nor is it ideal to rely on flying medical practitioners in and out of remote communities as this is a costly way to provide health services and does little to promote continuity of patient care as discussed later in this chapter overcoming resistance to change and the more strategic use of local health professionals already living in these communities will be key highperforming health services demonstrating strong governance should be identified and given greater freedom to develop and implement innovative models of care promoting quality health services and good outcomes one idea worthy of exploration is that of earned autonomy which has been adopted in the united kingdom box