Health NZ intends to rapidly establish bespoke Rural Telehealth Services (RTHS) that could alleviate the pressures on rural general practices and enhance rural community access to primary care services. 

Health NZ and the Māori Health Authority (MHA) recognise that Rural General Practice sustainability has been severely challenged through the impact of:

• Long term rural health workforce stressors across all rural health professions
• Relentless demands caused by 2.5 years of pandemic response
• Unsustainable rosters for PRIME and urgent care services
• Poor alignment of rurally adjusted funding to the realities of providing 24/7, comprehensive health services for geographically dispersed populations many of whom also experience significant seasonal fluctuations in numbers.

The RTHS could span both planned and un-planned service needs including:

• Telehealth locum GP
• In-clinic, afterhours, at home, urgent care
• Shared care with GP, patient, and telehealth specialist
• GP adjunct to nurse or other practitioner led services
• GP triage for PRIME and afterhours, and/or, backup to a paramedic or nurse attending an accident or medical emergency
• Telehealth consultations for overflow on the day of service
• Telehealth afterhours GP service.

Early thinking about the RTHS coincided with the launch of Hauora Taiwhenua Rural Health Network held in Wellington on 28 June 2022. Health NZ took this opportunity to discuss and explore the RTHS with 80 rural health experts in an afternoon workshop. Workshop participants received a preview of the rural component of the interim NZ Health Plan that assured them the RTHS would not proceed at the expense of key priorities, including workforce development and a review of rural afterhours, PRIME and Urgent Care services.

The Rural Telehealth Service project will be overseen by a National Steering Group that includes HNZ, MHA, Hauora Taiwhenua, and experts from a range of rural organisations and perspectives. This group will ensure it aligns, and leverages learnings and resources of related initiatives and programmes and will have technical expertise to advise it on.

Engagement with individual and groups of Rural General Practices (as defined by them as participating services) will inform a phased roll out of the RTHS that will:

• Cover a range of community settings and demographics, levels of rurality, and local ‘readiness’ to implement a RTHS
• Enable a continuous quality improvement approach
• Inform and enhance the subsequent tranches of service implementation
• Ensure sustainable development of service capacity.

Locally based working groups will:

• Co-design bespoke solutions for their defined areas of need
• Oversee the establishment and uptake of the service in their geographic region
• Monitor service impact on defined areas of need and agreed outcomes.

This initiative is one that can be implemented in an accelerated timeframe and anticipates a more comprehensive programme of rurally focussed initiatives that are outlined in the soon-to-be-released interim NZ Health Plan. It will leverage the increasing capability and acceptance of telehealth services by both patients and practitioners to move quickly to alleviate identified pressures in rural general practice.