Allied Health Rural Generalist Pathway in South Australia: benefits, challenges and recommendations

Introduction
Rural allied health professionals (AHPs) provide essential and wide-ranging services to consumers. AHP recruitment and retention is challenging in rural and remote areas, with workforce challenges a key barrier to rural consumers receiving consistent, quality, timely and accessible services.
AHPs come to rural and remote areas for a variety of reasons and a range of retention strategies are used in Australia, but most leave within the first 3 years of practice.
The Allied Health Rural Generalist Pathway (AHRGP) is one workforce strategy that was established to support early career AHPs to develop rurally relevant specialist skills across clinical areas, support career progression, and develop relevant quality improvement and project management skills.
In 2019, South Australia introduced the AHRGP for the first time with an initial cohort of 12 early career rural AHPs across regional local health networks (LHNs). Selected AHPs were from occupational therapy, physiotherapy, podiatry and speech pathology professions. The trial incorporated a funded evaluation in partnership with Flinders University, with objectives including:
1.To explore the experience of undertaking the AHRGP and the impact it has on trainees, teams, organisations and the consumers they work with.
2.To make recommendations for the sustainability of the pathway and to further improve workforce outcomes for rural and remote health services.
Method
A mixed methods approach was used. Fifteen AHRGP trainees and twenty-five of their supervisors, line managers and principal clinicians, 3 project leads and 5 consumer representatives were recruited to share their experiences and perspectives of the pathway. In-depth interviews were conducted with all participants pre and mid pathway, and consumer representatives participated in a focus group. Qualitative and quantitative results were analysed separately and reported together to comprehensively explore experiences and impacts.

Results
Phase one and two interim research findings include:
-The AHRGP is giving early career AHPs the opportunity for broad skill development and career progression
-Perceptions of trainees’ confidence and competence improved during the pathway
-Most trainees found the training to beneficial but some found aspects of the course not relevant to their caseload and learning needs
-Regular, quality, accessible clinical supervision and manager support is vitally important for AHPs to feel supported to participate in the pathway
-Rurally raised trainees were more likely to stay in rural areas than those raised in metropolitan areas
-Workload and organisational pressures in teams may contribute to trainees leaving earlier than they had planned.
Impact/Conclusion
Results and recommendations from the pre/midway evaluations provided background evidence to support additional funding for a second cohort of regional LHN trainees commencing the pathway from 2021. Early evaluation outcomes and a reflection on the 2019 cohort recruitment/selection was used to adapt recruitment/selection of the 2021 cohort. Insights gained into early positive outcomes and challenges experienced by the 2019 group is also being used to improve supports for the both training cohorts. Outcomes from the 2021 cohort will be closely monitored.