There is an imperative for GPs to develop and acquire new skills throughout their careers in rural Australia, yet current support strategies do not encompass the full range of skills needed to address patient driven needs in rural communities. Investment in the full range of advanced skills, both procedural and non-procedural, is required to meet the complex needs of rural and remote communities.
General practitioners provide person centred, continuing, comprehensive and coordinated holistic healthcare to individuals and their families.1 In a rural or remote context, GPs are often the only available workforce and healthcare is more likely to occur without immediate access to specialist support. The healthcare needs of rural communities shift frequently with changes in policy, infrastructure availability, disease burden and population profile, and GPs must be able to respond and upskill in order to meet the patient driven health needs of their community.
The NRF has recently undertaken widespread consultation and targeted research on advanced skills in rural general practice, the key findings of which provided the basis for the development of this position statement.
Advanced skills in rural general practice
Rural GPs require access to training opportunity, supervision and support in order to acquire and maintain the skills required to safely and confidently address the health challenges experienced by rural communities. Advanced skills training is the mechanism by which GPs can acquire these skills, offered in a range of procedural and non-procedural skill areas. However current workforce policy supporting the acquisition and maintenance of advanced skills reflects a limited understanding of the range of skills needed by rural GPs, focused solely on procedural skills (obstetrics, surgery, anaesthetics and emergency). The provision of procedural services in rural communities is a vital component of healthcare in rural communities; the issue lies in the lack of recognition that these are not the only skills required to address patient need.
Recent research2 undertaken by the NRF demonstrates that the range of skills sought by GPs in order to meet the needs of their rural communities extends well beyond the narrow procedural focus, encompassing a range of non-procedural skill areas. This clarification of skillset, prioritised by the profession, highlights the prominence of non-procedural skill areas such as mental health and chronic disease management in addressing rural health needs. Yet in current workforce policy the acquisition and maintenance of these skills is not equitably supported.
Training and support needs – future and existing rural GP workforce
Training and support requirements differ according to career stage, therefore there must be separate and distinct training strategies in place for the learner and the practising GP. For the learner, a flexible skill acquisition pathway is needed combined with targeted incentives to encourage rural recruitment and retention. Training opportunities for skill acquisition and maintenance opportunity, as well as expanded support strategies which encompass the extended range of skills, are required by the existing rural GP workforce.
Securing a critical mass of doctors with the advanced skills needed to address patient driven health needs in rural communities requires investment strategies and targeted incentives which support the acquisition and maintenance of advanced skills, both procedural and non-procedural. Future workforce and training reform must align with the skill requirements of rural GPs in order to improve health outcomes in these areas.
With over 11,200 members, the National Rural Faculty (NRF) supports and advocates for students, registrars and general practitioners living, learning and working in rural and remote Australia.