Recruitment and retention of rural nurses and allied health professionals

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1 Recruitment and retention of rural nurses and allied health professionals Stanford Harrison, Department of Health and Ageing The Australian Government is committed to ensuring that all Australians continue to have access to high quality health services, and recognises that nurses and allied health professionals are pivotal to Australia s health care system. The Government acknowledges that there are shortages of nurses and allied health professionals in parts of Australia, particularly in rural and remote areas. Accordingly, the Government is making a substantial investment in the education and training of these professionals to ensure that sufficient health services are available to meet the growing needs of the community in the future. This paper will outline some of the Government initiatives that aim to address rural health workforce shortages in Australia. Scholarships The Australian Government funds a number of nursing and allied health scholarships, primarily in aged care and rural and remote areas where shortages are most acute. There is solid evidence that rural students are more likely than their metropolitan counterparts to seek and maintain employment in a rural area after completing their studies. By supporting students of rural background, these programs will help to improve future recruitment and retention of nursing and allied health professionals in rural and remote areas. These programs include: The Nurse Scholarship Program (NSP) Since the program s inception in 1998, more than 3000 scholarships have been awarded. The program is made up of three scholarship schemes: Nurse Scholarship Program: Rural and Remote Undergraduate Scheme. This scheme is available to students who live in rural or remote Australia and are currently undertaking or intending to enrol in an undergraduate nursing course at a rural campus of an Australian university to become a registered/division 1 nurse. Direct-entry undergraduate courses leading to midwifery registration are also eligible. Funding of up to $ per year over three years is available to full time students or $5000 per year over five years for enrolled nurses wishing to upskill to registered nurse on a part-time basis. Nurse Scholarship Program: Continuing Professional Education Scheme For Rural and Remote Nurses. This scheme offers scholarships to registered/division 1 nurses, midwives and enrolled/division 2 nurses to assist with Continuing Professional Education courses, postgraduate study or conference attendance (as presenters or delegates). Applicants must be currently practising in a rural or remote area of Australia. Funding of up to $ is available per applicant. Nurse Scholarship Program: National Nurse Re-entry Scheme. This scheme is for registered/division 1 nurses, midwives and enrolled/division 2 nurses whose registration has lapsed and who have not practised for five years or more. This is a national program that targets both rural and metropolitan applicants. Scholarships are aimed at applicants intending to undertake or currently undertaking an accredited or approved Australian program or course that will enable them to re-enter the nursing/midwifery workforce in Australia. Funding of up to $6000 Page 1

2 is available for each applicant and can include the payment of child care while undertaking the course. Aged Care Nursing Scholarships The Government has invested $62.3m for Undergraduate Scholarships and Post Graduate/Continuing Education Scholarships to encourage more people to enter (or re-enter) aged care nursing, and to increase the skills of nurses already working in the aged care sector, especially in rural and regional areas. Over 1300 scholarships have been offered since 2002 and a further 1000 scholarships will be offered over the next four years. Support for Aged Care Training Program Funding of over $51.2m has been allocated since 2002 to assist aged care services in rural and remote regions of Australia to upgrade the skills of their personal care workers by providing support for training through flexible or distance training programs and to obtain full certificate qualifications. More than personal care workers have received training under the Support for Aged Care Training Program. The Nurse Scholarship Program and the Aged Care Nursing Scholarships are administered by the Royal College of Nursing, Australia (RCNA). For more information on the scholarships, please visit the RCNA s website at: or phone the freecall line Allied Health The Australian Government funds two allied health scholarship schemes to assist students to undertake study in allied health disciplines, or practising allied health professionals to undertake continuing professional development opportunities. Rural Allied Health Undergraduate Scholarship Scheme. The Rural Allied Health Undergraduate Scholarship (RAHUS) Scheme is an Australian Government initiative to assist eligible students with rural backgrounds with the costs associated with attending university. The Government is providing funding of almost $4 million over three years for scholarships under the scheme. This scheme offers up to 65 scholarships valued at $ per annum to students undertaking their first undergraduate or graduate entry-level degree in an allied health discipline leading to clinical practice. Eligible disciplines include Aboriginal health work, audiology, chiropractic, dentistry and oral health, dietetics, medical radiation science, occupational therapy, optometry, osteopathy, physiotherapy, podiatry, psychology and speech pathology. The Australian Rural and Remote Health Professional Scholarship Scheme. The Australian Rural and Remote Health Professional Scholarship Scheme provides scholarships to practising rural and remote allied health professionals to access continuing professional development opportunities, such as formal tertiary postgraduate study, individual clinical placements to enhance and expand on clinical skills, short courses and professional conferences. In the five scholarship rounds to date, over 500 scholarships have been awarded to a variety of health professionals, including physiotherapists, podiatrists, dentists, occupational therapists, speech pathologists, chiropractors, radiographers and optometrists. Both schemes are administered by Services for Australian Rural and Remote Allied Health (SARRAH). More information is available from SARRAH s website: or by calling Mental Health Postgraduate Scholarship Scheme (MHPSS) The Mental Health Postgraduate Scholarship Scheme (MHPSS) is part of the Better Mental Health Services for Australia Additional Education Places, Scholarships and Clinical Training in Mental Health COAG Mental Health package (outlined below), announced in the May 2006 Budget. This measure will provide scholarships for postgraduate studies in mental health nursing and clinical psychology. A total of up to 75 full-time equivalent scholarships will be available annually. Each scholarship will be worth $ per year for each year of full-time study in an approved course. Page 2

3 The scheme aims to improve access to high quality mental health services through an increase in the trained mental health workforce. The first cohort of scholarships will be available for the 2007 academic year. Information and application packages will be available through the RCNA scholarships website in the near future, at University initiatives The Government funds undergraduate nursing and allied health places, and in addition has identified nursing as a national priority in higher education. This priority identification means undergraduate Commonwealth-supported nursing courses are now placed in the lowest band in terms of student contribution. Thirty two Australian Universities offer pre-registration undergraduate nursing courses in 74 locations around Australia. Of these 74 locations, 46 are regional or rural campuses. Through the Council of Australian Governments (COAG) reforms to Australia s health workforce (outlined below) and to address workforce shortages, the Commonwealth Government has announced that it will fund over 1000 new higher education nursing places a year commencing in These places have been taken up by the following universities. Allocation of new nursing places Higher Education Nursing Providers New South Wales Avondale College 56 University of New England 20 University of Sydney 60 University of Notre Dame (Sydney) 40 TOTAL 176 Victoria Australian Catholic University Ballarat 35 Australian Catholic University Melbourne 85 La Trobe University 20 University of Melbourne 50 University of Ballarat 20 Victoria University 40 TOTAL 250 Queensland Australian Catholic University Brisbane 35 Griffith University 20 University of Southern Queensland 50 University of the Sunshine Coast 100 TOTAL 205 South Australia University of Adelaide 10 TOTAL 10 Western Australia Murdoch University 25 University of Notre Dame (WA) 70 TOTAL 95 Page 3

4 Higher Education Nursing Providers Tasmania University of Tasmania 250* TOTAL 250* Northern Territory Australian Capital Territory Australian Catholic University Canberra 50 TOTAL 50 TOTAL 1036 *150 of these places will be offered in Sydney The allied health workforce will also be boosted by the allocation of new health-related places through the Backing Australia s Future measure. Places for 2007 have been allocated as follows: Backing Australia s Future: Allocation of new health-related places Universities New South Wales Charles Sturt University 40 Bachelor of Clinical Science 40 University of Newcastle 118 Bachelor of Biomedical Science 10 Bachelor of Medical Radiation Science (Nuclear Medicine) 20 Bachelor of Medical Radiation Science (Diagnostic Radiography) 15 Bachelor of Medical Radiation Science (Radiation Therapy) 5 Bachelor of Nutrition and Dietetics 10 Bachelor of Occupational Therapy 17 Bachelor of Physiotherapy 8 Bachelor of Podiatry 23 Bachelor of Speech Pathology 10 University of Sydney 90 Bachelor of Dentistry and Bachelor of Oral Health 40 Master of Pharmacy 10 Master of Physiotherapy 20 Master of Speech Language Pathology 10 Postgraduate Clinical Program in Psychology 10 University of Wollongong 30 Bachelor of Health Science 20 Master of Science (Midwifery) 10 TOTAL 278 Page 4

5 Universities Victoria Deakin University 65 Bachelor of Biomedical Science 20 Bachelor of Health Sciences 35 Bachelor of Occupational Therapy 10 Victoria University 20 Bachelor of Health Science (Paramedic) 20 TOTAL 85 Queensland Griffith University 60 Bachelor of Medical Science 30 Bachelor of Oral Health in Dental Science 20 Master of Midwifery 10 Queensland University of Technology 85 Bachelor of Applied Science (Medical Science) 10 Bachelor of Biomedical Science 10 Bachelor of Health Science (Paramedic) 40 Bachelor of Health Science (Public Health)/Bachelor of Applied Science (Human Movement Studies) 25 University of Southern Queensland 20 Graduate Certificate of Indigenous Mental Health and Well Being 20 University of the Sunshine Coast 20 Undergraduate Nutrition and Dietetics 20 TOTAL 185 South Australia Western Australia Tasmania University of Tasmania 25 Associate Degree in Paramedic Studies (note 2 year course) 15 Bachelor of Pharmacy 10 TOTAL 25 Northern Territory Australian Capital Territory TOTAL 573 Page 5

6 On 5 April 2006, as part of the Commonwealth s contribution to the COAG mental health package, the Prime Minister announced additional mental health nursing places and clinical psychology places which will also contribute to the expansion of the health workforce. Places for 2007 have been allocated as outlined below: Allocation of clinical psychology places Universities New South Wales Charles Sturt University 10 University of New England 12 University of Newcastle 6 TOTAL 28 Victoria Australian Catholic University Melbourne 10 Deakin University 21 Swinburne University of Technology 6 University of Melbourne 10 University of Ballarat 5 Victoria University 10 TOTAL 62 Queensland Griffith University 30 Queensland University of Technology 5 University of Southern Queensland 10 TOTAL 45 South Australia University of Adelaide 10 TOTAL 10 Western Australia Curtin University of Technology 5 Murdoch University 15 University of Western Australia 20 TOTAL 40 Tasmania Northern Territory Australian Capital Territory Australian National University 10 University of Canberra 15 TOTAL 25 TOTAL 210 Page 6

7 Allocation of mental health nursing places Universities New South Wales University of New England 20 University of Newcastle 60 University of Notre Dame (Sydney) 20 University of Wollongong 10 TOTAL 110 Victoria La Trobe University 20 Monash University 50 RMIT University 5 University of Melbourne 45 Victoria University 40 TOTAL 160 Queensland Griffith University 20 James Cook University 10 University of the Sunshine Coast 30 TOTAL 60 South Australia Flinders University 40 University of Adelaide 25 TOTAL 65 Western Australia Edith Cowan University 10 University of Notre Dame (WA) 20 TOTAL 30 Tasmania Northern Territory Charles Darwin University 6 TOTAL 6 Australian Capital Territory TOTAL 431 University Departments of Rural Health (UDRH) The UDRH initiative aims to improve the recruitment and retention of rural health professionals and will provide around $17 million in to support the UDRH network. The program was initially announced as part of the Federal Budget, after which seven UDRHs were established. There are now 11 UDRHs across Australia, located in Broken Hill, Mt Isa, Shepparton, Launceston, Whyalla, Geraldton, Alice Springs, Warrnambool, Tamworth, Lismore and Moe. The network has a multi-disciplinary focus and provides medical, nursing and allied health students opportunities to practise clinical skills in a rural environment. It also supports those health professionals who are currently practising in rural settings by providing education and infrastructure, training and support as well as promoting research into rural and remote health issues. Funding also supports teaching and administration activities as well as student placements. Page 7

8 The University Departments of Rural Health support undergraduates in a range of ways, including: the UDRH Mental Health Project that will see the recruitment of a mental health academic at each UDRH. The academic will increase community access to mental health services and ensure other health service delivery professionals in their region are better equipped to recognise mental health problems in individuals and take appropriate action; the availability of accommodation for visiting students undergoing clinical placements during their study. Over the next 18 months the Australian Government will provide an additional $4 million to make it easier for students from a variety of health disciplines and other health professionals to practise their skills in a rural setting. This capital funding for UDRHs will increase accommodation for students, and subsequently open up more rural placement opportunities. the production of the book, Opportunities as vast as the landscape working in rural and remote health, which was published by the Australian Rural Health Education Network (ARHEN) with a grant from the Department of Health and Ageing. This book demonstrates the rewarding options that are available for doctors, nurses and other health professionals in the bush by highlighting the stories of people who have made it their life s work to improve the health services available to those outside Australia s big cities. National Rural Health Network (NRHN) The Australian Government provides funding to support the National Rural Health Network (NRHN), the national body representing 19 university student Rural Health Clubs around Australia. All members (approximately 5000) of these student clubs are members of the NRHN. Twelve of the clubs are attached to medical schools, while seven are made up of allied health and nursing students and based at universities without medical schools. The primary aim of the NRHN is to support and link Rural Health Clubs across Australia. The role of these clubs is to promote the benefit of undertaking rural practice, with a broad emphasis on the multidisciplinary approach to health care delivery within rural and remote communities. NRHN student members have a key role to play in helping address workforce shortages in rural areas by: helping to increase the number of health graduates who choose to practise in rural and remote areas; acting as a voice for health students on rural and remote issues; generating greater exposure and presence for the NRHN; providing ongoing and sustained support and opportunities for health students considering rural and remote careers; professionalising and optimising operations of the NRHN. The contribution made by student members is voluntary; however, it provides students with developmental and leadership opportunities at both the individual club and at national level. Students are funded to attend rural health conferences throughout the year, and may choose to undertake leadership roles within their club, or as a member of the NRHN Council and Executive. Council of Australian Governments The Council of Australian Governments (COAG) is the peak intergovernmental forum in Australia. COAG comprises the Prime Minister, State Premiers, Territory Chief Ministers and the President of the Australian Local Government Association (ALGA). The Prime Minister chairs COAG. Page 8

9 Mental health The Prime Minister announced on 5 April 2006 new Commonwealth funding of $1.9 billion over five years as part of the COAG Mental Health package. These funds were included in the Budget for These new funds are in addition to existing Commonwealth funding and measures previously announced. In July 2006, COAG agreed to a National Action Plan on Mental Health (available online at involving a joint package of measures and significant new investment by all governments over five years that will promote better mental health and provide additional support to people with mental illness, their families and their carers. A major focus of the plan is to build the capacity of the public, private and non-government workforce to deliver services. Governments are undertaking different actions as part of their Individual Implementation Plans. The Commonwealth Government s Individual Implementation Plan includes the following elements: Mental health services in rural and remote areas ($51.7 million) Access to mental health services for people in rural and remote areas will be improved through funding for treatment services provided by appropriately trained allied mental health professionals such as psychologists, social workers, occupational therapists, and mental health nurses. This will be implemented through flexible funding to a Division of General Practice or alternative organisations such as an Aboriginal and Torres Strait Islander primary health care service. Additional education places, scholarships and clinical training in mental health ($103.5 million) Funding will be provided to increase the supply and quality of the mental health workforce. An additional 420 mental health nursing places and 200 postgraduate psychology places each year will be provided as well as 75 postgraduate scholarships to nurses and psychologists, as outlined previously. Mental health competencies and mental health clinical training will be increased across the health workforce, including medicine, psychiatry, nursing, psychology, occupational therapy and social work. Mental health in tertiary curricula ($5.6 million) Funding will be provided to increase the mental health content in tertiary curricula through the development of mental health training modules for registered nurses, including the culturally appropriate management of Indigenous patients, and will provide students with clinical training in multi-disciplinary teams that include allied health, medical and nursing students. Improving the capacity of health workers in Indigenous communities ($20.8 million) Five new scholarships will be provided for Indigenous students undertaking studies in a mental health discipline, and 10 additional mental health worker positions will be created in Indigenous communities. A range of mental health training programs and resources will be provided for the existing Indigenous health workforce to enable them to identify mental illness and assist people to access appropriate treatment. Scholarships will be provided through the existing Puggy Hunter Memorial Scholarship Scheme. Health workforce COAG has agreed to a package of reforms to help ensure that the health workforce is able to respond to the evolving care needs of the Australian community, while maintaining the quality and safety of health services. The Commonwealth s total contribution to the package is in order of $300 million over four years. In April 2006, the Commonwealth announced that it would provide $93 million over four years to fund 1000 new higher education nursing places. The 2007 allocation to individual universities is listed above. In addition, the Commonwealth will provide around $31 million over four years to increase its contribution toward the cost of nurses clinical training from approximately $690 to $1000 a year per full-time student. States and Territories are also undertaking investment to maintain their roles in Page 9

10 attracting, retaining and developing the health workforce. More detail on State and Territory contributions can be found on the COAG website at Presenter Stanford Harrison s professional history covers a range of state and Commonwealth departments. Stanford has been a director in the Health Workforce/Workforce Distribution Branch of the Department of Health and Ageing in Canberra since He is currently Director of Workforce Distribution Programs with responsibility for training and support elements of the Australian Government nursing and allied health programs, with a focus on addressing the workforce shortages in rural and remote regions of Australia. Page 10