Research into rural health professionals’ skills

31st October 2019

Rural communities set to benefit from research into rural health professionals’ skills

Sarah Walker knows first-hand what it takes to be a practising physiotherapist in a rural community, and now she aims to determine whether rural allied health professionals in New Zealand require fundamentally different skills to their urban counterparts.

Walker has just been awarded a $204,000 Clinical Research Training Fellowship from the Health Research Council of New Zealand (HRC) to investigate the scope of practice, challenges and complexities experienced by rural allied health professionals.

She describes it as a first step in addressing the skills shortage in rural areas and reducing the ‘huge disadvantages’ faced by rural communities when it comes to accessing healthcare.

“Of all the geographic categories, New Zealand’s rural towns have the lowest socioeconomic status, highest proportion of Maori, and highest avoidable mortality rates,” says Walker.

Yet despite the higher health needs, rural residents have poorer access to health services and greater costs in accessing these services, which is largely due to workforce shortages in rural areas.

Currently in New Zealand, only 3 per cent of physiotherapists hold an annual practicing certificate to work in rural areas, and a similar pattern is repeated across a number of health professions, she says.

As well as not having a large presence in rural areas, health professionals from all disciplines in rural areas have been found to sustain a heavier workload and carry a higher level of clinical responsibility as a result of carrying out a wider range of services.

In Dunstan Hospital, where Sarah works for Central Otago Health Services, she’s required to treat acute in-patients and carry out rehabilitation both in hospital and in homes. “It’s the complexities that you get – rural hospitals don’t have specialist neuro-physiotherapists, or physios that have an interest in respiratory conditions – we have to take up those roles for ourselves.”

To date, there is no recognition of the ‘rural generalist’ skillset required, says Walker, nor are there rural-specific career-pathways for allied health professionals.

Her research will help determine if there’s a need for a distinct area of specialty within rural allied health and a need for extra support and training, to ensure that rural communities are provided with a skilled and relevant health workforce to meet their needs.

“When you consider the disparities in health needs and socio-economic standards in rural areas, it feels remiss to further disadvantage those communities by not providing health professionals that are experts in providing treatment for that population,” says Walker.

“Rural communities have been left behind, which I guess is partly because of the general New Zealand rural attitude that we just band together and get it done. But it’s not necessarily fair or necessarily right, and it could definitely be better.”

The HRC Fellowship will help Sarah Walker complete her PhD at the University of Otago. She is one of 67 researchers selected for funding in the HRC’s 2020 Career Development Awards announced today. The awards help foster and sustain New Zealand's health research workforce, and this year more than $13.4 million was awarded to researchers in clinical and academic roles, including Māori and Pacific health researchers.

These awards play a critical role in building capability and capacity in our research workforce, says the HRC’s acting chief executive Dr Vernon Choy. He says Sarah Walker’s proposal was notable, not only as it would establish her as New Zealand’s only rurally-based clinical academic physiotherapist but for its potential to inform future development and training of the rural health workforce.

“There’s increasing recognition of the health disparities within rural communities, and a clear goal of the HRC is to reduce inequities where they exist in New Zealand. We expect this research will contribute much-needed knowledge and evidence towards future rural health initiatives.”

See below for the 2020 Career Development Award recipients (in the General category). To read lay summaries of the research proposals (once the embargo is lifted) go to www.hrc.govt.nz/funding-opportunities/recipients and filter for ‘Career Development Awards’ and ‘2020’. For our Māori Career Development Award recipients, filter for ‘Māori Health Research’ and ‘2020’; for Pacific Career Development Award recipients, filter for ‘Pacific Health Research’ and ‘2020’.

2020 HRC Career Development Awards

General & Advanced Fellowships

Clinical Practitioner Research Fellowship

Dr Malcolm Battin, Auckland DHB Charitable Trust

Improving care and outcomes for babies at risk of brain injury

60 months, $823,756

Dr Craig Jefferies, Auckland DHB Charitable Trust

Improving outcomes for children and adolescents with diabetes

60 months, $896,261

Clinical Research Training Fellowship

Dr Scott Bolam, The University of Auckland

Understanding and treating obesity’s harmful effects on rotator cuff healing

36 months, $315,618

Ms Esther Calje, The University of Auckland

Optimising the care and outcomes for women with severe postpartum anaemia

36 months, $315,174

Dr Emme Chacko, The University of Auckland

Mindfulness-based cognitive therapy for family carers of people with dementia

48 months, $319,802

Dr Charlotte Chen, The University of Auckland

Understanding dyspnoea and exercise limitation in interstitial lung disease

36 months, $316,975

Ms Louise Fangupo, University of Otago

Does a sleep intervention reduce weight gain in infancy? A novel approach

36 months, $320,000

Dr Amanda Landers, University of Otago, Christchurch

Evaluating a model of care for patients with COPD in their last year of life

36 months, $319,850

Dr Karen Oldfield, Medical Research Institute of New Zealand

The Use of Cannabis as a Medicine in New Zealand

15 months, $129,933

Dr Matt Richardson, University of Otago

Nocebo Hypothesis Cognitive Behavioural Therapy (NH-CBT): an RCT

36 months, $320,000

Dr Peter Russell, The University of Auckland

The Role of Oedema and Lymphatic Dysfunction in Critical Illness

34 months, $281,630

Mrs Sarah Walker, University of Otago

Supporting Allied Health Professionals in Rural Areas

36 months, $204,586

Dr Michael Tzu Min Wang, The University of Auckland

Exploring the diagnostic methodology and epidemiology of dry eye disease

24 months, $212,036

Dr Melanie Woodfield, Auckland DHB Charitable Trust

Implementing Effective Treatments: Parent training for conduct problems

48 months, $320,000

Foxley Fellowship

Dr Josh Faulkner, Auckland University of Technology

The Role of Psychological Flexibility in Recovery following a Concussion

24 months, $98,232

Sir Charles Hercus Health Research Fellowship

Dr Nicholas Fleming, University of Otago

Rational extension of immunotherapy in colorectal cancer.

48 months, $600,000

Dr Christoph Goebl, University of Otago, Christchurch

Understanding the role of the aryl hydrocarbon receptor in cancer

48 months, $587,351

Dr Natasha Grimsey, The University of Auckland

Novel strategies to harness therapeutic potential of CB2 in the immune system

48 months, $565,312

Dr June-Chiew Han, The University of Auckland

Vulnerability of the female heart

48 months, $593,057

Dr Muhammad Hanif, The University of Auckland

Tickling Cancer Cells to Provoke an Antitumour Immune Response

48 months, $580,348

Dr Rachel Purcell, University of Otago, Christchurch

Molecular mechanisms and the gut microbiome in CRC

48 months, $598,972

Dr Hayley Reynolds, The University of Auckland

Precision cancer treatment using predictive software and imaging biomarkers

48 months, $469,821

Dr Jie Zhang, The University of Auckland

Adult stem cell treatments for corneal endothelial diseases

48 months, $575,742

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