1. Associate Professor Martin Jones Director University of South Australia Department of Rural Health
Rural mortality rates are up to 3 times higher than city rates meaning that 4,600 additional people die in rural Australia each year than would die if they lived in the cities
Aboriginal life expectancy in rural and remote areas is between years less than the rest of Australia
People with cancer in regional areas are 35% more likely to die within 5 years of diagnosis than patients in the city
Suicide rates may be up to 30% higher than the cities
What do you think the reasons are for this ?
Attention Grabber
There is a mounting evidence base showing that health students who undertake Multidisciplinary training in a rural area, and those from a rural background, are more likely to practice as health care professionals in Regional Australia and help address the maldistribution of the workforce that occurs in our country.
University of South Australia is an academic network in regional South Australia with strong connections to the community, which is part of a programme of workforce development activity referred to as the Rural Multidisciplinary Training programme.
Benefits
Next twenty minutes I am going to talk about the policy framework and objectives which underpin the Rural Multidisciplinary Training Programme.
Say a little bit about our team and what we do
Talk about the practical support we offer
Describe our activity to help us understand the impact of our business moving forward
Credibility
MHN by background, I worked in the NHS for 28 years, variety of roles, clinician, manager, more recently developing systems to provide assurance about the safety and quality of care provided by the NHS, serving a population of 1million in inner city London.
My research interests include nurse prescribing, preparing MHN to support people to adhere with medicines, and enabling MHN to increase their physical health skills for people living with SMI and more recently understanding how we can better prepare the future workforce to care for people living with LTC and depression.
Since coming to work and live in regional Australia I have been challenged by the health inequalities that exist between regional and metropolitan Australia. The Rural Doctors Association of Australia advise that:
and yet I am inspired by the national regional infrastructure (The Rural Multidisciplinary Training Programme) to prepare the future workforce across Australia, which has been operating for 20 years and a wonderful model for workforce development for Australia to share globally.

2. Rural Health Multidisciplinary
Training Programme
Facilitate effective rural training experiences
-Set an annual MDT rural clinical placement target
2. Student selection and rural student recruitment
-Develop and introduce rural enrolment targets
3. Progressing an evidence base and the rural health agenda
-Agreed rural health research plan
4. Aboriginal and Torres Strait Islander Health
-Set and meet enrolment and graduation targets for Aboriginal and Torres Strait Islander
-Access mentorship
-Cultural awareness training
-Educational, training and support for the existing workforce
5. Regional leadership in developing innovative training solutions to address rural workforce recruitment and retention
Direction
The Rural Multidisciplinary Training Programme is a commonwealth funded project which has invested in a network of Rural Clinical Training Schools (Medical Students) and University Departments of Rural Health (Nursing and Allied Health Students) as well as supporting metropolitan dental schools to offer extended clinical placements in rural areas.
The UDRH programme was established 1997, was considered ideal site for a DRH if the University had a Rural academic campus, a base for the RFD, and links with Aboriginal Health Services
They have a focus on expanding rural health workforce through:
Multidisciplinary education and training for the future and existing workforce
Regionally responsive research, evaluation and development
Currently there are 11 DRH across Australia, covering 40% of the land mass of Australia in which 10% of the Australian population live.
Across Australian, 20% of all nursing and allied health students will have a DRH experience, 10% of the population supporting 20% of student placements.
Across Australian, 20% of all nursing and allied health students will have a DRH experience, 10% of the population supporting 20% of student placements
The core aims of the programme:
Provide effective rural training experiences for health students; (KPI Number of students undertaking a MDT placement in our case to deliver 5,400 placement weeks in 2018)
Increasing the number of rural origin health and medical students; and (KPI Growing activity to support regional Australians to peruse a health care career)
Develop an evidence base for the efficacy of rural training strategies in delivering rural health workforce outcomes; (KPI Activity to support the existing workforce and conducting research to understand innovative models of service delivery to support rural communities)
Supporting rural health professionals to improve Aboriginal and Torres Strait Islander health; (KPI Activity to support Aboriginal health professionals in the region)
Maximising the investment of programme funds in rural, regional and remote areas for the maintenance of well supported academic networks to enhance the delivery of training to students to support the provision of medical services to communities (KPI Providing an academic network across the regional geographical footprint) .

3. Our Location and Team
The administrative centre for UniSA DRH is based in Whyalla, home to the friendliest dolphin's in Australia,
We are a diverse team of 17 full and part time, comprised of Occupational Therapists, Social Workers, Nurses, Nutritionists, Psychology Graduates, shortly a Podiatrist, researchers and most importantly our professional staff located across Regional South Australia. Our team is made up of people from Africa, United Kingdom, Aboriginal Australians and Non-Aboriginal Australians all committed to developing the rural health workforce.
Our vision is to provide a Great Rural Experience, we do this by working with our communities to help facilitate and grow quality learning experiences for the future workforce.
Currently we have major training centres in Port Lincoln, Port Pirie, Port Augusta
In our new contract the Commonwealth have requested us to establish training centres in, Mount Gambier, Murray Bridge, Mount Barker and Tanunda

4. Outcome: doubling placements
We are currently at 2,700 weeks.
5,400 weeks
staged approach
placement length
What Is Our Current Target
Before the renegotiation the target was 2,700 placement weeks per year
What Is Our New Target
In our new contract our target was doubled to 5,400 weeks, staged over the course of the project. This is as follows
4,000 placement weeks in 2016
5,000 placement weeks in 2017
5,400 placement weeks in 2018
Placement Length
increasing average duration of support from 6 weeks to 8 weeks.

5. What Support Do We Offer ?
Practical Support
Accommodation support
Transportation
Financial payment for placements
Online access
Community engagement
Extra curricula training
Housing Location
Port Lincoln
Port Pirie
Wallaroo
Whyalla
Port Augusta
Claire
Tanunda
Mount Barker
Murray Bridge
Strathalbyn
Victor Harbor
Barmera
How UniSA’s Department of Rural Health (DRH) supports students?
1. DRH offers generous support arrangements for eligible nursing and allied health students undertaking rural and remote placements in South Australia.
2. The aim of the support is to support students to gain invaluable experience of a regional placement while bringing much needed skills to our regional communities.
DRH can support you with:
Accommodation
Transport assistance
Financial payments for placements
As an academic network linked with our community we also conduct a number of Community Engagement activities which the students are invited to attend as part of their placement, e.g. In April we held a Solid Start Conference showcasing the benefits of becoming a health care professionals for 60 Aboriginal Children in which students undertaking a clinical placement attended and discussed their motivations about becoming a health care professional.
We also provide extra curricula training which may not be available in the city, hearing voices, cultural awareness training
Placement locations in which we have housing include
Port Lincoln
Port Pirie
Wallaroo
Clare
Tanunda
Mount Barker
Murray Bridge
Strathalbyn
Victor Harbor
Mount Gambier
Barmera

6. Innovative Training Programmes
Primary health care placements (Remote and Regional)
Allied health placements schools
Student clinics/Service Learning
Mental health
Aged Care
Aboriginal Communities
Over the coming years we will be working with our communities to build quality learning experience
1. Increased collaboration with other education providers in the RHMT framework which will include an Expansion of regional and remote primary health placements
Nurses are the lynpin underpinning rural communities
We are working with our DRH colleagues in Broken Hill to develop a remote nursing placement model which will deliver some core principles of a remote nursing experience across our footprint.
We will collaborate with Broken Hill DRH to create joint learning experiences for Nursing and Allied health student and work closely with the University of Adelaide Rural Clinical Training School to deliver joint learning experiences to Medical, Nursing and Allied Health students.
2. Allied Health Placements Schools
We are exploring how we can work with our colleagues in education to asses the feasibility of supporting allied health students to undertake placements in the local schools.
3. Development of a new multidisciplinary clinic on the UniSA Whyalla Campus in partnership with local health services
This clinic aims to provide student assisted services to under-serviced clients e.g. working closely with Podiatry, with the possibility of employing a podiatry academic to supervise podiatry students in the region
4. Mental Health
1 in 4 people in this room today will use mental health services at sometime during your life, yet we are no were near 1 in 4 MDT training experiences having a mental health component
Mental health conditions particularly depression are increasing. Queensland University in 2013 in population based study, concluded that depression is the second cause of disability, what we sometimes forget is that depression out of all the long-term conditions exerts greatest decrement in health for people living with conditions such as Angina, Arthritis, Asthma and Diabetes
We will partner with mental health services to provide quality learning experiences and explore opportunities to build partnerships with primary care in this area.
5. Aged Care
Aged Care-Partnering with Aged Care, discussing feasibility of nursing students to help with organisational development
6. Working with Aboriginal Communities
Aboriginal primary health service placements – we will partner with Aboriginal health services to provide quality learning experiences. This is a priority area for us, Aboriginal Australians experience the greatest health challenges, we need to understand how we can grow learning experiences with Aboriginal Communities to develop a culturally aware workforce.

7. A Successful Business Invests In Research and Development
Every successful business invests in research and development, it provides important feedback on the effectiveness of the business and allows for further growth and development.
Our Commonwealth colleagues have requested that we produce a research plan which helps us understand how
Service accessibility can be increased
How we can better support the Aboriginal health workforce
and better understand the impact of our programmes upon student experience and contribution to the region.
1. Increasing Service Accessibility
Understanding the attitudes of mental health clinicians to mental health nurses undertaking prescribing responsibilities
Adherence with medicines
Depression training with practice nurses
2. Aboriginal Health
Learning experiences with Aboriginal communities
Workforce development programmes for the Aboriginal Workforce “Deadly Thinking Training”
Cultural awareness training
3. Student Learning Experiences
Hearing Voices training
MDT Training Hubs
Student experience

8. Key Messages “A Great Rural Experience”
Innovative learning experiences
Growing the health workforce in regional and remote communities
Providing a range of practical support to students to provide them with “A Great Rural Experience”
As an academic network embedded in our communities we will facilitate innovative learning experiences
Growing the health workforce in regional and remote communities which helps to address some of the health inequalities I talked about earlier