Dear Rural Surgery Section Members,
It’s nearing two years since the Rural Surgery Section proposed the Rural Health Equity Strategic Action Plan (RHESAP) to RACS Council. Under the great leadership of the Rural Health Equity Steering Committee ably chaired by Councilor A/Prof Kerin Fielding, I’m pleased to note there have been significant strides made since its approval. The latest action to be ratified is that all RACS committee meetings must have rural as a standing agenda item. We hope to have rural representation incorporated into the composition of committees adopted next. It would be an integral step to ensure that rural voices are included in the decision-making process. Several projects implementing deliverables of the RHESAP are also well underway. These include:
The investigation and development of a rural-facing surgical curriculum and evaluation of next steps (with support from the Australian Department of Health and Aged Care STP support project) – more about it below
Asynchronous videocoaching in rural settings (with support from the Australian Department of Health and Aged Care STP support project)
As a follow-up to my presentation delivered at the 2022 ASC Brisbane, this is now a published journal article and can be cited in the latest edition of ANZ Journal of Surgery entitled Rural Health Equity Strategic Action Plan: excellence through equity.
The matter of non-medical surgical assistants has been at the forefront of the Section’s advocacy. This Australian-centric issue arose from the Medicare Benefits Schedule Continuous Review on expanding MBS access to non-medical surgical assistants. Their report recommends that appropriately trained and experienced non-medical surgical assistants (including advanced practice registered nurses, perioperative nurse surgical assistants and nurse practitioners) should be able to claim current MBS items for surgical assistant services.
This is an important issue in rural, regional and remote areas where non-medical surgical assistants have reliably provided assistance under the supervision of rural surgeons for several years when there has been a lack of medically trained surgical assistants. Surgeons are best placed to determine who can surgically assist with reference on the complexity of the procedure, the assistant’s level of competence and available local workforce. Whilst this presents a great opportunity, it must not be supported in circumstances where there is an available pool of medically trained surgical assistants (especially in urban settings), for complex operative cases, and where it might interfere with surgical trainees’ ability to access training in the operating theatre. Working with the relevant stakeholders, RACS can play a significant role in defining what constitutes adequate past experience, and adequate training for a non-medical surgical assistant. More information about the consultation is available on the MBS consultation website. RACS’ submission is available on the RACS website and received input from the Rural Surgery Section, Rural Health Equity Steering Committee and the Health Policy and Advocacy Committee.
I’m thinking of those of you currently affected by the widespread floods, suffering damage to homes or businesses or the impacts of roads still under water or damaged and impassable. Our home and farm are ok, but we are still taking long detours around closures to get to work and out-paddocks and to get the kids to and from school. It’s such a tough time for many rural and urban people and not easy or quick to recover from.
Thank you to Dr Damian Fry for his work and presentation as the Rural Coach at Provincial Surgeons Australia (PSA) Annual Scientific Conference (ASC). Feedback from Trainees and Junior Doctors on his presentation was great. Read the reports in the article below "Reflections from Trainees and Junior Doctors on the PSA".
I encourage you to contact me to let me know about your local challenges or successes in your area. This will allow me to advocate and help where possible or share successes for the benefit of all.
Dr Bridget Clancy MBBS FRACS GAICD