On 18 March 2015 the Alberta Government released its Rural Health Services Review final report. The Board of The Alberta Rural Physician Action Plan (RPAP), provided its comments on the report to the Minister and to the Premier earlier this week.
Regarding the Report’s recommendations, the RPAP Board supported the findings regarding community primary care and the need to evolve community primary care/PCNs in line with the 2014 Primary Health Care Strategy and the recommendations regarding funding models that support accountable, comprehensive primary care. The RPAP Board also supported the thrust of the recommendations regarding specialized services including telehealth as a support to the concept of Close to Home.
Regarding rural surgical/rural operative delivery (C-Section) services, the RPAP Board believes, and the evidence supports this, that these critical specialized services are best delivered in communities of practice or networks of care that include referral hospitals and community hospitals as follows:
“The Networked Model positions surgical care, including operative delivery, as a regional, rather than institutional phenomenon, where small operating rooms are recognized as extensions of core referral hospital programs and therefore care programs can be provided through a well-integrated and balanced surgical team including outreach surgeons and local surgical providers.” (Dr. Robert Woollard, Enhanced Surgical Skills National Steering Committee, April 2015)
Regarding the sustainability of rural communities and specifically recruitment and retention, the RPAP Board is pleased that the Report recognized that there are multiple factors at play:
- What rural Albertans want is access to the right healthcare provider at the right time and this is not always a physician
- That there needs to be better distribution of the health care work force to areas of need
- That better outcomes result when healthcare providers are linked into communities of practice, i.e. are “plugged into” the health care system and function positively together
RPAP, the Board said, will redouble its efforts to engage rural communities not already involved with it to establish and sustain community attraction and retention committees, and it will continue to engage rural communities to assist RPAP with its inter-professional rural medical skills weekends. Rural medical skills weekends are powerful opportunities in which students from a variety of health disciplines visit a rural community to experience rural living and rural practice, and run-through clinical skills with each other and with local providers. This initiative models interprofessional collaboration in a real and substantial way.
In light of RPAP’s existing efforts to promote interprofessional training and recruitment, the RPAP Board said that it looked forward to working with Alberta Health to re-fine its mandate to include province-wide support and coordination for recruiting all rural health care providers.
RPAP overall, the Board said, has been successful by itself and with its partners in addressing the many “moving parts” of practitioner attraction, recruitment and retention. And it will continue its efforts to enhance the collaboration it has with the faculties of medicine and other key partners both in Alberta and across the nation to advance the distribution of well-trained practitioners in Alberta.
Finally, the RPAP Board commended the work of the Government through this review process in identifying and moving to address the identified issues in the Report. RPAP is committed to continue its work with the Ministry to advance rural health care delivery for the benefit of Albertans.