1. Remote & Rural Steering Group Remote and Rural Health Project Dr. Annie Ingram, Project Director MHIB 11 th December 2007

2. Remote & Rural Steering Group Tertiary Services Secondary care Extended Primary Care team RGH DGH CH Emerging Model CH Standards and Formal Support Networks

3. Remote & Rural Steering Group EMERGING MODEL – Primary Care Framework SUPPORT NETWORKS Named responsible specialists Twinning of single/small practices Integration with RGHs, Comm. Hospitals Integrated Strategic Planning WORCEFORCE INFRASTRUCTURECOMMUNITY RESILIENCE Integrated Transport Systems IT – Broadband, local & networked Diagnostics (labs & imaging) E-health Solutions Telemedicine/Telemetry NHS 24 Anticipatory Care Emergency Response Retrieval Teams Transfer Emergency Care CDM Planned Care Primary Diagnosis Health Promotion Anticipatory Care Multi-skilled Generalists Rotations with larger centres Education  Distance learning Rural fellows, Nurse practitioner, Paramedicss community resilience

4. Remote & Rural Steering Group R&R Mental Health Crisis Model Community based model; Early detection of disease and prevention of escalation; Obligate network with specialist centre; Contingency arrangements for crisis management; Generalist practitioner delivered crisis management service.

5. Remote & Rural Steering Group Crisis Standards R&R Challenges STANDARD Access and Availability CHALLENGE 4 hours response time Access to specialist advice 24/7 Availability of specialist staff locally Places of Safety Delayed transfer and retrieval

6. Remote & Rural Steering Group Crisis Standards R&R Challenges STANDARD Planning and Delivering Support CHALLENGE Infrequent clinical exposure Lack of accessible and appropriate training OOH access to clients specialist plans

7. Remote & Rural Steering Group Crisis Standards R&R Challenges STANDARD Training and Workforce Development Working with communities CHALLENGE Lack of accessible and appropriate training Utilisation of all available resource

8. Remote & Rural Steering Group Discussion…………………