S.TRUEMAN PhD THESIS 2016

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2003; Stanley-Davies & Battye, 2004) model consists of a primary hub site providing a common core of acute services that are complemented by a range of intermittent visiting primary healthcare service providers (teams ‘parachuting’ into the community for a defined regular and periodic service provision). ‘Visiting (periodic) services’ (Booth, 1996; Neville, 1992) are teams of clinicians visiting for a predetermined period, (e.g., a week, 3 or 6 months at a time). FIFO services tend to involve visits for shorter periods than visiting services, but the same service delivery principles apply, for example, for a day or two. ‘Virtual Outreach Services’ includes telehealth and telemedicine (Misan, White, McKenzie & Paskett, 2002; Williams & Giles, 2012). These sub-classifications are not mutually exclusive, but rather can be designed and integrated to meet the needs and circumstances of a remote location. The gap in health funding for remote areas persists (AIHW, 2010). Despite adjustments for remoteness and Aboriginal and Torres Strait Islander populations, there is no adequate formula for adjusting primary healthcare funding appropriately for morbidity and the higher costs of providing services to a highly dispersed remote population (Wakerman, 2015). Accordingly, remote nurses are confronted by patients who have reduced access to primary healthcare, which is reflected in higher compensatory hospitalisations and more potentially preventable hospital admissions with increasing remoteness (AIHW, 2010). Hence, there needs to be focus on prevention and ‘[moving] beyond a focus on specialist medicine and acute care beds, to appropriate generalist skills, team based community care and the training and development of the nursing … workforce’ (Mason, 2013, p. 6). Access to primary (mental) healthcare reduces ‘down-stream’ costs

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