Patterns of resident health workforce turnover and retention in remote communities of the Northern Territory of Australia, 2013–2015

dc.contributor.authorRussell, Deborah J
dc.contributor.authorZhao, Yuejen
dc.contributor.authorGuthridge, Steven
dc.contributor.authorRamjan, Mark
dc.contributor.authorJones, Michael P
dc.contributor.authorHumphreys, John S
dc.contributor.authorWakerman, John
dc.descriptionThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (, which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.en
dc.description.abstractBackground The geographical maldistribution of the health workforce is a persisting global issue linked to inequitable access to health services and poorer health outcomes for rural and remote populations. In the Northern Territory (NT), anecdotal reports suggest that the primary care workforce in remote Aboriginal communities is characterised by high turnover, low stability and high use of temporary staffing; however, there is a lack of reliable information to guide workforce policy improvements. This study quantifies current turnover and retention in remote NT communities and investigates correlations between turnover and retention metrics and health service/community characteristics. Methods This study used the NT Department of Health 2013–2015 payroll and financial datasets for resident health workforce in 53 remote primary care clinics. Main outcome measures include annual turnover rates, annual stability rates, 12-month survival probabilities and median survival. Results At any time point, the clinics had a median of 2.0 nurses, 0.6 Aboriginal health practitioners (AHPs), 2.2 other employees and 0.4 additional agency-employed nurses. Mean annual turnover rates for nurses and AHPs combined were extremely high, irrespective of whether turnover was defined as no longer working in any remote clinic (66%) or no longer working at a specific remote clinic (128%). Stability rates were low, and only 20% of nurses and AHPs remain working at a specific remote clinic 12 months after commencing. Half left within 4 months. Nurse and AHP turnover correlated with other workforce measures. However, there was little correlation between most workforce metrics and health service characteristics. Conclusions NT Government-funded remote clinics are small, experience very high staff turnover and make considerable use of agency nurses. These staffing patterns, also found in remote settings elsewhere in Australia and globally, not only incur higher direct costs for service provision—and therefore may compromise long-term sustainability—but also are almost certainly contributing to sub-optimal continuity of care, compromised health outcomes and poorer levels of staff safety. To address these deficiencies, it is imperative that investments in implementing, adequately resourcing and evaluating staffing models which stabilise the remote primary care workforce occur as a matter of priority.en
dc.identifier.citationBourne, R. R. A., Flaxman, S. R., Braithwaite, T., Cicinelli, M. V., Das, A., Jonas, J. B., … Zheng, Y. (2017). Magnitude, temporal trends, and projections of the global prevalence of blindness and distance and near vision impairment: a systematic review and meta-analysis. The Lancet Global Health, 5(9), e888–e897.
dc.publisherBioMed Centralen
dc.rights© The Author(s). 2017en
dc.rights.holderThe Author(s).en
dc.subjectRemote healthen
dc.subjectRural workforceen
dc.subjectHealth workforceen
dc.subjectRural health servicesen
dc.subjectAboriginal health practitioneren
dc.subjectRemote area nurseen
dc.titlePatterns of resident health workforce turnover and retention in remote communities of the Northern Territory of Australia, 2013–2015en
local.contributor.authorOrcidLookupRussell, Deborah J:
local.contributor.authorOrcidLookupWakerman, John:
Original bundle
Now showing 1 - 1 of 1
Thumbnail Image
399.36 KB
Adobe Portable Document Format
Publisher version
License bundle
Now showing 1 - 1 of 1
No Thumbnail Available
1.84 KB
Item-specific license agreed upon to submission