1 Background
1.1 Vision
1.2 Mission
1.3 Values
1.4 Goals
1.5 Stakeholders
2 Strategic environment and opportunities
2.1 Rural Australian Demography
2.2 The Health of Rural Australians
2.3 The Rural Health Workforce
2.4 Technology
2.5 Competitors
2.6 Funding Environment
2.7 Strengths, Weaknesses, Opportunities and Threats
3.1 Priorities 2006 - 2010
3.2 Measures
Chairman’s Introduction
The Rural Health Education Foundation is unique
- The Foundation provides free continuing education television programs to health and medical professionals all over Australia - the only organisation which does so.
- It has developed and manages a dedicated satellite receiving network with more than 660 sites nationwide.
- More than 200 health and medical professional organisations and associations provide comprehensive publicity and promotions for Foundation programs.
- The Foundation has developed a dynamic model for distributing its programs, including a wide range of technologies, services and materials to respond effectively to a growing and evolving audience. This includes broadcasts on both SBS Television and the National Indigenous Television Service (NITV).
- Unlike commercial medical education organisations, the Foundation is a tax exempt, non-profit organisation with Deductible Gift Recipient status, and reinvests any project surpluses and donations into providing additional services.
Our relationships with people are central to our work
We could not do what we do without the valuable help of the rural health professionals and administrators all over Australia who volunteer to support our satellite network receiving sites.
Our work could not be so consistently rated by our audience as high quality, relevant, useful and appropriate without the contribution of Australia’s best health and medical subject experts who participate as volunteer panel members in our programs.
Thousands of rural health and medical professionals use and learn from our programs, providing feedback that the Foundation uses to drive continuous improvements.
The Australian Government Department of Health and Ageing and other long-term sponsors and partners have continuously supported the Foundation and thus have contributed to our achievements over the last fifteen years.
The Foundation’s Board of Directors also supports the work of the organisation through its voluntary service.
The Foundation has become Australia’s health and medical education lifeline to the bush.
Achievements 2003 – 2005
From 2003 - 2005 the Foundation worked to broaden its educational content and connectivity.
Achievements during this period include:
- Providing free continuing education television programs to health and medical professionals all over Australia.
- Gaining accreditation as a continuing professional education provider with the Royal Australian College of General Practitioners (RACGP), the Australian College of Rural and Remote Medicine (ACCRM), the Royal College of Nursing Australia (RCNA), the Pharmaceutical Society of Australia (PSA), the Australian Physiotherapy Association (APA) and other professional bodies on a per-program basis;
- Growing the satellite network by more than 20 percent;
- Developing more than 65 topical, evidence-based programs on a wide range of health and medical subjects that support rural health professionals in delivering culturally appropriate, up-to-date care for acute and chronic issues and to improve the mental, physical and social well-being of rural Australians;
- Expanding the Foundation’s program delivery model to meet our time-poor clients’ needs through the use of web-based technologies as well as widely distributed enduring materials (DVDs and videos).
Achievements since 2006
Since this Strategic Plan was originally adopted in 2006, the Foundation has achieved a number of results, including:
- Producing and widely distributing more than twenty programs each year, over a wide range and including national health priorities;
- Consolidating the Foundation’s position as an important provider of professional development for health professionals working with Aboriginal and Torres Strait Islander peoples;
- Maintaining its accreditation as an education provider with the key health and medical professional organisations;
- Continuing the growth of the satellite viewing network, including a number of high-need and isolated remote and very-remote health services, now at more than 650 sites across Australia;
- Creating funding partnerships with five grant-giving foundations and trusts, which are now supporting the Foundation’s work in key areas;
- Distributing Foundation programs through a number of other television services and thereby substantially expanding the audience and potential audience;
- Producing and distributing an Annual Report;
- Achieving financial sustainability and productivity;
- Delivering papers and making presentations at domestic and selected international conferences, and exhibiting at a large number of professional medical and rural health conferences around Australia; and
- Positioning the Foundation’s Board of Directors and governance structures for new challenges with an amended and updated constitution.
Rural Australian health professionals need accessible and ongoing education to give rural Australians high quality healthcare
There are unique challenges for health professionals in working in rural Australia. Vast distances, inadequate transportation networks and professional isolation are just three. The Rural Health Education Foundation has helped for more than fifteen years. Using modern technology we shrink those distances and help rural health professionals keep their skills up-to-date without having to leave their families, their clients, and the communities who rely on them. The Foundation is making a genuine contribution to improving the health and well-being of rural Australians.
This Strategic Plan 2006 - 2010 guides the development of the Foundation to a new level of service delivery to our constituents - the rural health professionals and their communities, our program partners and our funding partners.
1 BACKGROUND
1.1 Vision
Our vision is a well educated rural health team delivering consistently high quality care for rural Australians.
1.2 Mission
Our mission is to produce and deliver topical, high quality, evidence-based educational programs enriched by the voluntary participation of Australia’s best health and medical experts.
We shrink the vast distances of rural Australia with a national satellite broadcast network, the Internet and other distribution technologies.
We help rural health professionals keep their skills up to date without having to leave their families, their clients, and the communities who rely on them.
1.3 Values
- We recognise that skilled and well-supported rural health professionals are essential to rural and remote communities.
- We interact ethically with our customers and other stakeholders.
- We produce and deliver programs for our customers that are of the highest quality, relevance and usefulness to meet health and medical professional education needs.
- We aim to improve continuously the way we do business, with a particular focus on our core business results and how we achieve them.
- We appreciate our customers’ and other stakeholders’ feedback and we seek and act on that feedback to deliver superior value.
- We respect the valuable contribution made to our programs by Aboriginal and Torres Strait Islander peoples, increasing the programs’ cultural relevance and usefulness for their intended audiences.
1.4 Goals
The Foundation aims to:
- Maintain a customer-centric focus that delivers reliably on what our customers tell us they need from us.
- Ensure that our relationships with volunteers help the Foundation to achieve long term sustainability.
- Achieve long-term financial and organisational sustainability.
- Ensure that our professional networks and alliances with other organisations are beneficial, strategic, complementary and customer focussed.
- Be the leading provider of health and medical distance education to rural and remote Australia.
1.5 Stakeholders
1.5.1 Customers served
The Foundation’s primary customers are the health and medical professionals based in rural and remote locations around Australia. These include:
- Rural doctors
- Nurses
- Pharmacists
- Allied health professionals
- Indigenous health workers
- Academic and clinical undergraduate and postgraduate teachers and students.
- Health service managers, ambulance officers, emergency services personnel, community health workers and other professionals caring for the health and wellbeing of rural Australians.
Ultimately it is the health of rural communities that the Foundation will monitor to guide our activities and measure our progress. Thus we also regard rural Australians as our customers. As resources allow, we will seek to develop versions of some of our programs that will become useful as resources for community workers and community members themselves.
1.5.2 Strategic alliances
The Foundation forms strategic alliances that will contribute to achieving our goals. As well as the Australian Government Department of Health and Ageing, there are a number of other organisations and state, territory and local government departments in Australia with a mandate to improve the health and wellbeing of rural Australians. These organisations already and potentially provide a variety of forms of assistance to the Foundation from funding to program development and distribution. The Foundation recognises that our efforts are enhanced by strong alliances with health and medical professional associations, special interest health organisations, philanthropic trusts and foundations, corporations and individuals.
1.5.3 Volunteers
The Foundation relies on the input of many hundreds of volunteers each year to produce and distribute its programs. Aside from the Foundation’s Board of Directors – all of whom serve in an unpaid voluntary capacity – each year up to 100 medical experts and others participate in our programs, donating their time for payment of small honoraria. The Foundation’s network of volunteer site coordinators – more than 650 of them - is also an essential part of the educational service delivery, and enables the Foundation to maintain contact and communication with rural and remote health professionals throughout Australia.
2 STRATEGIC ENVIRONMENT AND OPPORTUNITIES
2.1 Rural Australian Demography
There are more than six million Australians living in rural and remote regions of Australia. The following table shows the Australian Bureau of Statistics’ demographic distribution of the Australian population.1
| Non-Indigenous | Indigenous | |
| Number (rounded) | 20,000,000 | 450,000 |
| Major Cities | 66% | 1% |
| Inner Regional | 21% | 2% |
| Outer Regional | 10% | 5% |
| Remote | 2% | 13% |
| Very Remote | 1% | 44% |
Females slightly outnumber males in major cities; males outnumber females in the other areas, substantially in some age groups in remote areas. Children are proportionately more numerous in regional and especially remote areas. There are proportionately fewer people aged 25-44 years in regional areas, but proportionally more in remote areas. There is an apparent trend for people over 65 years, (particularly the frail aged) to move closer to the greater health care facilities available in major cities.2
There are fewer than 100,000 health professionals in rural Australia.3
| Occupation | Inner Regional |
Outer Regional |
Remote | Very Remote |
Total |
| Medical practitioners |
6,691 | 2,632 | 349 | 131 | 9,803 |
| Nursing professionals |
36,668 | 15,416 | 2,057 | 918 | 55,059 |
| Enrolled nurses |
5,671 | 3,067 | 440 | 127 | 9,305 |
| Other health workers* |
12,565 | 4,818 | 561 | 147 | 18,091 |
| Total | 61,595 | 25,933 | 3,407 | 1,323 | 92,258 |
* Dental practitioners, pharmacists (approximately 4,500), occupational therapists, optometrists, physiotherapists, speech pathologists, chiropractors / osteopaths and podiatrists.
The Foundation has a satellite network with sites located in every state and territory of Australia, predominantly in public base and district hospitals, medical clinics and community health services. The locations proportionately and generally follow the population distribution. The satellite network also includes sites in more than 50 Aboriginal and Torres Strait Islander health services.
1 Australian Institute of Health and Welfare (AIHW), Australia’s Health 2006, June 2006.
2 AIHW, Rural, Regional and Remote Health, Indicators of Health, May 2005.
3 AIHW, Australia’s Health 2004, Cat. No. AUS 44.
2.2 The Health of Rural Australians4
The health of rural Australians is worse than that of city people. The health of Aboriginal and Torres Strait Islander Australians is worse than that of non-Indigenous Australians. Non-Indigenous Australians are growing older. The Aboriginal and Torres Strait Islander population is younger and growing.
Australians living outside major cities have shorter life expectancy, higher death rates, and are more likely to have a disability compared to city dwellers. This is so even when taking into account the effects of the known poorer health of Indigenous Australians, who make up a greater proportion of the population in regional and remote areas than they do in the cities, and affect health figures in remote and very remote areas in particular. People outside major cities were also more likely to place themselves at a higher risk of poor health: for example, they were more likely to smoke, be overweight and drink alcohol excessively.
4 AIHW, Australia’s Health 2006, June 2006.
2.3 The Rural Health Workforce4
In 2005, the Productivity Commission found workforce shortages across a number of health professions in rural and remote areas5. This analysis looks at the general practitioner workforce and assumes that it shares similar problems with other professional groups.
The ageing of Australia’s population is increasing demand for GP services. GPs are ageing too, and increasingly the GP is a woman. These two factors are leading to a growing tendency to part-time work and training. Most rural workforce agencies anticipate continued worsening discrepancies between the available supply of GPs and anticipated demand for GP services over the next five to ten years, and predict an increased shortage of GPs in rural and remote locations. This will lead to a further reduction in the number of services provided in rural and remote communities, even with some increases in the overall number of medical practitioners and other health professionals.
Newcomers to the GP workforce do not fill the gaps - there is a variable interest in general practice training; and 25% of GPs practicing in rural and remote locations are there because they are compelled to be because of Provider Number legislative requirements or bonding conditions (for overseas trained doctors).
The substantial increase in medical graduates expected from 2009 - 2010 will challenge the capacity of hospitals and training providers to provide adequate support and supervision for interns and trainees. Therefore, a simple increase to the number of medical undergraduate training places will not provide a rural and remote medical workforce solution if these increases are not adequately supported.6
5 Productivity Commission: Australia’s Health Workforce Research Report, Jan-06.
6 RHWA (formerly ARRWAG), March 2006, Doing the Sums: Will there be a future health workforce for rural and remote Australia?
2.4 Technology
Information and communications technologies (ICT) continue to grow in importance in Australia’s economic and social life and new business opportunities for the Foundation will depend on its capacity to develop new ICT-based products and services that improve its ability to connect with constituents on-line. The Foundation has provided constituents with the ability to access its programs through video web-streaming and audio pod-casting. In order to keep pace with current trends in connectivity, it will be necessary to develop the capability to meet all our customer needs, including facilitating online ordering and donations. The Foundation will also use technology to engage more deeply with its customers in the delivery of educational programs.
Satellite television broadcasting will continue to be an important medium for rural health professional education because of limitations in rural and especially remote broadband connectivity that degrade the visual quality of programs when web-streamed. Similarly, video-based education programs are a much stronger medium for community, academic and in-service group training than computer-based programs because there is a marked difference in program quality when comparing the typical health service’s computer set-up (often lacking expensive data projection equipment) versus television access for multiple viewers.
The Foundation has begun to utilise other television services (including SBS TV, the National Indigenous Television Service – NITV, and the NSW Government’s Channel NSW) to distribute its programs. The Foundation anticipates that the full-scale introduction of digital television to Australia will create a number of additional opportunities for distribution of its programs and services, and will closely monitor these for appropriate additional channels.
2.5 Competitors
The Foundation is the only non-profit organisation in Australia that nationally delivers free (to the viewer) television-based professional education to rural health professionals. The Foundation has a number of competitors which target health and medical professionals using a variety of production and distribution methods, and an analysis of the activities of these organisations informs this Plan.
2.6 Funding Environment
2.6.1 Government
The Australian Government has introduced a number of funding and policy initiatives intended to improve the health and wellbeing of rural and remote Australians. This includes direct funding programs as well as significant policy changes in Medicare and a range of health services delivered.
The Foundation continues to operate in a climate of uncertainty with respect to additional significant rural health workforce development funding from July 2008 onwards. At the same time, there are other Commonwealth and state departments with responsibilities for rural Australians’ wellbeing that have not been tapped. The Foundation is in the process of exploring opportunities to develop funding relationships with Commonwealth, state and territory departments with responsibility for policies and programs relevant to families, Indigenous Australians, veterans, education, rural Australia, communications and information technology.
2.6.2 Trusts and Foundations
Philanthropic funding from trusts and foundations continues to increase in Australia, with the tax concessions available to Prescribed Private Foundations encouraging continued growth in the sector. There are a large number of Australian foundation grant makers with an interest in rural issues and Aboriginal and Torres Strait Islanders’ health and well-being. The Foundation has begun to develop a number of good relationships with this sector, and will continue to do so.
2.6.3 Individuals
The capacity and tendency of individuals to give to charitable causes continues to grow, and is valued in the billions of dollars annually in Australia alone. Models of giving also continue to expand, with increasing emphasis on workplace and regular giving and involving people in charitable work as volunteers. The ageing population also has implications for long-term gift relationships, particularly bequests. There is every indication that the Foundation has enormous potential to further tap into the generosity of the health workforce through its extensive networks and contact points with constituents including site coordinators, program participants and viewers.
2.6.4 Corporations
The Foundation continues to build pharmaceutical company interest in sponsoring specific projects or programs. In terms of untied funding, Merck Sharp & Dohme (Australia) Pty Limited has played a key role since the inception of the Foundation and continues to provide annual support. Attraction of further untied or philanthropic funding from corporations provides a challenge. This is because corporate sustainability initiatives are demonstrating an increasing tendency to favour employee involvement as volunteers at the local workplace community level. The Foundation has some limited opportunities to tap into this model through the satellite network. However, this is an area in which the Foundation needs to move forward, by developing initiatives which are attractive to corporate sponsors.
2.7 Strengths, Weaknesses, Opportunities and Threats
As part of its environmental analysis, the Foundation has undertaken an extensive review of its strengths, weaknesses, opportunities and threats and this analysis informs the strategic priorities in this Plan. Highlights are:
Strengths:
- Satellite network mirrors rural population and health workforce demography.
- More than 660 satellite network sites with active site coordinators.
- Extensive program and educational service distribution utilises a number of modes, with very successful digital video and audio distribution via the Foundation’s website, as well as a number of other television services and “enduring” materials (DVDs & videos).
- Income tax exempt, non-profit and Deductible Gift Recipient status.
- Extensive program and operational funding from the Australian Government Department of Health and Ageing.
- Long-term financial and organisational support from major corporate sponsor Merck Sharp & Dohme.
- Accreditation with all key health and medical professional organisations.
- Wide professional networks with strong relationships with more than 200 health and medical associations and organisations.
- Reputation for production and delivery of high-quality educational programs.
- Growing the reach into the workforce delivering services to Indigenous Australians.
- Building staff capacity and monitoring national and international trends by active participation in conferences and forums.
- Committed and capable Board of Directors and staff.
Weaknesses:
- Reliance on unpaid volunteers at satellite network sites.
- Funding not diversified and overly reliant on too few sources.
- High cost of television program production and distribution.
- Relatively small size means that it could be difficult to weather a significant funding downturn.
- Competition from other organisations for top-quality staff.
- The time-poor target audience is sometimes unable to access programs.
- Recent growth has strained financial and administrative systems.
- Lack of accurate data on market needs and preferences.
- Inadequate data on average audience reach for programs.
Opportunities:
- Expand programming to include and provide more for other occupational groups such as dentistry, additional allied health, nursing, optometrists and aged care.
- Expand reach to serve more professionals working in Aboriginal and Torres Strait Islander people’s health.
- Increase direct engagement with customers and constituents.
- Develop sources of funding from individuals, corporations and other government departments.
- Develop and distribute programs for community members and consumers.
- Work more collaboratively with educational institutions.
- Develop linkages with Australian and international organisations operating in the Asia-Pacific region in order to produce and distribute relevant programs.
Threats:
- The large number of organisations working in health and medicine.
- Rapid evolution of technology may require expensive upgrades.
- Confused branding based on historical factors.
3 STRATEGIC PRIORITIES
The Board of the Foundation has endorsed six strategic priorities to take the Foundation to a new level of service delivery and impact in order to meet our long-term goals. These strategic priorities are summarised in the following paragraphs. The Foundation will use the indicators in Section 3.2 to measure its achievements.
3.1 Priorities 2006 - 2010
3.1.1 Customers served
| Increase the Foundation’s reach into key target audiences | |
| 1 | Ensuring quality services through evaluation activities |
| 2 | Determine customer satisfaction with Foundation programming |
| 3 | Develop programs relevant to Aboriginal and Torres Strait Islander Australians’ health needs |
| 4 | Diversify product range, delivery and reach |
| 5 | Develop and maintain the satellite network |
| 6 | Engage with customers more deeply through use of technology |
| 7 | Develop customer relationship management systems |
3.1.2 Volunteer relationships
| Build the Foundation’s relationships with volunteers and other supporters |
|
| 1 | Continue to develop the Foundation’s volunteer relationship processes |
| 2 | Recognise the volunteers’ contributions to the Foundation’s success |
3.1.3 Financial sustainability
| Consolidate and expand the Foundation’s funding base and operations |
|
| 1 | Diversify funding base |
| 2 | Expand revenue generation opportunities |
| 3 | Ensure sound financial administration processes |
| 4 | Achieve financial targets |
3.1.4 Strategic alliances
| Build strategic alliances that help the Foundation produce and disseminate high quality, relevant programs |
|
| 1 | Continue to establish and deepen relationships with key participants in the health industry and other organisations active in rural Australia |
| 2 | Review current strategic alliances and develop policy and plan for future, including vocational medical training |
| 3 | Develop linkages with Australian and international organisations that complement and support Foundation activities, particularly for service delivery in the Asia-Pacific region. |
3.1.5 Market position
| Promote the Foundation’s leadership in educational content quality and delivery |
|
| 1 | Develop and promote the Foundation’s brand |
| 2 | Widen recognition (including brand awareness) of the Foundation amongst key constituencies |
3.1.6 Intellectual capital
| Maximise the intellectual capital of the Foundation’s Board of Directors and Staff |
|
| 1 | Develop the staff in activities that support the Foundation’s growth and effectiveness |
| 2 | Develop the Board of Directors in activities that support the Foundation’s growth and effectiveness |
3.2 Measures
The Foundation will track the indicators in the following paragraphs to assess its progress towards meeting objectives and achieving long-term goals.
3.2.1 Customers served
- Number and content of viewers’ program evaluations received and surveys completed.
- Number of health services working with rural and remote Aboriginal and Torres Strait Islander Australians’ communities and Aboriginal and Torres Strait Islander health organisations that have viewing sites installed or can otherwise regularly access Foundation programs.
- Number of satellite receiving sites and stated unmet demand for more sites around Australia.
- Audience numbers through broadcasts, web-streaming, audio pod-casting, DVD/video distribution and other television services.
- Customer feedback on their preferred viewing methods and educational needs.
- Number and type of programs actively utilised by educational providers for undergraduate, post-graduate and vocational health and medical education.
- Measured perception of the Foundation as the rural health education leader in Australia.
- Tracking, assessment and analysis of reported changes in clinical behaviour by program viewers and users, particularly of those programs developed into active and extended learning modules.
- Utilisation of technology to provide high-quality educational experiences and outcomes.
- Implementation of new customer relationship management database.
3.2.2 Volunteer relationships
- Number and satisfaction of volunteers, including recognition of volunteer efforts to assist the Foundation.
3.2.3 Financial sustainability
- Ratio of funds invested in product development, staffing and market positioning.
- Annual growth rate of gross turnover.
- Annual growth in cash reserves.
- Growth of the Foundation’s passive income (investments and interest-bearing cash accounts).
- Ratio of income and expenditure and their proportions of gross turnover after deducting passive investment income.
- Funding ratio from diverse sources that include government, pharmaceutical companies, health and medical organisation partnerships, foundations, sponsorships, product sales; infrastructure hire, and donations and bequests.
- Annual funding from at least three separate major sources.
- Activities directed to support the achievement of long-term organisational sustainability.
3.2.4 Strategic alliances
- The number, breadth and depth of formal and informal relationships with relevant industry stakeholders.
- The Foundation’s recognition as an accredited provider of outcomes-based education by all relevant practitioner re-certification organisations.
- Perception of the Foundation as the rural health education leader in Australia.
3.2.5 Market position
- Brand research feedback.
- The Foundation’s recognition as a valuable education partner by the health professionals working in Aboriginal and Torres Strait Islander Australians’ health.
- Perception of the Foundation as the rural health education leader in Australia.
3.2.6 Intellectual capital
- Strategic planning is embedded in organisational practice and is periodically reviewed and endorsed by the Board.
- Succession planning and linked professional development plans are in place at Board, CEO and key operational levels.
- The Foundation’s Board members and CEO have the necessary skill-sets, and performance is reviewed annually under the stewardship of the Chair.
- Staff of the Foundation have the necessary skills with annual individual professional development goals appropriate to each stage of the organisation’s development; with individuals’ performance reviewed annually by the CEO or his/her designate.