Canberra November 2012 Minutes

Outcomes from the Meeting

Represented at the meeting:

Adelaide University

Australian National University

Deakin University

Flinders University

Flinders University NT

James Cook University

University of Melbourne

Monash University

University of Notre Dame

University of Newcastle

University of New England

University of Sydney

University of Queensland

University of Western Australia

University of Tasmania

University of Wollongong

University of Western Sydney

Commonwealth Department of Health and Ageing

DAY ONE: Thursday, 8 November

Department of Health and Ageing

-          the current Health Workforce review to respond to policy & reform issues in the context of the Health Workforce 2025 Report
-          Jennifer Mason has been appointed Independent Chair & has been attending round table meetings, with a draft report due to government before Christmas.
-          Previous reviews to be looked at in regards to effectiveness of current programs.   It was acknowledged that sometimes the timespan of achievements is longer than program itself. Findings of the review will feed into 2013 budget cycle.
Achievements Report

RCS Achievements

-          Jonathan Newbery (University of Adelaide) – Working in an urban centric, traditional medical school, winning credibility with urban specialists & academics.
-          Amanda Barnard (ANU) – Development & implementation of robust & sustainable models of community-based vertically integrated education & training.
-          Barry Morphett (Deakin University) – Established a new medical school with $70m infrastructure; first graduates doing rural internships.
-          Jennene Greenhill (Flinders University) – 14 universities have imitated the PRCC which now has international recognition through publications & 5 ALTC grants.
-          Sarah Strasser (Flinders NT Remote Clinical School) – Establishment of the Northern Territory Medical Program & riding the waves.
-          Suzanne McKenzie (James Cook University) – 2005 – 2010 86% of graduates intend to practice outside of capital cities (compared with 32% others), 67% did internship outside of metro (compared to 17% of others).
-          Bill Adam (University of Melbourne) – Excellent teaching & learning educational outcomes & student support changing perceptions attracting students to RCS.
-          Judi Walker (Monash University) – Over 40% of total MBBS cohort now undertakes a minimum of 1 year longitudinal rural clinical placement in one of our RCS sites (all with excellent infrastructure) in a School (integrated RCTS/UDRH programs) which extends over 1000 km across rural Victoria.
-          Jenny May (University of Newcastle, joint medical program UoN and UNE) – Able to negotiate a rural medical school and department of rural health.
-          Joe McGirr (University of Notre Dame) – At this point, getting established and in particular, at Lithgow (a small GP run hospital without history of teaching students).
-          Geoff Nicholson (University of Queensland) – Over a decade, the total number of students completing ONE year at UQRCS has increased from 26 (in 2002) to 117 (in 2012) and in 2013 the number will be 137. The proportion completing two years has steadily increased to 31%. Evidence that attendance at UQRCS is a highly significant predictor of subsequent rural practice.
-          Tony Brown (University of Sydney) – We exist! 10 years ago there were 6 students – there are now 64 students across Dubbo & Orange with a waiting list desperately wanting to come and the good cycle of graduates supporting the program.
-          Timothy Skinner (University of Tasmania) – In 2013 the UTAS RCS was over-subscribed for first time, all intern places in our region filled by RCS students.
-          Geoff Riley (University of Western Australia) – Arguably our proudest achievement is that we are over-subscribed every year! But also Carrick Award in 2007 & Premier’s Award in 2008.
-          Jenny Akers (University of Western Sydney) – A wide variety of research activities & projects & strong commitment to Indigenous health.
-          David Garne (University of Wollongong) – 75% of students do a longitudinal rural experience, publications re longitudinal placements.

Department of Health & Ageing, Q & A Session – Lou Andreatta & Padmaja Jha

Topics and discussion included:

Senate Inquiry over 300 written submissions, over 20 consultations at different locations with many issues & themes raised, including rural classification; education, training, 25% rural background. All recommendations relating to workforce distribution etc. will be considered in the review of health workforce. Government yet to finalise its response to Inquiry (3 months to respond). Independent Chair is familiar with recommendations & has been asking relevant questions at round table meetings and within DoHA. Senate Report and submissions on Senate Website

HWA is a COAG initiative & the Commonwealth is only one player in decision making. Partnership agreement review is underway. HWA strategic planning has been successful yielding an evidence base to look at future predictions & formulate future policy. Future of HWA and role unclear.

It is up to individual RCS how report is presented, providing it contains relevant information & response provided to show how each parameter is met. Including an addendum is an option. Currently there is no public access to collective reports. FRAME could request for reporting to be made public, i.e. FRAME website – options could include individual reports; anecdotal case studies etc. Agenda item carried over for discussion at caucus.

It’s possible this would be considered as it is within training and workforce, research into what rural communities need to deliver fully on parameters eg. a 12 month scholarship for research into relevant, specific rural health issues. Important that the funded research effort feeds back into education & training. Opportunities for reciprocity of research, recognising research as important for leverage in recruitment & retention with young career medical, nursing & allied health students, as they decide where they want to work. Innovation & new models happening in rural areas, publications needed.

Will be considered in the context of the review of Health workforce programs - parameters may be the same. Funding may not be based on student numbers alone, also other things like where training was held.

Minister is not considering any new medical schools.

Review is looking at continuum training and scholarships, and how can all link. This generated considerable discussion about rural generalist and rural specialist training and different models of vertical integration. Review wants to find out what vertical integration means, what is needed to make it happen, policy required and how to implement.

2013 program rolled out, full allocation complete. Plans for 2014 in place. A number of RCS included in collaborations. Engagement is needed in this area.

DoHA has introduced new system for payment of grants to help streamline the grants process. Health Workforce Division first to roll out, some teething problems. Once set up, both parties will have less paperwork. Once fully implemented it will be beneficial to all.

Policy thinking behind 5% rule, funding under RCTS needs to be expended in rural areas but recognises there is some expense in managing contractual arrangements. Not more than 5%. An RCS does not have to spend 5% on central administration. RCS should negotiate with its university.

FRAME ‘Vertical Integration’ Workshop

(Attachment 2 – FRAME Vertical Integration – ACRRM Rural Medical Generalism)

Cluster groups:

  1. South Australia, Tasmania, Western Australia (Lucie Walters)
  2. New South Wales (Joe McGirr)
  3. New South Wales (Jenny May)
  4. Northern Territory and Northern Queensland (Sarah Strasser)
  5. Southern Queensland (Geoff Nicholson)
  6. Victoria (Geoff Solarsh)

After the FRAME meeting, workshop leaders prepared a one page response based on discussion which formed the basis of the FRAME submission to the Review of Health Workforce Programs (Attachment 3).

FRAME Issues

FRAME/MSOD Survey – Lucie Walters

Lucie gave summary of FRAME- MSOD project to date (Attachment 4 FRAME Survey Report).

Discussion included:

FRAME Succession Planning Study – Lee Krahe

Rural Clinical Academic Leadership – David Campbell and Judi Walker

David Campbell focussed on preparing rural clinical academics as leaders and the outcomes of workshops held in South Africa and Canada during 2012 (Attachment 5).

ACTION: South African Workshop Report to be posted on FRAME website.

DAY TWO: Friday, 9 November

Review of Rural & Remote Health Workforce Innovation & Reform Strategy

Etienne Scheepers Executive Director Innovation & Reform, HWA

AMSA – FRAME relations

Catherine Pendrey (Vice-President External, Australian Medical Students Association) & Helen Jentz (CEO) ( Attachment 6 - AMSA FRAME presentation)

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FRAME issues

FRAME Leadership Course – Judi Walker and Jennene Greenhill

ACTION: Develop and circulate flyer and plan program (Judi Walker and Jennene Greenhill)

Aims of FRAME – Daryl Pedler

ACTION: Place Aims of FRAME document on the FRAME website for comment

Future Structure of FRAME – Policy Group

ACTION: Options paper to be crafted as a survey to be sent to each RCS for response and feedback before the May FRAME 2013 meeting

FRAME website – Kumara Mendis

ACTION: Helen Peacocke to liaise with each RCS Manager re uploading of articles of relevance to FRAME

Celebration/Research Working Group – Jennene Greenhill

ACTION: Jennene Greenhill to progress the Research Working Group and arrange breakfast meeting in Broome

Academic Partnership with ACRRM – Richard Murray

ACTION: ACRRM to liaise with FRAME to invite interested RCS to a workshop in Brisbane in February

John Flynn Placement Program – Denese Playford

ACTION: Individual RCS to contact Dianne McClusky This email address is being protected from spambots. You need JavaScript enabled to view it. as key contacts for JFPP

ACTION: Arrange session at Broome meeting to provide feedback to ACRRM

Agreements & Reporting – Padmaja Jha

Matters arising from Day 1

ACTION: Canvas through the survey of RCS (refer page 9)

Broome Meeting – Geoff Riley & Jenny McConnel

Dates for November 2013 in Canberra