Grampians Health: The Integrated Health Service Covering Western Victoria

Grampians Health, the integrated health service formed from the merger of Ballarat Health Services, Wimmera Health Care Group, and East Grampians Health Service in 2022, is one of the largest regional health services in Australia by catchment area and one of the most geographically challenging, serving a population of approximately 250,000 people spread across the 60,000 square kilometres of western Victoria from the Pyrenees in the east to the South Australian border in the west. The merged organisation's scale provides the administrative and clinical efficiency benefits that consolidation offers and the challenges of maintaining service quality and staff engagement across the dispersed sites and the diverse communities that the western Victorian health system encompasses.

Ballarat Base Hospital, the principal acute hospital of Grampians Health and one of the largest regional hospitals in Victoria, provides the Level 4 trauma and the specialist services that the western Victorian catchment depends on for the most complex medical needs that the smaller hospitals in Horsham, Ararat, and the surrounding towns cannot manage locally. The hospital's emergency department, serving both the Ballarat population and the ambulance transfers from the broader western Victorian region, manages the emergency workload that a regional referral hospital of its scale generates.

The mental health services of Grampians Health, including the psychiatric inpatient facilities and the community mental health teams that provide the outreach support to the rural and remote communities of the catchment, address the mental health burden that the agricultural community's economic pressures, the drought and flood cycles, and the geographic isolation generate. The challenges of providing responsive mental health services to a catchment of 60,000 square kilometres, where the distances between the major service centres and the outlying communities create access barriers that the service must bridge with the outreach teams and the telehealth platforms that technology enables, define the operational challenge of rural mental health provision in the Australian context.

The workforce strategy that Grampians Health pursues to attract and retain the clinical staff that the merged organisation requires across its multiple sites, including the rural health scholarships, the relocation assistance, and the career pathway programs that make the regional health career attractive to clinicians who might otherwise work in metropolitan settings, is one of the most consequential management challenges that the organisation faces. The workforce supply constraint in rural and regional health is the most consistent limiting factor in the quality and the safety of rural health services across Australia.

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