Veginadu, Prabhakar

Russell, Deborah J

Zhao, Yuejen

Guthridge, Steven

Ramjan, Mark

Jones, Michael P

Mathew, Supriya

Fitts, Michelle S

Murakami-Gold, Lorna

Campbell, Narelle

Tangey, Annie

Boffa, John

Rossingh, Bronwyn

Schultz, Rosalie

Humphreys, John

Wakerman, John

2024-08-22

Aboriginal Community Controlled Health Services (ACCHSs) in Australia aim to optimise access to comprehensive and culturally safe primary health care (PHC) for Aboriginal populations. Central to quality service provision is the retention of staff. However, there is lack of published research reporting patterns of staff turnover and retention specific to ACCHSs. This study quantified staff turnover and retention in regional and remote ACCHSs in the Northern Territory (NT) and Western Australia (WA), and examined correlations between turnover and retention metrics, and ACCHSs' geographical and demographic characteristics.The study used 2017-2019 payroll data for health workers in 22 regional and remote PHC clinics managed by 11 ACCHSs. Primary outcome measures included annual turnover and 12-month stability rates, calculated at both clinic and organisation levels.There was a median of five client-facing (Aboriginal health practitioners, allied health professionals, doctors, nurses/midwives, and 'other health workers' combined) and two non-client-facing (administrative and physical) staff per remote clinic, at any timepoint. Mean annual turnover rates for staff were very high, with 151% turnover rates at the clinic level and 81% turnover rates at the organisation level. Mean annual turnover rates for client-facing staff were 164% and 75%, compared to 120% and 98% for non-client-facing staff, at clinic and organisational levels, respectively. Mean 12-month stability rates were low, with clinic-level stability rates of only 49% and organisation-level stability rates of 58%. Mean annual clinic-level turnover rates were 162% for non-Aboriginal staff and 81% for Aboriginal staff. Both workforce metrics were moderately to highly correlated with the relative remoteness of clinics, size of regular clients serviced, and average annual headcount of employees in each clinic (p values < 0.01).Participating ACCHSs in remote NT and WA have very high turnover and low retention of healthcare staff. Overall, clinic-level turnover rates increase as distance from regional centres increases and are lower for Aboriginal staff, suggesting that greater employment of Aboriginal staff could help stabilise staffing. Improved retention could reduce burden on ACCHSs' resources and may also support quality of service delivery due to improved cultural safety and continuity of care.

Menzies School of Health Research, Charles Darwin University, PO Box 795, Alice Springs, Northern Territory, 0871, Australia. prabhu.veginadu@menzies.edu.au.

Menzies School of Health Research, Charles Darwin University, PO Box 795, Alice Springs, Northern Territory, 0871, Australia.

Northern Territory Department of Health, Darwin, Northern Territory, Australia.

Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia.

Top End Population and Primary Health Care, Northern Territory Government, Darwin, Northern Territory, Australia.

Psychology Department, Macquarie University, North Ryde, New South Wales, Australia.

Menzies School of Health Research, Charles Darwin University, PO Box 795, Alice Springs, Northern Territory, 0871, Australia.

Institute for Culture and Society, Western Sydney University, Parramatta, New South Wales, Australia.

Poche Centre for Indigenous Health and Well-Being, Flinders University, Alice Springs, Northern Territory, Australia.

Flinders Rural and Remote Health Northern Territory, College of Medicine and Public Health, Flinders University, Darwin, Northern Territory, Australia.

Ngaanyatjarra Health Service, Alice Springs, Northern Territory, Australia.

Central Australian Aboriginal Congress, Alice Springs, Northern Territory, Australia.

Miwatj Health Aboriginal Corporation, Nhulunbuy, Northern Territory, Australia.

Ngaanyatjarra Health Service, Alice Springs, Northern Territory, Australia.

Monash University School of Rural Health, Bendigo, Victoria, Australia.

Menzies School of Health Research, Charles Darwin University, PO Box 795, Alice Springs, Northern Territory, 0871, Australia.

Hum Resour Health . 2024 Aug 22;22(1):58. doi: 10.1186/s12960-024-00942-9.

1478-4491

0000-0002-5723-0996

https://pubmed.ncbi.nlm.nih.gov/39175025/?otool=iaurydwlib

https://hdl.handle.net/10137/13540

Aboriginal Community Controlled Health Services

Aboriginal and Torres Strait Islander peoples

Health workforce

Indigenous health services

Primary health care

Remote health

Retention

Turnover

Humans

Personnel Turnover

Northern Territory

Western Australia

Native Hawaiian or Other Pacific Islander

Health Services, Indigenous

Rural Health Services

Female

Health Workforce

Health Personnel

Primary Health Care

Community Health Services

Male

Patterns of health workforce turnover and retention in Aboriginal Community Controlled Health Services in remote communities of the Northern Territory and Western Australia, 2017-2019.

Journal Article

Publication