Partnership factors enabling co-planning of sustainable rural health models

Background Strong partnerships are the cornerstone for effectively co-planning primary healthcare models that meet community needs, however, there are few examples specifically for rural areas where smaller health services cover a dispersed population and wide geography with limited resources (thin markets). This study aimed to explore the partnership factors enabling the co-planning of sustainable rural health models in thin markets. Methods A qualitative study drawing upon in-depth focus groups with eight partnership members covering a combined estimated resident population of 24,620 people across three local government areas with small rural towns (<5000 population) was undertaken. Verbatim transcripts were thematically analysed. Results The overarching theme was that the partnership was valued and should continue. Four sub-themes included: the importance of the skilled and independent project lead to coordinate co-planning, the leadership and commitment of rural health service executives, strength and fragility of the project in the face of limited resources and staffing changes, and the importance of trust and relationships. Conclusions The research suggested that partnerships for co-planning of sustainable rural health models in rural thin markets are important. Independent and skilled leadership can assist small rural health services to engage with co-planning. This context also relies on committed rural health service executives who pay attention to building relationships and trust. Partnerships within this context are likely to be dynamic and require executives to spend time together to understand the range of problems and potential solutions as conditions change. With attention to these partnership factors, work on sustainable rural health models can be maintained.