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Purpose: While one-third of Australians live outside major cities, there are ongoing challenges in providing accessible, sustainable, and appropriate primary health care services in rural and remote communities. The purpose of this paper is to explore a partnership approach to understanding and addressing complex primary health workforce issues in the western region of New South Wales (NSW), Australia. Design/methodology/approach: The authors describe how a collaboration of five organisations worked together to engage a broader group of stakeholders and secure commitment and resources for a regional approach to address workforce challenges in Western NSW. A literature review and formal interviews with stakeholders gathered knowledge, identified issues and informed the overarching approach, including the development of the Western NSW Partnership Model and Primary Health Workforce Planning Framework. A stakeholder forum tested the proposed approach and gained endorsement for a collaborative priority action plan. Findings: The Western NSW Partnership Model successfully engaged regional stakeholders and guided the development of a collaborative approach to building a sustainable primary health workforce for the future. Originality/value: Given the scarcity of literature about effective partnerships approaches to address rural health workforce challenges, this paper contributes to an understanding of how to build sustainable partnerships to positively impact on the rural health workforce. This approach is replicable and potentially valuable elsewhere in NSW, other parts of Australia and internationally. [ABSTRACT FROM AUTHOR]

Objective: Access to services and workforce shortages are major challenges in rural areas worldwide. In order to improve access to mental health care, it is imperative to understand what services are available, what their capacity is and where existing funds might be spent to increase availability and accessibility. The aim of this study is to investigate mental health service provision in a selection of rural and remote areas across Australia by analysing service availability, placement capacity and diversity. Method: This research studies the health regions of Western New South Wales and Country Western Australia and their nine health areas. Service provision was analysed using the DESDE-LTC system for long-term care service description and classification that allows international comparison. Rates per 100,000 inhabitants were calculated to compare the care availability and placement capacity for children and adolescents, adults and older adults. Results: The lowest diversity was found in northern Western Australia. Overall, Western New South Wales had a higher availability of non-acute outpatient services for adults, but hardly any acute outpatient services. In Country Western Australia, substantially fewer non-acute outpatient services were found, while acute services were much more common. Acute inpatient care services were more common in Western New South Wales, while sub-acute inpatient services and non-acute day care services were only found in Western New South Wales. Conclusion: The number and span of services in the two regions showed discrepancies both within and between regions, raising issues on the equity of access to mental health care in Australia. The standard description of the local pattern of rural mental health care and its comparison across jurisdictions is critical for evidence-informed policy planning and resource allocation. [ABSTRACT FROM AUTHOR]

A contemporary Australian health system must be characterised by partnerships with consumers. Partnering with consumers is about healthcare organisations, healthcare providers and policy makers actively working with consumers to ensure that health policy, information, systems and services meet their needs. Recognition of the need for a more active role for consumers in healthcare is gaining momentum. Currently in Australia, emphasis is being given to the role consumers and communities can play in the governance of PHNs and local hospital networks, with some accompanying investment in recent years to provide governance training. However, there is a considerable way to go in harnessing the role consumers can play as agents of change in the health system. According to Alison Trimble, 2018 (King's Fund, UK)"Consumers are renewable energy and the secret ingredient to transformational change within the health and care system". Collaborative practice underpins co-design and is essential to implementing current health reforms in Australia. The King's Fund,(an independent charity in the UK) have developed a program Collaborative Pairs which is designed to support the development of the mindset and practices that underpin the culture of shared leadership and partnership and, specifically, joint clinician-consumer approaches to program and service development. The program consists of five one day sessions undertaken over a five month period to enable pairs to work on a shared work challenge in between sessions. The Consumers Health Forum of Australia in collaboration with the Western Health Alliance (operating the Western New South Wales Primary Health Network (WNSW PHN)) and three other PHNS and the Australian Commission on Safety and Quality in Health Care (ACSQHC)are implementing Collaborative Pairs as part of a National Demonstration Trial in Australia. As one of the largest rural and remote PHNs in Australia, Western NSW PHN is well placed to test the program in a rural and remote context. This contribution will provide an overview of the Collaborative Pairs Program, the model being implemented in the National Demonstration Trial with a specific focus on Western NSW. The challenges and opportunities of delivering a world class innovative program in a remote location will be discussed as well as the need to build capacity of both consumer and clinical leaders to work together in rural and remote Australia. The importance of collaborative practice and the ways that it is being practiced, supported and integrated in Western NSW as compared to other more urban sites will also be discussed. [ABSTRACT FROM AUTHOR]

The western New South Wales NSW region in Australia is one of 31 Primary Health Network PHN regions. Its land area is 441,609 km2 and with a resident population of approximately 310,000 people. Of the 28 Local Government Areas comprising western NSW, 64% are classified as socially and economically disadvantaged while 39% are classified as remote or very remote Health Intelligence Unit, WNSW: Health of the Population, December 2017. In western NSW, 12% of the population identifies as Aboriginal, compared to only 3% for all NSW. Access to health services is a key regional focus particularly for Aboriginal people Western NSW PHN: Needs Assessment, 2017. In their submission to the Australian Government Department of Health in early 2015 to operate the new Western New South Wales Primary Health Network WNSW PHN, the consortium for operating the new PHN highlighted their commitment to building and driving culturally appropriate services for Aboriginal people across the region, including with existing and prospective mainstream and other primary healthcare providers Debble Institute Canberra: 'What works' in partnering to deliver effective Aboriginal health services: The Western New South Wales Primary Health Network experience, 2017. Much has been written on the approaches to date by health services and related organisations to fulfil this important need. Programs are described in the literature and have included mandatory cultural awareness and sensitivity training, appointment of Aboriginal health workers, increasing the proportion of the workforce who identify as Aboriginal, and involvement of Aboriginal Elders and community leaders in service development, among other strategies. However, programs described are often occurring in isolation, predominantly in hospital settings, and with a considerable focus on antenatal care/midwifery and cardiovascular conditions. There is also limited evidence of evaluations of these initiatives to indicate their success or applicability across a range of health care settings. In 2016, WNSW PHN's Aboriginal Health Council recommended that the PHN develop its own comprehensive Cultural Safety Framework. The Framework could then guide all service providers funded by WNSW PHN Aboriginal and other, as well as the PHN's commissioning framework and the PHN itself in building a culturally safe primary healthcare system in Western NSW. Cultural safety in healthcare means designing and providing services that meet the needs of patients through a process of self-reflection, awareness of cultural biases and processes to actively respond in a way that will benefit the patient's health and wellbeing. WNSW PHN is playing a leadership role in the development of culturally safe models of care to ensure access to quality health care and wellbeing programmes for Aboriginal and Torres Strait Islander people. The WNSW PHN Cultural Safety Framework sets out a continuum for primary healthcare service providers in the transformation to cultural safety, involving three major steps: Cultural Awareness; Cultural Sensitivity; and Cultural Safety. Embedding a cultural safety process in WNSW PHN's commissioning of health services will play an important role in Closing the Gap between the health outcomes for Aboriginal and Non-Aboriginal People in western NSW. [ABSTRACT FROM AUTHOR]

Introduction: Western NSW is one of the most vulnerable regions in Australia with a fractured service network and poor health outcomes. A strategy to transform current services into a patient centred, coherent system of care is well into its 4th year. A range of locality-based initiatives are being implemented to better connect health and social care providers to improve health outcomes for the region. Methods: The Western NSW Integrated Care Strategy (Strategy) is being implemented using a collaborative partnership approach between the LHD, the Western Primary Health Network, and Bila Muuji Aboriginal Health Service. The vision for the Strategy: To transform existing services into an integrated Western NSW system of care that is tailored to the needs of our rural and remote communities, and improves access to care and health outcomes, with particular focus on closing the Aboriginal health gap. A key element of the Strategy was the establishment of local demonstrator sites to test new integrated models of care at a locality level. Features of the models include: Primary care led team based care Risk stratification Comprehensive assessment Shared care planning Health and social care coordination Multi-disciplinary case conferencing in primary care. Results: Over 4 years the Strategy has: Enrolled 1500 people across 12 local demonstrator sites focusing on chronic disease management, the first 2000 days of life and Aboriginal Health. Strengthened the connection between care providers to provide team based care Appointed local Health and Social Care Coordinators Introduced primary care based multidisciplinary case conferencing Established a change team to enable rapid transfer of integrated models across the region Evaluation of the Strategy is indicating an improved health journey, improved health outcomes and a reduction in acute care utilisation. Discussion: We consider the learnings from our experience transferable to other environments, with suitable local tailoring. [ABSTRACT FROM AUTHOR]