www.arhen.org.au

ANNUAL REPORT 2016

ARHEN thanks UDRHs and their students for the photos used in this report.

ARHEN ANNUAL REPORT 2016

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ARHEN ANNUAL REPORT 2016

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ARHEN CHAIRI am delighted to provide this report on the progress and influence of ARHEN. The impact of innovative workforce approaches like the service learning model and the ability of our expanding group of UDRHs to deliver quality learning experiences for students has again been acknowledged by the Department of Health (DoH) and the Australian Government. ARHEN welcomes the recognition of the success of the UDRH program ‘on the ground’ through the 2016-18 doubling of funding for expanded nursing and allied health clinical placements, as well as the proposed establishment of an additional 3 UDRHs. In 2016, UDRHs have been planning how best to use the increased funding to build on the opportunities they provide for students to rectify remote and rural health workforce maldistribution and contribute to the health and wellbeing of Australians in the bush.

I was pleased to welcome the new Assistant Minister for Rural Health, the Hon Dr David Gillespie MP, to the ARHEN Board regional meeting in Whyalla in September. The Minister restated the Government’s commitment to ensuring health students have opportunities to train outside major cities, citing well-accepted evidence that those who train in rural areas are more likely to stay and work there. A highlight of the meeting were the presentations to the Board and Network members by the five Staff Network Chairs. Thanks to all for sharing their ideas, achievements and expertise.

The SA meeting was also a good opportunity to welcome new Board members. The former Greater Green Triangle UDRH has been replaced by 2 organisations - Deakin Rural Health, Victoria, headed by Prof Peter Harvey and Flinders Rural Health SA, headed by Prof Jennene Greenhill. ARHEN also welcomes Prof Ross Bailie who now leads the University Centre for Rural Health, North Coast NSW. I also thank Prof David Lyle who stepped down after serving on the ARHEN Executive for almost 8 years, and welcome new Treasurer Prof Robyn Langham to the role.

I look forward to working with all members throughout another challenging year in 2017. Success depends on effective team work - I thank and acknowledge the critical role of my fellow Directors and the leadership and support of the ARHEN National Office, the services and practitioners we collaborate so closely with and our students.

Professor Sabina Knight

NATIONAL DIRECTOR The ARHEN National Office continued to support the Board and Staff Networks in a busy 2016, with our member UDRHs now funded through DoH’s Rural Health Multidisciplinary Training Programme. The Government’s announcement regarding additional UDRH funding and new UDRHs underlined the valuable profile ARHEN has developed during the past 16 years. Besides the usual advocacy, regular Board meetings at Parliament House have provided important access for MPs and bureaucrats, increasing understanding and support for the UDRH agenda.

During the past three years ARHEN has prepared more than 20 submissions to government about diverse rural and remote health issues impacting on UDRH business, including mental health services, simulated learning, infrastructure needs and continuation of the Rural Pharmacy Liaison Officer Programme. All are part of our vital remit to contribute to national health policy and program development by presenting members’ views and linking and supporting their work across Australia.

I look forward to continuing this work in 2017.

Janine Ramsay

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ARHEN OVERVIEWThe Australian Rural Health Education Network was established in 2001 and is the peak body for 12 University Departments of Rural Health (UDRH) located in every state and the NT. UDRHs seek to expand and enhance the rural and remote health workforce through multidisciplinary education and training, research, professional support and service development.

The ARHEN Board comprises the Directors (or their delegates) of UDRHs. National Office supports the Board and UDRHs at the network level through engagement with the Australian Government and stakeholder organisations.

ARHEN’S APPROACH

VISIONAchievement of better rural and remote health through learning.

GUIDING PURPOSE To lead and initiate the rural and remote health agenda in the areas of education and research.

12 University Departments of Rural Health across Australia.

KEY MESSAGES ARHEN provides leadership in health education, research and innovation. Our key messages are:

1. Teaching. Our clinical placements and teaching provide rich, authentic learning experiences which prepare students for professional practice n distinctive remote and rural settings.

2. Research. Our UDRHs undertake research focused on rural and remote problems and develop and test original solutions including research which may have national and international significance. This research informs the development of accessible and sustainable health services for Australia.

3. Service. Our UDRHs work with their communities to build capacity to respond effectively to the contemporary challenges in rural and remote health.

Broken Hill

Shepparton

Renmark Canberra(ARHEN National Office)

Lismore

Tamworth

Alice Springs Mount Isa

Launceston

Moe

Whyalla

Geraldton

Warrnambool

ARHEN ANNUAL REPORT 2016

OUR ORGANISATION THE ARHEN BOARD 2016

EXECUTIVE

Professor Sabina Knight – Chair. Mount Isa Centre for Rural and Remote Health, Queensland.

Professor Knight has been Chair since 2014. She has an extensive background in nursing, remote and Indigenous primary health care and is a recognized leader in rural and remote health and education and health system reform.

Associate Professor Martin Jones – Deputy Chair. Department of Rural Health, University of South Australia, Whyalla, SA.

Associate Professor Jones has experience leading and developing services for people with a serious mental illness. As well as his current role, he has worked in the UK National Health Service. He has been Deputy Chair since 2015.

Professor Robyn Langham – Treasurer (from September 2016). Monash University School of Rural Health, Victoria.

Professor Langham became Treasurer in 2016. A nephrologist and researcher, she is committed to improving the lives of people in rural communities with kidney disease through research and new models of care.

Professor David Lyle – Broken Hill University Department of Rural Health, NSW.

Professor Sandra C Thompson – Western Australian Centre for Rural Health, Geraldton, WA.

Professor Peter Harvey – Deakin Rural Health, Warrnambool, Victoria.

Professor Jennifer May AM – University of Newcastle Department of Rural Health, Tamworth, NSW.

Professor Jennene Greenhill – Flinders Rural Health, Renmark, South Australia.

Associate Professor Tony Barnett – Centre for Rural Health, University of Tasmania, Launceston, Tasmania.

Professor Ross Bailie – University Centre for Rural Health North Coast, Lismore, NSW.

Professor Lisa Bourke – Department of Rural Health, Shepparton, Victoria.

Professor Tim Carey – Centre for Remote Health, Alice Springs, Northern Territory.

More information about ARHEN is available on our website www.arhen.org.au.

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ARHEN NATIONAL OFFICEARHEN National Office is located at 1 Geils Court, Deakin ACT.

Janine Ramsay – National Director

Jane Smith – Policy and Communications P/T

FUNDING AND GOVERNANCE: ARHEN is funded by UDRH members. ARHEN is a public company limited by guarantee and is taken to be registered under the Corporations Act 2001 in the ACT.

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STAFF NETWORK REPORTS

RURAL PHARMACY SUPPORT– CHAIR: HANAN KHALIL, DEPUTY CHAIR: SELINA TAYLOR. The RPSN met several times in 2016 including a face-to-face meeting in March attended by eight members. Key issues included the extension of work contracts and the review of the Rural Pharmacy Liaison Officer program being conducted by the DoH which began in late 2016. Pending the results of the review, existing RPLO contracts were extended until early 2017. A member of the Network is assisting with the review process. Several members co-authored papers published as a result of a survey conducted by the National Australian Pharmacy Students Association.

MENTAL HEALTH ACADEMICS – CHAIR: KATE SCHLICHT, DEPUTY CHAIR: LEE MARTINEZ Over the past 12 months MHAs have continued cross-UDRH collaborations including projects to evaluate peer worker roles and the psychology 5+1 pathway and piloting and evaluating recovery camps. In particular, the collaboration to write the MHA Rural and Remote Health paper has brought into sharp focus the unique roles that MHAs play in local communities. Sitting at the interface of university and local health services, MHA roles take different forms in different regional contexts, as illustrated in the paper. MHAs are also liaising closely with Primary Health Networks while some are taking positions on Clinical Councils and other committees.

ABORIGINAL STAFF ALLIANCE – CHAIR: PETER FERGUSON, EXECUTIVE: SHARON DENNIS, KATH NADENThe ASA held their annual face-to face meeting in Whyalla, South Australia, in September 2016. Arrival was on late Saturday afternoon with a local cultural visit scheduled for the next day in the Flinders Ranges. Three ASA members, Kimberley, Tahnee and Michael, organised a brilliant day out with a local Traditional Owner who shared many stories about his country in both his Traditional language and English. His telling of his traditions and dreaming stories gave real depth to us gaining some understanding of Aboriginal connection to country. The following day the ASA worked to share our own work histories and issues, forming smaller writing teams to address emerging themes. One team will work on a historical document around the development of the ASA and more broadly about what our major functions include. A more innovative article will be driven by our three young and recently graduated Aboriginal staff from Whyalla addressing important issues around Aboriginal employment in generalist positions within university structures, especially when people have ‘extra’ roles within their home-based communities. The ASA looks forward to producing these papers in the new year.

ARHEN ANNUAL REPORT 2016

SUCCESS COMES IN MANY DIFFERENT FORMS

STUDENT TO LECTURER – UNIVERSITY OF NEWCASTLE, DEPARTMENT OF RURAL HEALTHEmma Bohringer, 30, grew up on the NSW central coast and now lives in rural Tamworth where she works as a lecturer, researcher and dietician.

Emma travelled for several years when she first left school before studying dietetics at the University of Newcastle. She spent her final year at the Tamworth-based Department of Rural Health.

During a four week community placement in her second year, Emma worked with many other allied health and medical students.

“This really helped me learn about and understand what their roles involved and how we could work together as a multidisciplinary team to provide the best outcomes for our patients,” Emma recalled.

“I really valued the support there was from both the dietetics team and UDRH staff. When I wasn’t busy with placement activities, I had lots of opportunities to engage with the community through health promotion activities and programmes. I ended up working with one of the local Indigenous mums and bubs groups for most of the year.”

Emma now works two days a week as an associate lecturer in Nutrition and Dietetics and one day a week as a researcher. The other two days a week Emma works as a hospital-based diabetes dietician.

“It’s a perfect mix of clinical work, research and teaching,” she says. “Sometimes I have to remember what day it is … but it also means I’m not bored!” Emma also loves living in Tamworth.

“I can’t quite put my finger on what it is – but to me it has always felt just right!”

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EXECUTIVE OFFICERS – CHAIR: LEEANNE COONAN, DEPUTY CHAIR: MANDY ROYLEExecutive Officers provide broad support to UDRH Directors across areas including finance and administration, human resources, staff and student facilities and everyday operations. Regular meetings allow the Network to provide a valuable forum for collaboration and information sharing in a changing environment. The need for additional student accommodation continued to be a key issue and EOs coordinated valuable input for ARHEN’s infrastructure bid to the DoH. There was also a focus on changes to RHMT funding and implementing and reporting changes in key performance indicators. The Network will continue its focus on communicating and aligning operations with parent universities’ changing structures and ensuring comprehensive reporting to DoH.

STUDENT PLACEMENT COORDINATION – CHAIR: JOELENE MITCHELL, DEPUTY CHAIR: ANNIE FARTHINGThe SPCN met several times, including a face-to- face meeting in Whyalla in September. Members continued to collaborate and share information and resources such as student handbooks and policies. Key issues included increased demand for student accommodation given requirements for longer placement duration and increased student numbers. Approaches to student supervision were also discussed. Members noted that student placements are increasingly focused on multi-disciplinary approaches and community learning opportunities outside traditional settings. Several members gained valuable research experience participating in ARHEN’s Student Survey Working Group. The group also updated its Terms of Reference to better reflect its work.

ABORIGINAL EDUCATION – UDRH, SHEPPARTONThe University of Melbourne UDRH at Shepparton has a strong commitment to improving Aboriginal education to build health workforce participation in the local community. By providing education access and support, the UDRH is building capacity and empowering community members to improve the health and wellbeing of their own community. The Shepparton programme means Aboriginal students in the region can get a university education without having to leave their community – they continue to live and work in the area while studying.

Several cohorts of students have enrolled in the university’s Master of Public Health programme. Core classes have been brought to Shepparton and video-conferencing used where appropriate . Students have also been assisted with entry into the programme, supported to travel to Melbourne for elective subjects and offered ongoing support, encouragement and tutoring. Three students graduated in 2014 and another six are currently enrolled. For the Shepparton region to have so many Aboriginal health professionals with these vital research, analytical and public health skills empowers and builds capacity within the local community.

MENTAL ILLNESS RECOVERY – UNIVERSITY OF TASMANIA CENTRE FOR RURAL HEALTH Students and staff from the University of Tasmania’s Centre for Rural Health, Launceston, took part in a special camp to help people recover from mental illness in April.

The recovery camp, held in the picturesque Fingal Valley south-east of Launceston, allowed clinical placement students to gain mental health placement hours in a supportive learning environment. Originally designed by the University of Wollongong, the camp was a state pilot, funded through a University of Tasmania grant.

Six students from nursing, social work, psychology and exercise physiology disciplines took part, along with CRH staff and nine community volunteers with a stable, diagnosed mental illness. The camp aimed to increase support and understanding about recovery from mental illness, while also providing inter-professional learning opportunities. The program offered fun, challenging mental and physical activities to promote wellbeing through the involvement of consumers and future health care providers. Outdoor activities focused on teamwork and trust, which students considered provided the turning point of the camp.

There was also a bush dance and choir performance, combined with individual reflections about the camp experience. The camp will be evaluated as an alternative mental health placement experience for students from various health disciplines.

ARHEN ANNUAL REPORT 2016

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Outdoor activities at the mental health recovery camp.

ARHEN ANNUAL REPORT 2016

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2015 UDRH STUDENT SUMMARY

PREAMBLEUnless otherwise specified, figures in the following report refer to domestic undergraduate students who were hosted by the UDRH program for periods of 2 weeks or more. Data for students who undertook shorter placements has not been included. There were some minor discrepancies in student numbers and in quantification of allied health student disciplines from source data for some UDRH resulting in a slight underestimate of proportional representation of allied health disciplines. All averages and percentages have been rounded to one decimal point.

STUDENT NUMBERS 2015Over the 11 year period from 2004 – 2015, the national UDRH program has supported a total 51,833 undergraduate students (Fig. 1).

In 2015 the total number of students supported by the UDRH program was 6,064. Of these 5,375 (93.6%) were domestic undergraduates and 367 (6.4%) were domestic postgraduate students; 301 (5%) undergraduate students and 21 (0.3%) postgraduate students were of international origin.

Compared with 2014, the student cohort grew by 7.3% in aggregate with undergraduate numbers increasing by 6% and postgraduate numbers by 29.8%. Total domestic student numbers increased by 6.3% with domestic undergraduate numbers growing by 5% and domestic postgraduate students by 31.1%.

Figure 1. UDRH undergraduate student numbers 2004 – 2015

3,017 3,071 3,2413,458

3,876

4,3734,607 4,537

4,855 4,8655,121

5,375

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STUDENT WEEKSThe aggregate of weeks for all student placements across the UDRH program in 2015 was 29,950 with domestic students accounting for 28,313 weeks or 94.5% of the total. The total number of undergraduate weeks in 2015 was 27,728 (92.6% of total weeks) compared with 26,673 in 2014, an increase of 4%. Of these, undergraduate domestic students accounted for 26,251 weeks (94.7% of total undergraduate weeks and 92.7% of total weeks) which represented a 2.3% increase over 2014 (25,652 weeks) (Fig. 2).

In 2015, postgraduate placement weeks totalled 2,222 over the period. Domestic postgraduates accounted for 2,062 weeks (92.8% of all postgraduate weeks; 6.9% of total weeks) and international students for 160 weeks (7.2% of all postgraduate weeks; 0.53% of total weeks). As in 2014, the total number of postgraduate placement weeks in 2015 decreased compared with the previous year. The decrease in total postgraduate weeks was 23.7% (2,222 in 2015 cf. 2,914 in 2014). Domestic postgraduate student placement weeks decreased 22.7% (from 2,669 in 2014 to 2,062 in 2015).

Figure 2. Total weeks of undergraduate student placement 2004 - 2015

PLACEMENT DURATIONThe average length of student placement for the 2015 cohort (4.9 weeks) decreased by 5.7% compared with 2014 (5.2 weeks). The average placement length for domestic students in 2015 was 4.9 weeks compared with 5.2 weeks in 2014, a decrease of 6%. For undergraduate domestic students, the average duration of placement was 4.9 weeks and for postgraduates 5.6 weeks, representing a decrease of 2.5% (from 5 weeks) and 41.1% (9.5 weeks) over 2014, respectively. (Fig. 3).

Figure 3. Trend in average duration (in weeks) of student placement 2010 – 2015

ARHEN ANNUAL REPORT 2016

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13,73614,970

16,611 15,74217,351

19,81921,605

19,57921,030

23,82025,682 26,251

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4.64.9

5.1

4.6 4.5 4.5 4.74.3

4.1

4.9 4.95.0

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ARHEN ANNUAL REPORT 2016

STUDENT ACTIVITY BY PROFESSIONAL GROUP Nursing students continued to account for the largest professional group of students hosted by the UDRH program. In 2015, the respective combined (i.e. domestic and international) professional group figures were nursing 43.4%, allied health 33.9% and medicine 17.4%. As a proportion of the total number of domestic students (undergraduate and postgraduate), nursing students accounted for 2,785 students (48.5% of the total), allied health1,919 students (33.4% of total) and medicine 1,038 students (18.1% of total).

Overall undergraduate nursing student numbers increased by 12.9% in 2015 compared with 2014 (2,772 in 2015; 2,455 in 2014). Domestic nursing student numbers increased by 11.6% from 2,353 in 2014 to 2,627 in 2015.

Overall allied health student numbers increased marginally by 0.5% from 1,914 in 2014 to 1,923 in 2015. Domestic allied health student numbers decreased by 1% from 1,820 in 2014 to 1,802 in 2015.

Overall medical student numbers remained relatively unchanged from 2014 with only marginal changes in numbers in 2015 (981 in 2015 cf. 983 in 2014). Similarly, domestic medical student numbers were essentially unchanged (948 students in 2014 cf. 946 in 2015).

Figure 4. Domestic undergraduate student numbers by professional group 2004 – 2015

STUDENT ACTIVITY BY DISCIPLINEIn 2015, the top 5 non-medical / non-nursing disciplines supported by the UDRH program were pharmacy (5%), physiotherapy (4.8%), dental (4.3%), occupational therapy (3%) and speech therapy (3%), collectively accounting for a total of 1,082 students or 20.1% of the total undergraduate domestic cohort and 60% of the total domestic non-medical / non- nursing student number (Fig. 5). The comparative figures for the top five allied health disciplines in 2014 were physiotherapy (6.4%), dental (5.3%), pharmacy (5.3%), occupational therapy (5.3%), and speech pathology (5.3%), collectively accounting for a total of 1,164 students or 22.7% of the then total undergraduate, domestic cohort and 63.9% of the non-medical / nursing cohort. As described in the preamble to this section of the report, minor discrepancies in student numbers as well as missing data for some UDRHs has resulted in a slight underestimate of the proportional allied health representation for some disciplines.

Figure 5: Leading non-medical / nursing disciplines supported by the UDRH program in 2015.

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Medicine Allied healthNursing

48.8%

17.6%

5.0% 4.8% 4.3% 3.0% 3.0% 2.2% 1.9% 1.5%

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5375

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Nursing Medicine Physiotherapy Dental Pharmacy OccupationalTherapy

SpeechPathology/Therapy

DieteticsMedicalRadiation

Unspecified

2,627

946

269 257 234 163 159104118 83

PO Box 242 Deakin West 2600

Phone: 02 6282 2166

www.arhen.org.au