The purpose of this document is to provide a consolidated report on the findings of the external review of the National Rural Locum Program (NRLP). The NRLP comprises the Specialist Obstetrician Locum Scheme (SOLS), General Practitioner Anaesthetist Locum Program (GPALS) and the Rural General Practitioner Locum Program (RGPLP).
Communio was contracted to undertake an external review of the NRLP to assess the appropriateness, effectiveness and efficiency of the three programs, in supporting the Australian Government’s aim to provide Australians living in rural and remote areas with access to quality health care. A two stage process was implemented with:
- Stage 1 concentrating on SOLS and GPALS, using program data up to 30 June 2010
- Stage 2 on all three programs using program data up to 31 December 2010.
Communio has used a triangulated approach to draw robust conclusions from the review, noting that no single data source would be sufficiently comprehensive.
Data from a range of sources including the academic and grey literature, online resources, stakeholder consultation, and program data has been reviewed.
Approaches were made to a range of stakeholders in order to gather a wide diversity of views. Stakeholders included individuals from peak bodies, as well as a number of obstetricians and anaesthetists, both those who have used the NRLP schemes and those who have not. A total of 22 interviews were conducted. A list of stakeholder is provided at Attachment 1.
A brief literature scan and a review of a range of relevant web sites were also undertaken to inform the review. The result of the literature scan is at Attachment 3.
The Australian Society of Anaesthetists (ASA), the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG), the Australian College of Rural and Remote Medicine (ACRRM) and the Royal Australian College of General Practitioners (RACGP) distributed an electronic survey to their membership/fellows as part of the review process. The aim of the electronic survey was to extend the reach of the consultation, and to seek the views of stakeholders including hosts, locums and those who have never used any of the programs. A total of 244 responses were received. An analysis of the electronic survey and a copy of the survey are provided at Attachments 5 and 6 respectively.
Twenty rural hospitals with active operating theatres were also contacted and sent a specific survey. A further 10 hospitals were contacted and were either unavailable to participate in the survey or no longer provided operating theatres. The GPALS Rural Hospital Survey is provided at Attachment 7.
Site visits with hosts from the various programs were also planned. However, due to tight schedules for the doctors concerned, surveys and email correspondence were used instead.
The following section of this report provides contextual information about the demographics of the rural and remote workforce. This is followed by an overview of the three programs, an analysis of the appropriateness, effectiveness and efficiency of the NRLP and a summary of key findings.
Attachments 1, 2 and 3 provide further detail on the method of the review, including a list of consultations, results of the web site review and the brief literature scan. Further attachments expand and provide background information relevant to the discussion in the body of the report, including a full analysis of the survey results provided as Attachment 5.