Foreword 2
Executive summary 4
Purpose and scope 4
Why a Framework for Rural and Remote Health? 5
The National Strategic Framework for Rural and Remote Health 5
Vision 5
Goals 5
Outcome areas 6
The rural context 6
Box 1: Classifying ‘remoteness’ 7
Health services 10
Rural and Remote Hospitals 11
Health status 13
Box 2: Rurality, distance and prevalence link to health outcomes 13
Mental health 13
Dental health 13
Box 3: Closing the Gap targets 15
Determinants of health 16
Remoteness 16
The rural and remote challenge for health service delivery 16
Rural and remote health service delivery is not the same 17
The policy context 18
Developing the National Strategic Framework 18
Where does this Framework fit with other health policies and plans? 19
Box 4: National Health Reform 19
National Strategic Framework for Rural and Remote Health 21
Vision 21
Goals 21
Principles 22
Key outcome areas 22
Outcome area 1: Access 23
Introduction 23
Meeting community needs – the Central Highlands Community Health Centre, Ouse (Tasmania) 24
Using technology to improve access to services 25
Outcome area 1: Access 26
Outcome area 2: Service models and models of care 27
Introduction 27
Multipurpose Service Program 27
Networking Cancer Services - CanNET (Western Australia) 28
Outcome area 2: Service models and models of care 29
Outcome area 3: Health workforce 30
Introduction 30
Rural Workforce Incentives (National) 30
Recruiting the right workforce 31
Retaining rural and remote health professionals 32
Rural Generalist Medicine (Queensland) 33
Remote Area Nursing Emergency Guidelines and Training (Victoria) 33
Outcome area 3: Health workforce 34
Outcome area 4: Collaborative partnerships and planning 35
Introduction 35
Enhancing health services in the Pilbara (Western Australia) 36
Local planning 36
Implementation of the Strategy for Planning Country Health Services (South Australia) 36
Building partnerships for healthier communities 37
Healthy partnerships in the Ntaria Aboriginal Community (Northern Territory) 38
Collaborative development of primary health care clinical guidelines (Queensland) 38
Outcome area 4: Collaborative partnerships and planning 39
Outcome area 5: Strong leadership, governance, transparency and performance 40
Introduction 40
Supporting Clinical Governance (Queensland) 41
Credentialing and Scope of Practice for Rural and Remote Districts 41
Continuous Quality Improvement in Primary Health Care 41
Improving accountability and performance 41
Aboriginal Health Key Performance Indicators (Northern Territory) 42
Outcome area 5: Strong leadership, governance, transparency and performance 43
Glossary of key terms 44
References 47
Appendix A: Consultation participation 49
Workshop schedule 49
Participating Stakeholder Organisations: 49
Queensland 49
Victoria 50
New South Wales 51
South Australia 51
Tasmania 52
Australian Capital Territory 53
Northern Territory 53
Western Australia 54
Interviews: 54
Written submissions received: 56