title: Future of specialised roles in allied health practice: who is responsible?
abstract: Allied health professions have developed specialised advanced and extended scope roles over the past decade, for the benefit of patient outcomes, allied health professionals' satisfaction and to meet labour and workforce demands. There is an essential need for formalised, widely recognised training to support these roles, and significant challenges to the delivery of such training exist. Many of these roles function in the absence of specifically defined standards of clinical practice and it is unclear where the responsibility for training provision lies. In a case example ofphysiotherapy practice in the intensive care unit, clinical placements and independence of practice are not core components of undergraduate physiotherapy degrees. Universities face barriers to the delivery of postgraduate specialised training and, although hospital physiotherapy departments are ideally placed, resources for training are lacking and education is not traditionally considered part of healthcare service providers' core business. Substantial variability in training, and its evaluation, leads to variability in practice and may affect patient outcomes. Allied health professionals working in specialised roles should develop specific clinical standards ofpractice, restructure models ofhealth care delivery to facilitate training, continue to develop the evidence base for their roles and target and evaluate training efficacy to achieve independent practice in a cost-effective manner. Healthcare providers must work with universities, the vocational training sector and government to optimise the ability of allied health to influence decision making and care outcomes for patients.
authors.affiliation: Department of Physiotherapy, Western Health, 176 Furlong Road, St Albans, Vic. 3021, Australia. Email.
authors.forename: Elizabeth H
authors.initials: EH
authors.lastname: Skinner
authors.affiliation: Department of Allied Health, Austin Health, Burgundy Street, Heidelberg, Vic. 3081, Australia. Email.
authors.forename: Kimberley J
authors.initials: KJ
authors.lastname: Haines
authors.affiliation: Department of Physiotherapy, Alfred Health, Commercial Road, Prahran, Vic. 3181, Australia. Email.
authors.forename: Kate
authors.initials: K
authors.lastname: Hayes
authors.affiliation: Department of Physiotherapy, Older Adult Rehabilitation and Allied Health (ORA) Services, Capital and Coast District Health Board, Riddiford Street, Newtown 6021, Wellington, New Zealand. Email.
authors.forename: Daniel
authors.initials: D
authors.lastname: Seller
authors.affiliation: Immediate Response Service, Western Health, 176 Furlong Road, St Albans, Vic. 3021, Australia. Email.
authors.forename: Jessica C
authors.initials: JC
authors.lastname: Toohey
authors.affiliation: Department of Physiotherapy, School of Rehabilitation and Occupation Studies, Faculty of Health and Environmental Sciences, AUT University, Private Bag 92006, Auckland 1142, New Zealand. Email.
authors.forename: Julie C
authors.initials: JC
authors.lastname: Reeve
authors.affiliation: Department of Physiotherapy, Western Health, 176 Furlong Road, St Albans, Vic. 3021, Australia. Email.
authors.forename: Clare
authors.initials: C
authors.lastname: Holdsworth
authors.affiliation: Allied Health Research Unit, Faculty of Medicine, Nursing and Health Sciences, Monash Health, Cheltenham, Vic. 3192, Australia. Email.
authors.forename: Terry P
authors.initials: TP
authors.lastname: Haines
mesh_terms: D000488:Allied Health Personnel; D001315:Australia; D002983:Clinical Competence; D006801:Humans; D007362:Intensive Care Units; D009520:New Zealand; D059825:Physical Therapists; D024382:Professional Role; D013038:Specialization