform in any medical institution, or service, and are synergistic with other aspects of health delivery. The need to travel large distances to access medical services is not only time-consuming and expensive, but also separates people from their families and communities at a time when they are most vulnerable.
The maldistribution of the O&G workforce and the barriers to access to maternity care in rural and remote areas is well-documented by RANZCOG’s workforce data, as well as through experience of our consumers and members. The data also identifies the lack of upskilling and training opportunities in rural and remote areas. The College has been in ongoing discussions with the Commonwealth Department of Health to develop a program and framework that enables health professionals in rural, regional and remote areas to avail upskilling opportunities. Following these discussions, the College is piloting the Obstetrics and Gynaecology Education and Training (OGET) program. The aim of this program is to deliver upskilling and education for a range of medical professionals who play a role in the provision of maternity or maternity-related services. A multi-disciplinary approach is imperative in delivering such a program, as many rural and remote areas are serviced by a broad range of health professionals.
How does it work?
The program will be delivered using a hub and spoke model, where the hubs provide onsite or outreach training to their peripheral hospitals in the form of case-based learning and interactive forums. The pilot will be rolled out to five hubs across Australia, with the hubs being selected by RANZCOG. It is estimated that each hub would service five to seven peripheral sites, enabling the program to cover close to 35 rural, regional and remote sites. A FRANZCOG or DRANZCOG employed at the hub hospital will be nominated to be the program lead for that hub. The program lead will liaise with RANZCOG and the peripheral sites to develop a training schedule.
RANZCOG will develop and host content, and hubs will also be able to develop their own learning tools and resources, which will be shared across the program where applicable. The College will also provide program administration and governance, with oversight from the recently established OGET Steering Committee, who will provide strategic direction and guidance for the pilot. The program budget includes some salary support to cover the program lead’s time, and a nominal allowance to support program administration at hub level. The budget also covers approximately two to three training days per site (the actual days will vary depending on hub and site capacity). The pilot will run for a year, concluding in February 2023.
How will the program be delivered?
The fundamental aim of the program is to deliver upskilling and education for a range of medical professionals who play a role in the provision of maternity or maternity-related services. The program will focus on case-based learning and case debriefs across a range of clinical scenarios. The case debriefs will also provide an opportunity for the group to undertake refreshers on the relevant systems and protocols applicable to each specific scenario. The case-based learning will be facilitated by the program lead either at the hub or through outreach. In addition to clinical skills, the training will also address other critical skills such as cultural competence, leadership, communication and people management. Such training will be delivered in a format as agreed upon by the program lead and RANZCOG.
What is the objective?
The pilot aims to gather evidence on the effectiveness of targeted training in rural and remote areas. The pilot also seeks to develop a framework for a sustainable model for maternity care in rural and remote areas through capacity-building and upskilling within local hospitals. Reporting and evaluation are built into the project requirements and will help identify further opportunities to improve the quality of education and training provided. The hub and spoke model will create networking and knowledge-sharing opportunities in rural and remote areas. A successful pilot will provide the foundations for a scalable and sustainable program that can be customised and replicated across a broad range of health settings.
Adequate health services underpin the success of every community and are the base upon which other services develop and thrive. In turn, this translates into economic, social and cultural benefits. Access to maternity care attracts young families and the associated staff and support people. Supporting specialists, GP obstetricians, midwives, nurses and allied health staff through education and upskilling programs ensures that the quality of medical care remains at the highest standard. The absence of a consistent approach towards providing quality maternity care in these communities will result in fragmented and sporadic efforts towards upskilling and training of medical professionals. It will result in inconsistencies in the access, quality and standard of maternity care provided.
As the peak body for women’s health in Australia, RANZCOG is well-placed to plan and implement this pilot. The expected outcome is an evidence base for the viability of a such an initiative in a larger format, and the development of a framework for a program that strengthens maternity services in rural, regional and remote Australia, supporting the people who care for their community. When done in collaboration with other important stakeholders across the different medical disciplines, this pilot will help in evaluating the merits of a consistent approach to upskilling and supporting medical professionals in rural, regional and remote Australia in delivering high-quality maternity care.
- Bourne K, Houghton K, How G, et al. The Big Movers: Understanding Population Mobility in Regional Australia. 2020. Regional Australia Institute, Canberra.