The Wobbly Hub and Double Spokes (WH&DS) project was funded by the National Health and Medical Research Council as a partnership between researchers at the Faculty of Health Sciences, University of Sydney: Professors Craig Veitch, Michelle Lincoln and Anita Bundy and University of Western Sydney, Dr Gisselle Gallego, and New South Wales (NSW) Family and Community Services, Ageing, Disability and Home Care (ADHC) Western Region.
The project aimed to develop, implement and evaluate new models of therapy service delivery for people with a disability living in rural areas.
Rural services are traditionally delivered via a ‘hub and spoke’ model whereby services are grouped in larger regional town ‘hubs’ and delivered via outreach to remotely located ‘spokes’. Under this model, the spokes should bring service providers closer to service users, reducing travel time and costs and increasing service providers’ knowledge of and connection to the community. Meanwhile, the hub was situated in a large enough centre to support service providers administratively and professionally while fostering collegial relationships. The Wobbly Hub and Double Spokes project name was coined by one of the regional therapists who described the then model of therapy service delivery in western NSW as consisting of a loose collection of multiple hubs (wobbly) connected by numerous (double) spokes.
For more information about the development of the project, please read our publication Integrating evidence into policy and sustainable disability service delivery in western New South Wales, Australia: the ‘wobbly hub and double spokes project’ published in BMC Health Services Research.
Stages of the Project
Stage 1 involved literature searches, policy document review and interviews with senior government and non-government managers. The purpose of this initial stage was to develop a thorough understanding of the context within which therapy services were delivered in western NSW.
Stage 2 involved the collection of data about the delivery of therapy services from people living and working in western NSW. Focus groups and interviews were conducted with service providers (including but not restricted to therapists), carers and people with a disability. The purpose of this stage was to hear from people ‘on the ground’ about their experience of therapy provision both from a professional and personal viewpoint.
This qualitative data was used to develop questions to be included in two surveys. The first survey was sent to therapists working in western NSW to ask about issues related to current and preferred retention strategies. The second survey was sent to carers of people with a disability to ask about current and preferred access to therapy.
Analysis of the qualitative data also fed into the development of a Rural and Remote Person-Centred Approach which informed the implementation of four rural and remote pilot projects funded by ADHC WR to trial place-based and technology-assisted therapy service delivery models. The Wobbly Hub team are involved in the evaluation of these pilot projects.
The next stage of the project involved the translation of the research findings into policy that supports the delivery of therapy services to rural people with a disability.