Workforce redesign and reform

The Ministerial Taskforce on health practitioner expanded scope of practice (the Taskforce) was a commitment in the Health Practitioners (Queensland Health) Certified Agreement (No. 2) 2011. The focus was to explore opportunities for more effective and efficient use of the allied health workforce in Queensland Health in order to achieve better outcomes for patients, the community and the workforce.

The Ministerial Taskforce on health practitioner expanded scope of practice: final report was released in June 2014. This report made a number of recommendations to facilitate delivery of client-centred, cost-effective services through allied health professionals expanding their scope of practice. Taskforce findings focussed on expanding the scope of practice of the allied health professions to:

• optimise full scope of practice.
• extend scope of practice in appropriate contexts.
• delegate tasks to the support workforce to enable full scope and extended scope.

Building on the work of the Ministerial Taskforce, a new five-year strategy has been developed. The Allied Health Expanded Scope Strategy 2016-2021 (PDF 2411 kB) (PDF 2411 kB) - The Strategy - has been developed through state-wide consultation with key stakeholders, building upon the recommendations of the 2014 Ministerial Taskforce on health practitioner expanded scope of practice: final report.

The strategy is a high-level document that will inform annual work plans as they evolve. The priorities and activities outlined represent a large program of work that will be executed over the next five years by the Department of Health, Hospital and Health Services and their partners. The Strategy will continue to guide a comprehensive program of work aiming to develop a modern, responsive and effective allied health workforce, improving patient access to high-value healthcare.

A framework has been established to support the development, implementation and evaluation of prescribing trials by allied health professionals in Queensland public health services not already authorised to prescribe under the Health Drugs and Poisons Regulation 1996.

• A framework for allied health professional prescribing trials within Queensland Health (PDF 337KB)

The Office of the Chief Allied Health Officer contracted Queensland University of Technology to review the current status of the speech pathology, dietetic and psychology qualifications, against the national Prescribing Competencies Framework. The report outlines current capabilities of speech pathologists, dietitians and psychologists, and identifies competency areas that require additional training before a prescribing role can be considered.

• A review of the prescribing capability of speech pathologists, dietitians and psychologists (PDF 964KB)
  • Appendix A: speech pathology mapping (PDF 883KB)
  • Appendix B: dietitian mapping (PDF 731KB)
  • Appendix C: psychology mapping (PDF 828KB)

Professional skill-sharing involves two or more allied health professionals sharing knowledge, skills and responsibilities across professional boundaries in assessment, diagnosis, planning and/or intervention. The patient journey is enhanced through more efficient assessment and discharge planning processes and improved continuity of care. Resources to develop safe and effective skill sharing models include:

• Skill sharing framework (PDF 7142 kB)
• Clinical Task Instructions for skill sharing

The full scope of practice of a profession includes the full spectrum of roles, functions, responsibilities, activities and decision-making capacity that individuals within that profession are educated, competent and authorised to perform. The full scope of a profession is set by professional standards and in some cases legislation.

Working to full scope means working to the full extent of the profession’s recognised skill base and/ or regulatory guidelines, acknowledging that some functions may be shared with other professions, individuals or groups.

Full scope roles and tasks include:

• first contact in the care pathway
• making direct referrals to medical specialists in Queensland Health
• making direct referrals to other allied health professionals
• requesting investigations to enhance current decision-making and care
• prescribing equipment and consumables
• documentation of findings on investigations performed by diagnostic allied health professionals
• criteria led discharge
• criteria led admission (e.g. from acute to sub-acute services).

A number of role redesign frameworks and guidelines have been developed to encourage contemporary practice and assist hospital and health services, managers and clinicians when considering new or redesigned roles and tasks that more fully utilise an allied health practitioner's scope of practice.

• Framework for allied health professional prescribing trials within Queensland Health (PDF 337 kB)
• Guideline for allied health professionals requesting pathology tests (PDF 2297 kB)
• Employing Health Practitioner 1 (HP1) and Allied Health Assistants (PDF 1628 kB)

A number of workforce redesign and reform initiatives and models of care undertaken within Queensland public health services have potential for application to other sites. Information and resources are available to support Hospital and Health Services who wish to implement the following models:

• Emergency department physiotherapy practitioner role (PDF 81 kB)
• Primary contact occupational therapy hands clinic (PDF 82 kB)
• Physiotherapy-led pelvic health clinic (PDF 81 kB)
• Allied health-led vestibular services (PDF 87 kB)
• Torres and Cape Hospital and Health Service telepharmacy service model (PDF 54 kB)

Overviews of projects completed between 2008 and 2013 are provided in the Innovations in models of care for the health practitioner workforce in Queensland Health reports, which can be found on our publications page.