Do you struggle to recruit allied health professionals to your rural area or organisation? This article describes a model that has successfully supported multiple rural communities to recruit health professionals through establishing a Health Workforce Recruiter Connector position (HWRC).
Recruitment and retention of allied health practitioners is a widespread challenge for employers, irrespective of location. However, regional, rural and remote towns have faced a longstanding struggle to attract and retain an adequately skilled allied health workforce.
We know that workforce shortages contribute to health inequalities in regional, rural and remote towns. People living in more remote areas face unique challenges due to their geographic isolation and often experience poorer health outcomes compared to people living in major cities.
Should I stay or should I go? Factors affecting rural retention
Health professionals’ decisions to stay or leave a rural position are multifaceted. Most existing rural health workforce frameworks are often highly complex and don’t easily support the development of strategic action at a community level.
To date, most solutions have largely focused on increasing the supply of health professions by providing more university training places and by providing incentives and career supports to lure health professionals to rural areas.
Research evidence shows however that to retain allied health professionals in rural areas, communities and organisations first need to attract ‘ideal’ candidates. Once ideal candidates are attracted to the job, rural communities and organisations then need to support these ‘ideal’ candidates and their partners and families to settle-in, make connections and thrive locally. To date, strategies that address these factors are not widely accepted.
My research has identified that an ‘ideal’ candidate for a rural community will:
- have appropriate professional skills and experience;
- be interested in practising rurally;
- have interests that match well with the local community and the place.
Equally as important, my research also identifies that for a rural community to attract and retain health professionals, it is essential that the rural community itself must be fully engaged in supporting new-to-area health professionals and their families, in particular in their first year in the community. This includes, if wanted, supporting partners to find employment that utilises their skills and experience.
The combination of my research, community development roots and recent Churchill Fellowship has led me to develop a new approach to tackle this long-standing problem for rural communities. I call it the ‘Whole-of-Person Retention Improvement Framework’. The Framework has three domains: Workplace / Organisation, Role / Career and Community / Place (Figure 1).
Each domain identifies the necessary pre-conditions for improving retention through strengthening new-to-area health professionals’ job and personal satisfaction levels. The Framework recognises and embraces the need for a whole-of-community response to address individual and workforce level problems. It is a valuable resource to help address avoidable rural health workforce turnover. Uniquely the Framework provides the key ingredients that rural health services and communities can independently use to address their long-standing workforce problems in-place.
Origin and success of the Health Workforce Recruiter Connector position
The Health Workforce Recruiter Connector (HWRC) role was developed as a way for local communities to implement the Community / Place domain of the Whole-of-Person Retention Improvement Framework.
The HWRC position is a dedicated role in the community used to build networks that will better identify and successfully attract health professionals (allied health, doctors and nurses) who are a ‘strong fit’ for their rural community and the employing health service or business. The position provides tailored support to new-to-area health professionals and their family members with settling in, making connections and thriving in-place.
The highly successful community-led HWRC position was created ten years ago, by a rural community in Marathon, Ontario, Canada. It was established in response to three of the town’s five family physicians (term for GPs in Canada) resigning and the possible risk of losing all five family physicians. Since its establishment, the HWRC has been funded continually by a collective of local businesses include health services, local government and the local gold mine. It is managed by a committee of community representatives including health and local government representatives. In the ten years the position has been in operation, Marathon has had no medium or long-term vacancies of health professionals, despite operating in an area of severe health workforce shortages. You can learn more about the Marathon model here and meet the Marathon HWRC here.
By having in place a full, stable and sustainable health workforce, the range of health services available in Marathon has been able to expand. Retention of the current health professionals is now actively supported by having a strong locum pool in place to encourage the town’s health professionals to take regular breaks and avoid burnout. There is also sufficient capacity and energy among the health workforce to build the health workforce pipeline by providing allied health and medical students and GP registrars well-supported short and long-term placement opportunities.
The HWRC solution addresses many of the missing pieces that other rural health workforce solutions do not by offering an evidence-informed, community-led health workforce strategy addressing the professional and social determinants of attraction and retention.
Thanks to funding from Foundation for Rural and Regional Australia (FRRR) and support from Services for Australian Rural and Remote Allied Health (SARRAH), the HWRC model is currently being piloted in rural communities in New South Wales and will extend into Victoria in 2022. AHP Workforce’s Dr Anna Moran is helping to evaluate the program.
Is this model suitable for your rural community?
As a result of working with rural health services and communities for the last ten years and piloting evidence-based health workforce solutions, I have developed a list of essential criteria that need to be in place for the HWRC solution to be successful. In summary these are:
- Your community is heavily reliant on local primary health care services to meet residents’ health and wellbeing needs;
- Your community has a track record of community mobilisation and collaboration in undertaking whole-of-community initiatives;
- The health services and allied services operating in your area are keen to work collaboratively with each other and the local community to address local health workforce challenges; and
- The local council and major employers understand the economic development case for a stable and sustainable health workforce and will support initiatives to achieve it.
The challenge of addressing the wicked problem rural health workforce shortages cannot be understated. It is essential that you use the criteria provided in this article to ascertain your readiness as an organisation and community to embrace the HWRC approach to recruit health professionals to your rural community. More information about the HWRC solution and the Whole-of-Person Retention Improvement Framework to strengthen your allied health workforce is available here.