Ms Amanda O’keefe1, Ms Rebecca  Keeley1

1Top End Health Service, Darwin, Australia


The Allied Health Rural Generalist Pathway is a workforce development initiative that aims to support sustainable and accessible rural and remote allied health workforce models of service. An early career speech pathologist was employed utilising an Allied Health Rural Generalist Training Position to fill a service gap within our health service.
The aim of our project was to establish sustainable models of care for speech pathology services in a rural hospital three hours from a regional centre.
An early career speech pathologist was employed at a regional hospital to establish speech pathology services in the remote hospital 319km away. A range of service models were implemented including telehealth, delegation and education and upskilling of support staff. Activities such as dysphagia nurse screening, modified diet audits, service mapping and establishing speech pathology care pathways were also undertaken.
Established staff at the remote hospital were utilised including an allied health assistant, allied health professionals and nursing staff.
Since commencing the program referrals for speech pathology at the remote hospital have tripled. Pre and post education questionnaires indicated a significant improvement in the knowledge of local kitchen, nursing and allied health staff in the areas of dysphagia and communication.
The Allied Health Rural Generalist Training Position is a valuable resource enabling the establishment of speech pathology services in a remote Australian hospital. Despite the absence of an onsite speech pathologist, a variety of strategies ensured improved processes for managing communication and swallowing difficulties.


Amanda is a speech pathologist and currently the Manager of Speech Pathology at Royal Darwin Hospital and the speech pathology profession lead for Top End Health Service (TEHS). Amanda has spent most of her 20 year career working in various rural health services delivering clinical services to adults. Rebecca Keeley is a speech pathologist currently employed in an allied health rural generalist training position with the TEHS. She is one of the founding group members for Speech Pathology Australia’s Early Career Reference Group, liaising with the organisation on graduate needs where she leads the rural and remote key issue group.

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