Creating an Integrated Care Fellowship in Rural Ireland

This paper outlines the need for developing a new training model for Integrated Care Medical Consultants in rural Northern Ireland, how the model was developed in collaboration with key stakeholders in the community using ECHO methodology, the implementation of the Integrated Care Fellowship scheme and the potential that this model offers for other rural areas where there are medical workforce challenges. Across the world sustaining a medical workforce in rural areas is a challenge. Existing training schemes tend to be based around major population areas and it is often hard to attract consultants to rural areas. In addition, existing training schemes may not be geared to the particular needs of a rural population, and recent changes in the training programmes of both Care of the Elderly and Palliative Care Doctors in the UK has been implicated for a fall off in numbers seeking such training. Through the Pathfinder project key stakeholders across the Western Trust used the ECHO methodology to identify the key priorities that the community living in rural Tyrone and Fermanagh wanted from a health service in relation to the elderly, frail and those needing palliative care services. The findings can be summarised as wanting more integrated and locally connected services. To respond to this and the demographic need of rapidly increasing numbers of elderly and frail people in the population we created an Integrated Care Fellowship training scheme combining the Care of the Elderly Curriculum with that of the Palliative Care Curriculum. The four year fellowship seeks to create a robust consultant workforce equipped with the skills and knowledge to lead the development of a more integrated way of working across the geography and in collaboration with existing assets and supports from both the statutory and voluntary sector to better deliver the care of the future that people in rural areas want. Support for the programme has been demonstrated by the Western Trust, the numbers of applicants for the programme, the quality of those candidates and by existing traditional training scheme leaders.