Developing a core workforce of Rural Generalists will not only provide continuity of care for our population, it will also improve the long-term sustainability of services and support a more integrated model of care. By improving service access, it will help us support people to stay well, reduce health inequities and improve health outcomes – all key goals for our health system. It also means more people will be able to receive the care they need closer to home.
Importantly, we aren’t completely moving away from a specialist model. We are moving to a mixed model which involves all professions – medical, nursing, midwifery and allied health – working to the full extent of their scope of practice as members of a multi-disciplinary team and supporting each other to maintain high standards. One that includes both speciality specific Senior Medical Officers and Rural Generalist/Rural Hospital Medicine Specialists. Our maternity team of Midwives, Obstetricians and obstetric Rural Generalists will continue to provide birthing and emergency care for women on the Coast, working as a team that support one another.
The international evidence from decades of safety data from both Australia and Canada demonstrates that clinical outcomes under this model are as safe as a traditional urban speciality-specific model. Rural Generalism also addresses our current challenge in primary care of being reliant on locums and it will mean Coasters gain good access to primary care provided by permanent GPs, which is paramount to improving patient care and outcomes.
Primary care/general practice sits at the heart of the Rural Generalist skill set and model and the majority of Rural Generalist Senior Medical Officers are skilled in primary care. The Rural Generalist role has flexibility in that these same practitioners can work in both primary care settings (including rural GP practices) and other hospital environments, like the emergency department.
A Rural Generalist doctor, for example, may be qualified to work in both general practice and hospital settings with a speciality in obstetrics or general practice. They would also be supported by local and Christchurch-based specialists, enhancing the capacity, capability and resilience of our health system.
With a population of 33,000 people, the reality is that the West Coast DHB will always need to refer people to larger centres for highly specialised care, such as neurosurgery, some cardiac care, cancer treatments, specialised burns treatments and neonatal intensive care. These services will continue as they always have.
Coasters can be reassured that our Rural Generalist model supports our goal of ensuring that Coast communities receive the right care in the right place, from the right people, at the right time.