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Introduction: The COVID-19 global pandemic has been a significant challenge worldwide. This has been particularly so in rural and remote communities where largely metropolitan-based policies do not translate into the rural context. Western NSW Local Health District (Australia), a region spanning almost 250,000 km2 (slightly larger than the UK), has implemented a networked approach that spanned public health measures, acute care services and psycho-social supports for rural communities., Method: A synthesis of field observations and experiences in planning and implementing a networked rural approach to COVID-19., Results: This presentation reports on the key enablers, challenges and observations in operationalising a networked, rural-specific, 'whole-of-health' approach to COVID-19. As of 22 December 2021, the region (total population 278,000) had confirmed over 112,000 cases of COVID-19 across some of the state's most disadvantage rural communities. This presentation will provide an overview of the framework used to address COVID-19, including descriptions of the public health response, specific care needs of those with COVID-19, cultural and social support for vulnerable peoples and an approach to keeping the community well., Discussion: Responses to COVID-19 need to be 'rural proofed' to ensure that the need of rural communities can be met. Acute health services must leverage a networked approach that supports existing clinical workforce through effective communication and developing rural-specific processes to ensure best practice care can be delivered. This includes utilising advances in telehealth to ensure people can access clinical support when diagnosed with COVID-19. Managing the COVID-19 pandemic across rural communities requires 'whole-of-system' thinking and strengthening partnerships to manage both public health measures as well as an acute care response.

Introduction: Recruiting and retaining a highly skilled medical workforce in rural and remote communities is challenging1,2. In Western NSW Local Health District (Australia), a Virtual Rural Generalist Service (VRGS) was established to support rural clinicians in providing safe and high quality care. The service leverages the unique skillset of rural generalist doctors to provide hospital-based clinical services in communities without a local doctor or where local doctors request additional support., Method: Presenting observations and outcomes during the first 2 years of operationalising VRGS., Results: This presentation reports on the success factors and challenges in developing VRGS to supplement face-to-face care in rural and remote communities. In its first 2 years, VRGS has provided over 40,000 patient consultations across 30 rural communities. The service has delivered equivocal patient outcomes compared with face-to-face care and has been COVID-19 resilient during a period where existing fly-in-fly-out workforce has been unable to travel due to border restrictions in Australia., Discussion: Outcomes of the VRGS can be mapped to the quadruple aim3, focusing on improving patient experience, improving the health of populations, increasing the effectiveness of healthcare organisations and ensuring sustainable health care into the future. The findings described regarding VRGS can be translated to support both patients and clinicians in rural and remote settings worldwide.

Introduction: Across Australia, providing sustainable primary care services in small rural communities (<1000 population) has been increasingly challenging. It is acknowledged that health system planners must take coordinated action to strengthen systems to enable a community-empowered response to such challenges. In partnership with the Australian Government, Collaborative Care is a whole-of-system approach used in five Australian rural sub-regions to align communities, organisations, policy and funding levers with a common purpose in health workforce and service planning (article here)., Methods: A synthesis of field observations and experiences of community and jurisdictional partners in planning and implementing a Collaborative Care model., Results: In this presentation, we report on the success factors and challenges in developing models for improved rural primary health care access. Successes include sustained community participation, improved community health workforce literacy, coordination of stakeholders and resources across health and community systems combined with health service planning expertise. Challenges include the time and investment to build a coordinated partnership approach and in identifying mechanisms for ongoing financial sustainability., Discussion: Including community as a partner in design and implementation is a key enabler for achieving a tailored primary health workforce and service delivery model that is acceptable and trusted by communities. The Collaborative Care approach strengthens community through capacity building and integrating existing resources across both primary and acute care services to achieve an innovative and quality rural health workforce model built around the concept of rural generalism. Identifying mechanisms for sustainability will enhance the usefulness of the Collaborative Care Framework.