Challenges around recruitment, retention, and professional isolation for the health workforce in rural and regional Australia are well documented15. Submissions to the Tripartite Plan from radiation oncology professionals, jurisdictions and peak groups have all highlighted a significant concern around workforce sustainability in regional cancer centres. Submissions stressed that regional radiation oncology centres are currently experiencing difficulties with recruitment and retention of specialist staff in the absence of a planned national approach for regional radiation oncology workforce. The issue is expected to become more acute over the coming decade as new regional cancer centres become operational.
Radiation oncology should learn from the experience of other acute medical services which have a longer history with service provision in rural and regional areas. There have been a number of studies undertaken to identify barriers to ensuring sustainable workforce in rural and regional areas. Research indicates a connection between a number of factors and rural practice, which affect recruitment and can be summarised as follows16-26:
- Rural and regional origin;
- Partners of rural origin and other family considerations;
- Professional background and career plans at the time of admission to medical school;
- Long term earning potential;
- Professional development opportunities;
- Availability of quality primary and secondary education; and
- Rural undergraduate and post graduate training experience.
At present, radiation oncology workforce training is necessarily concentrated in metropolitan centres. This may have an impact on the availability of workforce to staff regional cancer centres27. It is therefore pivotal that training is extended to rural and regional locations. However, this must be done in a sustainable and clinically appropriate way, so as not to compromise patient care and to ensure appropriate level of training and supervision.
Workforce planning for rural cancer centres must ensure comprehensive care inclusive of expert radiation oncology nurses, all allied health groups and psycho-oncology professionals, in addition to access to multidisciplinary medical teams.
Retention of skilled workforce in regional and rural areas similarly requires a proactive approach and planning. There are personal, professional and service-related considerations that play a part. Consultation findings suggest that these considerations in radiation oncology include:
- Level of workload;
- Quality of service and the availability of modern techniques and technologies;
- Incentivised payment structure for staff;
- Access to and ability to participate in clinical trials and research;
- Professional development opportunities (such as conference attendance); and
- Career progression opportunities.
Building a sustainable regional workforce in radiation oncology requires a calculated approach, which takes into account service expansion, current capacity to train new workforce and incorporates strategies to make regional facilities attractive to work in.