The challenge
Royal Flying Doctors Service Victoria (RFDS) Victoria is interested in strategic developments to enhance primary care in rural communities beyond its traditional core operations (aeromedical transports and telehealth consultations).
Robinvale is an important bordertown in north-western Victoria with a population of 3313, and only one resident full-time General Practitioner: Dr Jane Neyland, principal of Robinvale District Medical Centre. In late 2021 Dr Neyland approached RFDS Victoria with the idea of transferring ownership of the clinic, as she felt overworked and was at risk of burnout. Dr Neyland has been providing whole-of-community medical services to the Robinvale community through general practice, in residential aged care centre, and in urgent care. Not being able to find a purchaser for the clinic would see it closing, leaving the community with no community medical practitioner.
RFDS Victoria was initially receptive to the idea and felt there may be an opportunity to work more closely with other local providers (including Robinvale District Health Service, Murray Valley Aboriginal Corporation, and the council) to further integrate and expand service provision.
The key challenge for RFDS Victoria was the absence of an existing business case to acquire the clinic, nor a clear understanding of what an expansion would really look like. Larter was engaged to address this challenge and provide data and insights to inform the purchasing decision.
Our approach
Larter developed a business case for RFDS Victoria to purchase and expand this primary care service. The business case addressed RFDS Victoria’s strategic intent – that its primary health services (a) provide multidisciplinary, coordinated care including for vulnerable populations, (b) make extensive use of digital health tools, and (c) consider new kinds of service models to meet community needs.
To progress the work, Larter consultants devised a methodology that would consider four key elements of a business case: operational model, workforce, finances, and innovation/expansion.
Our work to inform these elements included:
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- Local stakeholder consultation – in particular to find opportunities to integrate care with existing providers, and expand care to meet local need
- Developing a budget outlining investment required and breakeven point
- Workforce retention and recruitment strategies
The final business case was presented to RDFS Victoria’s board.
The outcome
The final advice outlined a clear business case for acquisition, and was accepted by the RFDS Victoria Board. The formal acquisition of Robinvale District Medical Centre occurred on 1 May 2023.
This outcome was a resounding success for:
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- (a) the rural community of Robinvale that now has ongoing access to a reliable medical practice
- (b) Dr Neyland is able to continue to practice medicine without the burdens of owning/operating the general practice through a stronger support network of the RFDS
- (c) RFDS Victoria who continues its enviable record of addressing market failure in rural Australia, in new ways.
Larter also recommended specific future expansion opportunities to better meet local community need, such as innovations for providing care to student and migrant populations working in agriculture in the region.
Our work resulted in a model that aligns with RFDS’ primary healthcare strategy, providing them confidence to open similar discussions in other rural towns experiencing, or at risk of, market failure. This would ensure that more people in remote areas can receive the care they need, while RFDS continues to uphold its commitment to providing coordinated care and utilising cutting-edge digital health interventions.
The development of the Robinvale general practice business case delivered both tangible benefits and a sense of pride and confidence for our client.
We engaged Larter to develop a business case that considered the strategic purchase and/or operational management of a rural Medical Centre, with the aim to build a sustainable health service by leveraging existing local experience and infrastructure. Larter swiftly understood the context and key requirements, including the operational aspects of what we wanted to achieve. They were able to provide time sensitive deliverables and responded to all queries in a timely manner. The Larter consultants’ deep understanding of the context of the work and its importance was clearly demonstrated in their exceptional presentation to the RFDS Victoria Board.