Allied Health Assistant Framework

Transcription

1 Guidelie Allied Health Assistat Framework Documet Number GL2013_005 Publicatio date 05-Aug-2013 Fuctioal Sub group Persoel/Workforce - Workforce plaig Persoel/Workforce - Recruitmet ad selectio Miistry of Health, NSW 73 Miller Street North Sydey NSW 2060 Locked Mail Bag 961 North Sydey NSW 2059 Telephoe (02) Fax (02) space space space Summary This documet provides a goverace framework for the effective employmet ad utilisatio of Allied Health Assistats (AHAs) i the NSW Health workforce. The Framework defies the roles ad resposibilities that AHAs have i the delivery of patiet care; provides a structure for Allied Health Professioals to effectively supervise ad delegate to AHAs ad provides iformatio to assist with growig this workforce safely ad effectively. Author Brach Workforce Plaig ad Developmet Brach cotact Daijela Radovaovic Applies to Local Health Districts, Chief Executive Govered Statutory Health Corporatios, Specialty Network Govered Statutory Health Corporatios, Affiliated Health Orgaisatios, Commuity Health Cetres, NSW Ambulace Service, Public Hospitals Audiece AH Professioals, AH Maagers, AH Directors, Workforce Plaers, Healthcare Assistat Coordiators Distributed to Public Health System, Health Associatios Uios, NSW Ambulace Service, Miistry of Health, Private Hospitals ad Day Procedure Cetres, Tertiary Educatio Istitutes Review date 05-Aug-2018 Policy Maual Not applicable File No. H13/70513 Status Active Director-Geeral

2 ALLIED HEALTH ASSISTANT FRAMEWORK GUIDELINE SUMMARY PURPOSE The AHA Framework is a goverace documet that describes the effective employmet ad utilisatio of Allied Health Assistats (AHAs) i the NSW Health workforce. The Framework defies the roles ad resposibilities that AHAs have i the delivery of patiet care; provides a structure for Allied Health Professioals (AHPs) to effectively supervise ad delegate to AHAs ad provides iformatio to assist with growig this workforce safely ad effectively. KEY PRINCIPLES The AHA Framework defies the eight compoets requirig cosideratio whe employig ad workig with AHAs. The eight compoets each have a set of guidelies that act as a check poit for health services whe implemetig the Framework. The compoets provide guidace to uderstadig the roles ad resposibilities of AHAs ad AHPs as well as the supervisio ad support AHAs require to work safely with patiets. The quick referece to the eight compoets ad their respective guidelies are o pages of the Framework. The eight compoets are as follows: 1. Scope of Practice (pg 14) 2. Skills ad Competecies (pg 22) 3. Positio Descriptio (pg 27 ad Appedix A) 4. Educatio Pathway (pg 28) 5. Cliical Supervisio Guidelies (pg 29) 6. Delegatio Guidelies (pg 34) 7. Itegratig AHAs ito AH Teams (pg 38) 8. Professioal Developmet (pg 39) USE OF THE GUIDELINE The AHA Framework provides broad guidelies to assist health services whe creatig ew AHA positios ad whe reviewig existig AHA positios. The Framework is iteded to be used as a guide ad is flexible eough to meet the eeds of the variety of services ad settigs withi NSW Health. The Framework should be used i cojuctio with the AHA Olie Traiig Module which is available o the HETI website. Tools to assist staff at LHDs with implemetatio of the Framework ca be foud o the Allied Health pages of the NSW Health website. GL2013_005 Issue date: August-2013 Page 1 of 2

3 GUIDELINE SUMMARY REVISION HISTORY Versio Approved by Amedmet otes July 2013 GL2013_005 Deputy Director Geeral, Goverace Workforce ad Corporate New Guidelie. ATTACHMENTS 1. Allied Health Assistat Framework. GL2013_005 Issue date: August-2013 Page 2 of 2

4 Allied Health Assistat Framework

5 NSW MINISTRY OF HEALTH 73 Miller Street NORTH SYDNEY NSW 2060 Tel. (02) Fax. (02) TTY. (02) This work is copyright. It may be reproduced i whole or i part for study or traiig purposes subject to the iclusio of a ackowledgemet of the source. It may ot be reproduced for commercial usage or sale. Reproductio for purposes other tha those idicated above requires writte permissio from the NSW Miistry of Health. NSW Miistry of Health 2013 GL2013_005 August 2013 SHPN (WPD) ISBN Further copies of this documet ca be dowloaded from the NSW Health website

6 Cotets Abbreviatios... 3 Executive Summary... 4 Itroductio... 5 How to use this Framework The Eight Compoets of Employig AHAs Compoet 1 Scope of Practice Compoet 2 Skills ad Competecies Compoet 3 Positio Descriptio Compoet 4 Educatio Pathway Compoet 5 Cliical Supervisio Guidelies Compoet 6 Delegatio Guidelies Compoet 7 Itegratig AHAs ito AH teams Compoet 8 Professioal Developmet Appedix A Positio Descriptio Template Bibliography Refereces Allied Health Assistat Framework NSW Health PAGE 1

7 List of Tables ad Figures List of Tables Table 1: Task/Activity List for AHA Scope of Practice Table 2: List of relevat qualificatios for AHAs by therapy group...23 Table 3: Certificate IV i Allied Health Assistace Course Details List of Figures Figure 1: Steps to cosider whe establishig a ew AHA positio Figure 2: Questios to ask for existig AHA positios Figure 3: Diagrammatic Structure of Certificate IV i Allied Health Assistace Figure 4: Delegatio Flow Chart...36 PAGE 2 NSW Health Allied Health Assistat Framework

8 Abbreviatios AAC AH AHA AHP AP CS&HISC HETI HSU HWA LHD MoH NAHAWG NHS RPL RTO Augmetative ad Alterative commuicatio Allied Health Allied Health Assistat Allied Health Professioal Assistat Practitioers Commuity Services ad Health Idustry Skills Coucil Health Educatio & Traiig Istitute Health Services Uio Health Workforce Australia Local Health District Miistry of Health Natioal Allied Health Assistat Workig Group Natioal Health Service Recogitio of Prior Learig Registered Traiig Orgaisatio Allied Health Assistat Framework NSW Health PAGE 3

9 Executive Summary The health workforce is experiecig icreasig pressures to deliver health services to a evolvig populatio. 1 Icreased use of a assistat level workforce with ew models of care is oe strategy to respod to this challege; this icludes developig the Allied Health Assistat (AHA) workforce. This documet provides a goverace framework for the effective employmet ad utilisatio of AHAs i the NSW Health workforce. This Framework will: 1. Clearly defie the roles ad resposibilities that AHAs have i the delivery of patiet care; 2. Provide a structure for AHPs to effectively supervise ad delegate to AHAs; 3. Provide iformatio to assist with growig this workforce safely ad effectively. This resource documet supports the NSW Health AHA iitiative, the aims of which iclude: Expadig the utilisatio of AHAs across NSW Health; Ehacig existig models of care to better itegrate the assistat workforce; Supportig a team-based approach ad better utilisatio of the skills withi the professioal workforce; Developmet of a robust, rigorous ad cosistet approach to cliical goverace of AHAs. The framework cosists of eight compoets providig guidace whe desigig roles, employig ad workig with AHAs as part of the health care team. These eight compoets are: 1. Scope of practice 2. Skills ad competecies 3. Positio descriptio 4. Educatio pathway 5. Cliical supervisio guidelies 6. Delegatio guidelies 7. Itegratig AHAs ito AH teams 8. Professioal developmet Key guidelies withi each of the eight compoets aim to give a clear ad cosistet directio for health services whe employig ad workig with AHAs. A guide o how to implemet this Framework for both ew ad existig AHA positios is outlied i Chapter 2. The implemetatio of this state-wide framework will facilitate the safe ad cosistet expasio of the AHA workforce which will assist i supportig the efficiet ad timely delivery of allied health services. 1 Health Professioals Workforce Pla , NSW Miistry of Health PAGE 4 NSW Health Allied Health Assistat Framework

10 Itroductio Cotext The allied health workforce is a essetial compoet of the health workforce, ad the demad for allied health services will further icrease with the ageig of the populatio, the growig burde of chroic disease ad a icreasig emphasis o the delivery of multidiscipliary care. 2 Oe strategy i respose to this challege is to develop ew models of care which iclude icreased use of a assistat level workforce with well defied roles. I NSW, the strategy to realig the health workforce with ew models of care ad to develop the healthcare assistat workforce has bee well documeted ad supported. The followig publicatios have subsequetly iformed the developmet of this Framework. I the Fial Report of the Special Commissio of Iquiry ito Acute Care Services i NSW Public Hospitals (2008) Commissioer Garlig recommeded that the NSW Health workforce be realiged so that patiet cetred care is provided by a multidiscipliary team ad compoets of that care are performed by a team member utilisig the best mix of skills, qualificatios ad experiece to deliver quality healthcare. Eablig the assistat workforce to expad their roles ad take o ew tasks will allow health professioals to focus o more complex service delivery tasks ad develop exteded scope of practice roles to further support health care demads. Health Professioals Workforce Pla provides a high level overview of the strategies that eed to be implemeted to esure that NSW ca trai, recruit ad retai doctors, urses, midwives, oral health practitioers ad allied health professioals i order to cotiue to provide a quality health service to the people of NSW. Strategy 7.8 is to grow the Allied Health workforce i lie with forecast health service demad ad delivery requiremets, withi this is the developmet of a evidece based Allied Health Care Assistat Framework. Role of Allied Health Assistats i Australia ad Overseas Govermets across Australia has recogised the importace of developig the AHA workforce i respose to the atioal ad global future health workforce shortages. Jurisdictios have developed a variety of resources to assist with uderstadig the AHA workforce. Wester Australia Health has published a variety of useful resources for employig ad maagig AHAs. These are available at < The Departmet of Health i Victoria developed a approach to implemetig a assistat workforce that was largely focused o the triallig ad implemetatio of AHA roles. This resulted i the publicatio of a variety of resources, available at: < Queeslad Health has worked to icrease the umber of traied AHAs i the workforce ad has published a evaluatio report, available at: < 2 Health Professioals Workforce Pla , NSW Miistry of Health Allied Health Assistat Framework NSW Health PAGE 5

11 The South Australia Govermet has developed a iformative website o the role of AHAs ad the future directio of AHAs i SA, available at: < These jurisdictios all cosistetly reported that employmet of AHAs lacked structure, that roles were defied differetly withi Health Services ad the level of resposibility ad services provided by AHAs withi their localities varied greatly. I 2007 the Commuity Services ad Health Idustry Skills Coucil itroduced the Certificate IV qualificatio i Allied Health Assistace, with the optio to specialise i six differet Allied Health disciplies. More recetly, jurisdictios aroud Australia formed a Natioal AHA Workig Group (NAHAWG), which meets quarterly to share iformatio relatig to AHA Iitiatives ad to facilitate a coordiated atioal approach to growig this workforce i a safe ad effective way. The Health Workforce Australia (HWA) Work Pla icludes developmet of healthcare assistat roles at Sectio 2.3 Workforce Flexibility Assistat ad Support Roles. The goal is to icrease the productivity ad capacity of the health workforce by idetifyig opportuities for the developmet of assistat ad support roles. The NAHAWG has made recommedatios to HWA regardig the developmet of AHA roles icludig the requiremet to create ad implemet a atioally cosistet supervisio ad delegatio framework; to develop a competecy framework for traiig ad supervisio; ad to develop a sustaiable traiig ad educatio framework for Allied Health Professioals (AHPs) to supervise ad safely delegate work to AHAs. The Uited Kigdom (UK) is a global leader i developmet of healthcare assistat roles. The Natioal Health Service (NHS) employs both Health Care Support Workers (HCSWs) ad Assistat Practitioers (APs). HCSWs work closely with patiets ad are ivolved i direct care activities to complemet some roles ad resposibilities of Registered Nurses. HCSWs are ot required to have formal traiig or to hold a recogised qualificatio. A sigificat UK workforce policy iitiative ad importat career developmet for HCSWs is the AP role. 3 APs are a higher level of support workers, itroduced i the UK to complemet the work of registered professioals ad work across professioal groups i both hospital ad commuity settigs. APs have a remit to deliver protocolbased cliical care ad cover activities previously associated with the work of registered practitioers. This protocolbased care is udertake uder the directio ad supervisio of a state registered practitioer. APs require formal traiig (atioal vocatioal qualificatio or foudatio degree) ad career progressio occurs alogside pay structures that reflect their levels of preparatio ad practice for healthcare work. 4 Some jurisdictios i Australia, icludig Queeslad ad South Australia, have based the developmet of AHA roles locally o this UK model. Beefits of workig with AHAs Evidece from the literature highlights health care beefits from itroducig AHAs i terms of both process ad service outcomes. These iclude icreased patiet satisfactio, icreased itesity of cliical care, more time for AHPs to cocetrate o complex tasks ad improved cliical outcomes. 5 Itroductio of AHAs i the workplace has also led to improved levels of cliet satisfactio ad are a cost effective additio to the allied health workforce. 6 3 Spilsbury K et al; Mappig the itroductio of Assistat Practitioer roles i Acute NHS (Hospital) Trusts i Eglad; Joural of Nursig Maagemet 2009, 17: Mora A et al; Are we usig support workers effectively? The relatioship betwee patiet ad team characteristics ad support worker utilisatio i older people s commuity-based rehabilitatio services i Eglad; Health ad Social Care i the Commuity; 2012 doi: /j x 5 Lizarodo L, Kumar S, Hyde L, Skidmore D; Allied Health Assistats ad what they do: A systematic review of the literature J. of Multidiscipliary Healthcare 2010: Evaluatio Rural Allied Health Assistat (RAHA) Project Iterim Reports 1 (Dec 2010) & 2 (Nov 2011), Rural Divisio, Health Educatio & Traiig Istitute PAGE 6 NSW Health Allied Health Assistat Framework

12 Barriers to itroductio of AHAs There are some barriers to itroducig AHAs i healthcare settigs. These iclude ogoig ucertaity regardig the scope of AHA roles ad resposibilities, protectioism of AHPs ad feeligs of iadequacy by AHAs themselves. 7 Clear role delieatio should therefore address the issue of professioal status ad security, which ca lead to adequate ad appropriate utilisatio of AHA services, ad ultimately safe ad high quality healthcare. How this Framework was developed A Advisory Committee with key stakeholder participatio was established to provide strategic stakeholder iput. Members of the Advisory Committee icluded represetatives from the NSW Miistry of Health (MoH), Local Health Districts (LHDs), the Health Services Uio (HSU), the Commuity Services ad Health Idustry Skills Coucil (CS&HISC), Health Educatio ad Traiig Istitute (HETI) ad Health Registered Traiig Orgaisatio (RTO). The Framework developmet was based o: 1. A literature search which icluded: Positio papers from atioal groups Positio papers or guidelies from atioal AH bodies Positio papers or guidelies from iterstate bodies ad govermets HWA literature review Reports from Healthcare Assistat Co-ordiator projects Rural Allied Health Assistat (RAHA) Project i the former Greater Souther AHS HETI publicatios State awards 2. A state-wide AHA survey A survey seekig iformatio i relatio to employed AHAs was coducted by the NSW Miistry of Health i July The itetio of the survey was to collect iformatio regardig the umber of AHAs workig across NSW public health facilities, the job titles used to describe AHAs ad the various Allied Health disciplies they supported. This survey represeted the first time this iformatio had bee collected o a state-wide level. It thus provided baselie data agaist which future surveys could measure chage ad progress of the iitiative. 3. Cosultatio Forums Themes ad issues idetified through the literature search ad prelimiary results from the survey were used to develop a overview ad key statemets used to iform the Framework. These were approved by the Advisory Committee ad were used as the basis for cosultatio. A mixture of face to face, phoe ad video-coferecig were used for the cosultatio process coverig rural, regioal ad metropolita LHDs. Over 300 participats took part, which icluded AHAs, AHPs, AH Maagers, workforce services persoel ad AH Directors. The feedback from these cosultatios was used to further develop this Framework. 7 Lizarodo L, Kumar S, Hyde L, Skidmore D; Allied Health Assistats ad what they do: A systematic review of the literature J. of Multidiscipliary Healthcare 2010: Allied Health Assistat Framework NSW Health PAGE 7

13 Purpose of the Framework This Framework aims to provide a goverace structure to clearly defie the roles ad resposibilities that AHAs have i the delivery of patiet care, how to effectively supervise ad delegate as well as iformatio to assist with growig this workforce safely ad effectively. The state-wide Framework aims to facilitate the implemetatio ad expasio of the AHA workforce which will support the efficiet ad timely delivery of allied health services. This resource documet supports the NSW Health AHA iitiative, the aims of which iclude: Expasio of the utilisatio of AHAs across NSW Health; Ehacig existig models of care to better itegrate the assistat workforce; Supportig a team-based approach ad better utilisatio of the skills withi the professioal workforce; Developmet of a robust, rigorous ad cosistet approach to cliical goverace of AHAs. Scope of the Framework This Framework is a overarchig guide that ca be used by LHDs ad specialty etworks to ehace existig or establish ew local structures aroud the effective use of AHAs. This Framework ca be utilised: I the developmet of ew AHA positios. To promote the safe ad effective utilisatio of the existig AHA workforce. To assist both AHPs ad service maagers to better uderstad roles ad scope of practice of the health workforce. To support AHPs to delegate ad supervise safely ad effectively to the assistat workforce. Who are AHAs ad what do they do? The allied health workforce i Australia is comprised of AHPs ad other techicias, assistats ad support workers who work with AHPs. 8 A AHA has bee defied as: A perso employed uder the supervisio of a allied health professioal who is required to assist with therapeutic ad program related activities. Supervisio may be direct, idirect or remote ad must occur withi orgaisatioal requiremets. 9 A cross discipliary AHA is a assistat that works i more tha oe allied health disciplie. AHP disciplies that curretly utilise AHAs i NSW Health are: Physiotherapists Occupatioal Therapists Diversioal Therapists 8 Allied Health Professioals Australia 9 Commuity Services ad Health Idustry Skills Coucil HLT42512 Certificate IV i Allied Health Assistace PAGE 8 NSW Health Allied Health Assistat Framework

14 Dieticias Radiographers Pharmacists Speech Pathologists Orthotists Prosthetists Podiatrists Audiologists Child Life Therapists This list is ot exhaustive ad does ot preclude other allied health disciplies from utilisig assistats, for example, Social Workers. Allied Health Assistat Framework NSW Health PAGE 9

15 How to use this Framework This Framework draws together a umber of areas that eed to be cosidered ad itegrated whe employig ad workig with AHAs. The followig two figures are represetatios of the cosideratios to be made whe creatig ew AHA positios ad for existig AHA positios whe implemetig this Framework. The compoets that are referred to i these steps are summarised i Chapter 3 ad provided i detail throughout the Framework. Figure 1 Steps to cosider whe establishig a ew AHA positio Step 1 Opportuity Idetificatio Idetify the fuctios of the cliical service Idetify the curret level of allied health service i the cliical service Determie if there are ay 'umet eeds' that are relevat to NSW Health Determie if ay of the curret ad/or 'umet eeds' could be met usig a AHA Determie resource/fudig optios Step 2 Plaig Select the relevat tasks or activities from Table 1 (Compoet 1) Idetify the skills liked to these tasks (Compoet 2) Cosider these skills whe recruitig Iclude the selected tasks i the Positio Descriptio (Compoet 3) Idetify the supervisio ad delegatio resposibilities (Compoets 5 & 6) Cosider what professioal developmet/support will be eeded for the supervisig AHP ad the AHA (Compoets 7 & 8) Step 3 Implemetatio Recruit to the positio Fialise the AHP positio that will be supervisig the AHA positio Provide orietatio to the positio Commece formal supervisio ad delegatio Support the AHP workig with the AHA Commece relevat qualificatio traiig if required Step 4 Evaluatio/Review Assess whether the cliical eeds of the service idetified at Step 1 are met Review whether the AHA has commeced the relevat qualificatio (if required) Review whether formal documeted supervisio sessios have occurred (Compoet 5) Determie if delegatio resposibilities ad accoutabilities have bee clearly defied (Compoet 6) Idetify whether the AHP's ad AHA's professioal developmet ad traiig eeds have bee met (Compoets 7 & 8) PAGE 10 NSW Health Allied Health Assistat Framework

16 Figure 2 Questios to ask for existig AHA positios Does the AHA have a positio descriptio with a clear scope of practice? If ot, review ad update positio descriptio usig Compoets 1 & 3 Does the AHA have a qualificatio relevat to their positio? If ot, explore recogitio ad traiig optios usig Compoet 2 Is the AHA supervised effectively by a AHP? If ot, chage supervisio arragemets usig Compoet 5 Have the delegatio resposibilities ad accoutablitites bee clearly defied? If ot, refer to delegatio guidelies i Compoet 6 Has the AHP bee traied to work effectively with AHAs? If ot, explore traiig optios usig Compoet 7 What relevat professioal developmet opportuities are available for AHAs? Refer to Compoet 8 for suggestios. Allied Health Assistat Framework NSW Health PAGE 11

17 The Eight Compoets of Employig AHAs This chapter provides the guidelies for each of the compoets that make up the NSW Health AHA Framework. There are a total of eight compoets to cosider whe employig ad workig with AHAs. These provide guidace to uderstadig the roles ad resposibilities of AHAs ad AHPs as well as the supervisio ad support AHAs require to work safely with patiets. Compoet 1 Scope of Practice AHAs workig i NSW Health will have a defied scope of practice liked to the service eeds. The scope of practice will iclude tasks that the AHA ca safely perform listed by cliical settig ad disciplie. Where available, the task list will refer to the uits of competecies withi the relevat qualificatios. Flexibility to adapt the scope of practice is required i order to reflect the eeds of the local service. The scope will vary depedig o settig ad disciplie eeds. For example; paediatric, geriatric, metal health. Compoet 2 Skills ad Competecies A relevat qualificatio at Certificate III or IV level equips AHAs to udertake the scope of practice as outlied i their positio descriptio. AHAs curretly employed i NSW Health will be ecouraged to participate i a recogitio of prior learig process as part of meetig the relevat qualificatio requiremets. Relevat qualificatios will be determied by the requiremets of the positio. Optios iclude: Certificate III ad IV i Allied Health Assistace Certificate III ad IV i Hospital Health Services Pharmacy Support Certificate III i Prosthetic/Orthotic Techology Certificate IV i Leisure ad Health Certificate IV i Audiometry Compoet 3 Positio Descriptio AHAs workig i NSW Health will have a positio descriptio that reflects the positio type ad settig. A sample positio descriptio template is icluded at Appedix A. This cotais core elemets icludig positio details, positio purpose, supervisor, key accoutabilities, key challeges ad selectio criteria. A task list is available from the scope of practice sectio. PAGE 12 NSW Health Allied Health Assistat Framework

18 Compoet 4 Educatio Pathway AHAs are to be ecouraged to progress to attaimet of the competecies that are required, or liked, to the positio. Compoet 5 Cliical Supervisio Guidelies AHA positios are to be cliically supervised by a AHP. AHA positios will have a desigated cliical supervisor positio. Formal supervisio sessios will be documeted i accordace with local requiremets. Cliical supervisio may be direct, idirect ad/or remote. Compoet 6 Delegatio Guidelies AHPs will have a clear uderstadig of what ca be delegated to AHAs ad the related resposibilities ad accoutabilities. AHAs ad AHPs will have a clear uderstadig of allocated tasks. AHAs will have a clear uderstadig of their resposibilities whe acceptig delegatio from AHPs. Delegatio will be documeted. Compoet 7 Itegratig AHAs ito AH teams AHPs are required to have kowledge ad uderstadig of the roles ad resposibilities of AHAs. AHPs may require support to develop effective supervisio ad delegatio skills whe workig with AHAs. Compoet 8 Professioal Developmet As with all health professioals, AHAs are to have access to ogoig professioal developmet. This is a shared resposibility betwee the idividual ad their employer, aimed at optimisig performace ad ehacig patiet care. Allied Health Assistat Framework NSW Health PAGE 13

19 compoet 1 Scope of Practice Guidelies AHAs workig i NSW Health will have a defied scope of practice liked to the service eeds. The scope of practice will iclude tasks that the AHA ca safely perform listed by cliical settig ad disciplie. Where available the task list will refer to the uits of competecies withi the relevat qualificatios. Flexibility to adapt the scope of practice is required i order to reflect the eeds of the local service. The scope will vary depedig o settig ad disciplie eeds. For example, paediatric, geriatric, metal health. AHAs work i a diverse rage of settigs ad allied health disciplies. This diversity ca make it challegig to defie the scope of practice for this group. It is importat however to defie the scope of practice as it relates to both the cliical settig ad the allied health disciplie/s. Scope of practice of a professio A professio s scope of practice is the full spectrum of roles, fuctios, resposibilities, activities ad decisiomakig capacity that idividuals withi that professio are educated, competet ad authorised to perform. Some fuctios withi the scope of practice of ay professio may be shared with other professios or other idividuals or groups. The scope of practice of all health professios is iflueced by the wider eviromet, the specific settig, legislatio, policy, educatio, stadards, ad the health eeds of the populatio. Scope of practice of a idividual The scope of practice of a idividual is that which the idividual is educated, authorised ad competet to perform. The scope of practice of a idividual AHA may be more specifically defied tha the scope of practice of their disciplie. To practise withi the full scope of practice of the disciplie the idividuals may eed to update or icrease their kowledge, skills or competece. This highlights the eed for scope of practice decisio makig to be embedded i a robust cliical goverace, risk maagemet, ad regulatory framework to eable AHAs to work withi the full ad potetial scope of practice. This sectio describes the scope of practice for the AH groups broadly as determied by the AHP groups ad the relevat qualificatios. PAGE 14 NSW Health Allied Health Assistat Framework

20 Scope of practice of a Allied Health Assistat AHAs have a scope of practice that ecompasses both support tasks ad the compoets of cliet care that have bee delegated by the AHP. The AHA may be ivolved i screeig tasks but do ot udertake assessmet. Withi this delegated model of scope of practice for AHAs, a idividual AHA s scope of practice is iflueced by: Their educatio; Their kowledge ad skills; Their level of experiece ad o the job traiig; Their currecy of practice; The level of supervisio they receive ad; The type ad level of services provided by the facility i which they work. The followig activities may oly be udertake by a AHP ad are ever to be icluded i the AHA scope of practice AHP groups have idetified activities that are oly udertake by a AHP. These iclude: Iformig patiets/cliets ad families about the type, frequecy, ad duratio of services; Makig cliical decisios, icludig determiig patiet/cliet selectio for iclusio/exclusio i caseload ad dischargig patiets/cliets from treatmet; Commuicatig with patiets/cliets, parets ad family members about diagosis, progosis ad treatmet pla, uless these are doe with explicit istructios from the AHP; Coductig assessmets; Preparig idividual treatmet plas; Iterpretatio of referrals; Iitial assessmets or iterviews; Developmet of treatmet goals ad plas for cliet; Plaig ad modificatio of treatmet programs or goals; Discharge plaig; Pressure care assessmet, prescriptio ad itervetio icludig providig advice about the suitability of specialised equipmet, icludig beds ad chairs; Assessmet ad prescriptio of: Splitig Specialised seatig ad wheelchairs Specialised equipmet, aids ad appliaces, e.g. cutlery or writig tools Home ad evirometal istallatio or modificatios Assessmet ad diagosis of swallowig disorders; Demostratio of swallowig strategies or precautios to cliet, family, carers or other staff; 10 Ijectio of local aaesthetic, woud debridemet ad sharps debridemet. Who assesses competecy? Competecy i the workplace eeds to be idetified ad assessed by a experieced AHP workig with the AHA o a day to day basis, whe addressig specific workplace eeds that are ot withi a qualificatio. 10 Guidelies for AHA Scope of practice, Delegatio ad Supervisio; Wester NSW LHD Allied Health Assistat Framework NSW Health PAGE 15

21 Resposibility for the assessmet of competecy for the purpose of issuig a qualificatio rests with the Registered Traiig Orgaisatio (RTO). The RTO will work with the AHP i determiig competece i the workplace. Competecy stadards for all uits as udertake i the relevat qualificatio are available from the traiig.gov.au website which ca be foud at < Determiig scope of practice The scope of practice of a positio eeds to be determied at the time of creatig a ew AHA positio ad eeds to be i lie with the requiremets of the service. Scope of practice for a positio should be determied by the relevat staff makig decisios relatig to service eeds i a allied health departmet, this ca iclude the Allied Health Director, Maager ad/or the supervisig AHP. The scope of practice should be attached to the positio descriptio; this will esure the scope is reviewed each year durig the appraisal process to esure it remais relevat to both the service eeds ad the idividual recruited to the positio. This process will also idetify ay additioal traiig eeds. A list of tasks is provided i Table 1 (page 18) to assist i formulatig a scope of practice for a positio. These tasks are sourced from the uits of competecy withi the Certificate IV i Allied Health Assistace ad are iteded for use as a guide oly. Addig tasks to scope of practice There may be tasks i additio to Table 1 that are relevat to specific services that also eed to be icluded whe determiig the scope of practice for a positio. It is importat that the scope is flexible eough to reflect the requiremets of the service. A example is i the paediatric settig, there may be equipmet or treatmet methods that are specific to paediatrics. It is importat that whe addig tasks to the scope of practice for a AHA that: 1. The tasks are clearly idetified; 2. The traiig requiremets for the AHA are idetified ad delivered; 3. Adequate supervisio for the AHA is provided; 4. Ogoig competecy assessmet is icluded to esure the AHA is competet to udertake these additioal tasks. The delegatio flow chart o page 36 ca provide guidace i idetifyig additioal tasks that may be appropriate to delegate to a AHA. How to use Table 1 Table 1 provides examples of tasks that ca be icluded i the scope of practice for AHAs. This task list was extracted from the uits of competecy from the Certificate IV i Allied Health Assistace. Tasks are listed agaist both cliical settig ad professioal groups. The codes i the last colum ca be used to locate the relevat uits of competecy withi the Certificate III ad IV i Allied Health Assistace foud i Table 3 (See pages 24-25). PAGE 16 NSW Health Allied Health Assistat Framework

22 Matchig the uits of competecy withi Table 3 from a task i Table 1 gives a idicatio of the type of educatio ad traiig required to perform a particular task ad therefore may assist with both recruitmet ad positio descriptios, for both sigle disciplie ad cross-discipliary AHAs. For example, if the role icluded the task Apply ad remove plasters uder the directio of the supervisig Physiotherapist, you are directed to A1, which is the code for the uit of competecy Assist with the applicatio ad removal of a plaster cast. This uit would eed to be part of the AHAs qualificatio or it ca be udertake as a stadaloe uit. Refer to the pharmacy specific uits of competecy withi the Certificate IV i Hospital-Health Services Pharmacy Support for tasks that fall withi the scope of practice for this group. Refer to specific uits of competecy withi the Certificate III i Prosthetic/Orthotic Techology for tasks that fall withi the scope of practice for orthotic assistats. The tasks or activities that are listed uder geeral optios are icluded as a pick list that may be relevat for may assistat groups ad should be cosidered i additio to those tasks uder the disciplie specific groups. The tasks listed i this table will eed to be reviewed ad expaded to reflect workplace chages ad the cliical eeds of the service. Allied Health Assistat Framework NSW Health PAGE 17

23 Table 1 Task/Activity List for AHA Scope of Practice Task/Activity Prepare patiets/cliets for treatmet. Delegated Patiet Care geeral optios for AHAs Assist i patiet/cliet treatmet, therapeutic activities, retraiig programs accordig to the specific care pla that has bee prescribed by a AHP, beig aware of backgroud diagosis ad precautios. Assist with routie evaluatios by AHP, collect observatioal data as required, ad report ay chages i patiet/cliet behaviour or performace. Supervise activities ad exercises of patiets/cliets idividually or i groups uder directio of the AHP. Check posture ad positioig ad report o performace, problems or eed for chage. Provide assistace i therapy where two or more people are required for safety; assist with patiet/cliet positioig/maual hadlig. Report ay chage i behaviour or performace of patiets/cliets. Assist with the orgaisatio of groups, prepare ad coduct or co-facilitate group activities. Act as escort to patiets/cliets requirig supervisio/assistace i the healthcare facility eviromet or o home visits, (for Metal Health facilities ad settigs please refer to local policies i relatio to the escortig of patiets). Documet i patiet/cliet medical record as appropriate to role. Code L2 L2 B B L2 B B1 L2 B2 B3 L2 B2 B3 D3 L2 May Assist with patiet/cliet itake collect referrals, eter data. Prepare treatmet space/room for ext patiet/cliet. Cliical Support geeral optios for AHAs Prepare or make aids/devices for therapy uder the supervisio of the AHP. Update/maitai resources. Participate i quality activities, assist with the compilatio ad/or evaluatio of data o projects, satisfactio surveys etc. Maitai learig, for example, participatio i departmetal ad LHD educatio, orietatio ad madatory traiig programs. Assist with cleaig of therapy aids ad equipmet; esure all equipmet is safe ad fuctioal. Assist with admiistratio of equipmet loa pool ad other services as deemed ecessary by the AH maager. Deliver equipmet ad adjust i home accordig to specificatios from AHP. Assist i developmet of patiet/cliet hadouts/developig resources for commuity educatio. Participate i supervisio processes. L2 L2 L2 L2 L6 L6 May D4 D4 D3 May Book appoitmets. Admiistrative Support geeral optios for AHAs L2 Collect data for moitorig quality improvemet or statistical purposes. L2 Assist with orderig ad/or purchasig of supplies ad materials icludig statioary, stock ad o stock items. L2 Admiistrative duties word processig, telephoe duties, photocopyig, moitor resource usage, lamiatig, schedulig ad reschedulig appoitmets. Assist i the sourcig ad orderig of equipmet ad resources as delegated by the AHP. Participate i LHD performace maagemet processes, for example, performace appraisal. L2 D4 L6 PAGE 18 NSW Health Allied Health Assistat Framework

24 Task/Activity Occupatioal Therapy optios Acute ad Commuity (i additio to tasks icluded i geeral optios for AHAs) Code Assist with Occupatioal Therapy program as directed by the supervisig Occupatioal Therapist. Implemet self care retraiig programs as prescribed by the supervisig Occupatioal Therapist. Order/provide ad demostrate basic equipmet. Joit home visits for patiets/cliets where assistace of a secod staff member is required. Follow through positioig ad/or splitig regimes as prescribed by the supervisig Occupatioal Therapist. Eergy coservatio/falls prevetio/hip precautios/persoal alarms advice as per Occupatioal Therapist s recommedatios. Cotiue therapy programs as per Occupatioal Therapist s recommedatios. Assist i joit treatmet sessios where a secod staff member is required. L2 D2 B2 D1 D4 B2 A4 B2 B2 D3 B2 D1 B2 Complete home modificatio/quick Cad drawigs as per Occupatioal Therapist s specificatios. Coduct patiet/cliet activity groups uder directio of the Occupatioal Therapist. B2 D3 Physiotherapy optios Acute (i additio to tasks icluded i geeral optios for AHAs) Assist with Physiotherapy program as directed by the supervisig Physiotherapist. L2 Apply splits ad braces uder directio of the supervisig Physiotherapist. D4 Apply ad remove casts uder directio of the supervisig Physiotherapist. A1 Nutritio ad Dietetics optios Acute, Sub-acute ad Commuity (i additio to tasks icluded i geeral optios for AHAs) Assist with Dietetic program as directed by the supervisig cliical Dieticia. Participate i risk screeig icludig malutritio screeig ad other relevat screeig programs. Idetify ad report factors that place patiets at utritioal ad hydratio risk. Facilitate access to food ad fluids. Apply cliical utritio/therapeutic diet protocols as delegated. Assist the cliical Dieticia with implemetatio ad moitorig of prescribed utritio care plas, icludig discharge plaig. Facilitate ad moitor orders to patiet food services, as required by the local facility system ad protocols. Maage ad coordiate the provisio of eteral feeds, commercial oral supplemets ad ifat feedig formulas. Assist with utritioal support for patiets with dysphagia. Commuicate with all ecessary other health service persoel regardig patiet therapeutic diet requiremets. Support the provisio of basic utritio advice/educatio. L2 G1 G1 G1 G1 G1 J2 A3 J3 A3 J3 G1 G3 Allied Health Assistat Framework NSW Health PAGE 19

25 Task/Activity Code Speech Pathology optios Acute (i additio to tasks icluded i geeral optios for AHAs) Assist with Speech Pathology program as directed by the supervisig Speech Pathologist. L2 Make AAC (Augmetative/Alterative Commuicatio) equipmet as delegated by the supervisig Speech Pathologist. E3 Assist i provisio of modified diet items for patiets followig discharge uder the directio of the supervisig Speech Pathologist. Orgaise equipmet ad/or food items required for swallowig assessmets. Observe/supervise meals uder the directio of the supervisig Speech Pathologist. Assist with prescribed compoets of care as directed by the supervisig Speech Pathologist, for example, oromotor exercises. Assist i formulatio/compilatio of resources ad/or therapy activities. E2 E2 D4 E2 E1 E1 Physiotherapy optios Commuity (i additio to tasks icluded i geeral optios for AHAs) Assist with Physiotherapy program as directed by the supervisig Physiotherapist. Apply ad remove casts uder directio of the supervisig Physiotherapist. Apply ad review use of equipmet uder directio of the supervisig Physiotherapist. Prepare for hydrotherapy program. Guide the cliets/patiets to complete the hydrotherapy program accordig to prescribed treatmet pla. Assist cliet/patiet after hydrotherapy sessio. L2 A1 D4 A2 A2 A2 Geeral moitorig ad day to day maiteace of the hydrotherapy pool. L2 Speech Pathology optios Commuity (i additio to tasks icluded i geeral optios for AHAs) Assist with Speech Pathology program as directed by the supervisig Speech Pathologist. Make AAC equipmet as delegated by supervisig Speech Pathologist. Assist with group service provisio as directed by supervisig Speech Pathologist. Prepare materials for home programs as directed by supervisig Speech Pathologist. Assist i formulatio/compilatio of resources ad/or therapy activities. L2 E3 D3 E1 E1 Assist with oral hygiee procedures as directed by supervisig Speech Pathologist. E1 Occupatioal Therapy optios Sub-acute (i additio to tasks icluded i geeral optios for AHAs) Assist with Occupatioal Therapy program as directed by the supervisig Occupatioal Therapist. Implemet self care retraiig programs as prescribed by the supervisig Occupatioal Therapist. Sew ad fabricate soft splits. Order/provide ad demostrate basic equipmet. Joit home visits where assistace of a secod staff member is required. L2 D2 B2 D1 D4 D4 B2 Esure positioig ad/or splitig regimes are adhered to. Eergy coservatio/falls prevetio/hip precautios/persoal alarms advice as per Occupatioal Therapist s recommedatios. Assist with Occupatioal Therapy assessmet (upper limb, had, ad trasfer assessmets). B2 B2 D3 d2 B2 D1 PAGE 20 NSW Health Allied Health Assistat Framework

26 Task/Activity Code Physiotherapy optios Sub-acute (i additio to tasks icluded i geeral optios for AHAs) Assist with Physiotherapy program as directed by the supervisig Physiotherapist. L2 Assist with serial castig. A1 Udertake exercise programs with patiets/cliets as directed by supervisig Physiotherapist. B Patiet mobilisatio as directed by supervisig Physiotherapist. Prepare for hydrotherapy program. Guide the cliets to complete the hydrotherapy program accordig to prescribed treatmet pla. Assist cliet after hydrotherapy sessio. B A2 A2 A2 Speech Pathology optios Sub-acute (i additio to tasks icluded i geeral optios for AHAs) Assist with Speech Pathology program as directed by the supervisig Speech Pathologist. Make AAC equipmet as delegated by Speech Pathologist. L2 E3 Assist i provisio of modified diet items for patiets/cliets followig discharge uder the directio of the supervisig Speech Pathologist. Observe/supervise meals uder the directio of the supervisig Speech Pathologist. Assist with prescribed compoets of care as directed by the supervisig Speech Pathologist, for example, oromotor exercises. Assist with oral hygiee procedures as directed by supervisig Speech Pathologist. Assist i formulatio/compilatio of resources ad/or therapy activities. E2 E2 E1 E1 E1 Podiatry optios (i additio to tasks icluded i geeral optios for AHAs) Assist with Podiatry program as directed by the supervisig Podiatrist. Prepare for ad perform basic foot hygiee (excludig scalpel work). L2 C1 Apply paddig ad cushioig as prescribed by the supervisig Podiatrist. C1 Prepare for surgical podiatry procedures. Assist with surgical podiatry procedures. Assist with templatig for maufacture of orthotic devices. Assist with modificatio to orthoses ad footwear. Assist with support ad advice to cliets i the selectio of footwear. Clea ad store equipmet. Prepare for the delivery of podiatry exercise program or assessmet procedures. Deliver podiatry exercise or rehabilitatio program. Assist with podiatry assessmets. C2 C2 C2 C2 C2 C2 C3 C3 C3 Note: This table was adapted from Wester NSW LHD guidelies Allied Health Assistat Framework NSW Health PAGE 21

27 compoet 2 Skills ad Competecies Guidelies A relevat qualificatio at Certificate III or IV level equips AHAs to udertake the scope of practice as outlied i their positio descriptio. AHAs curretly employed i NSW Health will be ecouraged to participate i a recogitio of prior learig process as part of meetig the relevat qualificatio requiremets. Relevat qualificatios will be determied by the requiremets of the positio. Optios iclude: Certificate III ad IV i Allied Health Assistace Certificate III ad IV i Hospital Health Services Pharmacy Support Certificate III i Prosthetic/Orthotic Techology Certificate IV i Leisure ad Health Certificate IV i Audiometry There are a rage of vocatioal qualificatios relevat to the rage of AHA positios. These qualificatios exist at either a Certificate III or IV level or i some areas both. For a qualificatio to be accepted it must match the eeds of the positio ad the cliet group it is supportig. Recogitio of Prior Learig (RPL) may be relevat for existig positios. Qualificatios at a Certificate III level are oly appropriate for positios that ivolve direct supervisio of the cliical duties beig udertake by the AHA. These positios may have a larger admiistrative role that is ot directly supervised. The Certificate IV i Allied Health Assistace is the most appropriate qualificatio for may AHAs workig i cliical roles withi NSW. AHAs shall either have a relevat qualificatio whe commecig employmet or be prepared to udertake traiig to gai a relevat qualificatio durig the course of employmet. Govermet assisted traieeship fudig may be available to employers for the provisio of traiig. A coditio of access to fudig is that traiig must commece withi three moths of commecig full-time employmet ad twelve moths of commecig part-time employmet. There are other requiremets for the fudig ad further details are available from Australia Appreticeship Cetres. Employers are to ecourage ad support existig AHAs that do ot hold a formal qualificatio to udertake RPL ad/or further traiig to meet the relevat qualificatio. RPL is a process for givig cadidates credit for skills, kowledge ad experiece gaied through workig ad learig. It ca be gaied at ay stage of their lives, through formal ad iformal learig. RPL is a form of assessmet that allows the kowledge ad skills obtaied by the learer to be ackowledged, ad results i a formal qualificatio or statemet of attaimet. This assessmet is completed by a RTO. Table 2 lists the relevat qualificatio for each therapy group ad role. PAGE 22 NSW Health Allied Health Assistat Framework

28 Table 2 List of relevat qualificatios for AHAs by therapy group Allied Health Assistat Positio role Relevat qualificatio Physiotherapy Assistat Cliical Cert IV i AHA with Physiotherapy electives Physiotherapy Assistat Admiistratio or direct supervisio Cert III i AHA Occupatioal Therapy Assistat Cliical Cert IV i AHA with Occupatioal Therapy electives Ay AHA Admiistratio Cert III i AHA Speech Pathology Assistat Cliical Cert IV i AHA with Speech Pathology electives Podiatry Assistat Cliical Cert IV i AHA with Podiatry electives Dietetic ad/or Nutritio Assistat Cliical reportig to ad supervised by cliical dieticia Cert IV i AHA with Dietetic electives Diet Aid Cliical Cert III i Nutritio ad Dietetic Assistace Pharmacy Assistat Pharmacy Techicia See health employees (state) award See health employees (state) award Cert III i Hospital-Health Services Pharmacy Support Cert IV i Hospital-Health Services Pharmacy Support Diversioal Therapy Assistat Cliical Cert IV i Leisure ad Health Diversioal Therapy qualificatio, e.g. certificate Radiography Assistat Cliical Cert III i AHA with medical imagig assistace uits. Orthotic/Prosthetic Assistat Cliical Cert III i Prosthetic/Orthotic Techology Prosthetic/Orthotic Techology qualificatio Audiology Assistat Cliical Cert IV i Audiometric Assessmet AHA Metal Health Cliical Cert IV i AHA with relevat AH electives ad a maximum of 3 electives from the Cert IV i Metal Health. Note: Where positios iclude more tha oe therapy area, more tha oe skill set will eed to be icluded i the qualificatio. How the Certificate IV i Allied Health Assistace iforms the scope of practice for AHAs The Certificate IV i Allied Health Assistace is a vocatioal qualificatio. It has a complex structure to ecompass the wide rage of therapy assistat roles that exist i the workplace. A good grasp of this qualificatio will assist with uderstadig the scope of practice for AHAs. All relevat vocatioal qualificatios for AHAs ca be used as a guide to determie scope of practice. Relevat AHA qualificatios are listed i Table 2. The Certificate IV i Allied Health Assistace ca be used to determie the scope of practice for a umber of therapy areas icludig physiotherapy, occupatioal therapy, speech pathology, podiatry, ad utritio ad dietetics. The elemets ad performace criteria withi each of the uits of competecy may be liked to roles that are appropriate for assistats to complete. These competecies were reviewed by idustry ad professioal bodies prior to beig published i the traiig package. Both the prerequisites ad the core uits iclude compoets of practice that are cosidered withi the scope of all AHAs. The disciplie specific uits describe the scope of practice for assistats workig i these specific areas. The codes, title ad descriptios of this qualificatio may chage as reviews occur. The most recet versio of this qualificatio ad uits of competecy ca be foud at Allied Health Assistat Framework NSW Health PAGE 23