Develop Allied Health led pathways and roles

There is so much more that allied health professionals can do and such variation across the globe in what they are enabled to do.  In NZ alone there is huge variation, private to public and so forth as well as within what was the DHBs.  I'd propose a significant drive to apply existing proven allied health led models across the country.  Release the potential of this under tapped workforce and allow them to practice without walls and barriers.  Doing so could make a huge different to acute/emergency care, long term conditions, rehabilitation and primary care.  

Why the contribution is important

The demand for services is not going to change unless we do radically different things to drive new models.  The capabilities of allied health are not utilised in NZ despite highly educated and experienced people being available.  As an example why have we not got physiotherapists in all emergency departments, given the proven evidence of effectiveness, safety and patient preference in the research?  What about telehealth based allied health services?  Why have we not got chronic pain services in all areas lead by allied health practitioners?  Allied are the untapped alternative which NZ could be utilising.  Outcomes are better and it would free up other capacity in some high volume demand areas.

by jude2305 on October 28, 2022 at 05:17PM

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Average rating: 4.6
Based on: 16 votes

Comments

  • Posted by SamanthaBaldwin October 31, 2022 at 13:15

    Great suggestion. Could you elaborate on the walls and barriers?
    (Admin)

  • Posted by jude2305 October 31, 2022 at 18:27

    In my experience allied health are not able to practice with the autonomy their training provides. There are options for first contact practitioner roles. Currently most in the public sector work via referral which can create bottlenecks. It also stops the public from directly accessing their services. International research will indicate this is not necessary and does not limit demand in the system as some would suggest. There is a need to move from a professional role concept to a skills-based concept in the distribution of work.

    There are also the capacity issues faced by many in the health sector. A solid graduate training and recruitment plan (there is currently a focus on other professions not allied health) would address these matters which are not quick solutions but need to be put in place. The role of the kaiāwhina workforce for allied health needs to be developed concurrently to support delegation. Funding flows also don't support these new pathways, limiting the opportunities in the past - this could all change with Te Whatu Ora and the new arrangements.

    A quick literature review of the contribution allied health can offer will provide all the evidence needed. This straddles the therapy group but also the technical and scientific professions. The opportunities are plentiful with leadership and support offered at all levels.

  • Posted by DG November 04, 2022 at 14:34

    100% agree with you. I've been making a case for this for a while. I would also go as far by saying both Physio and Podiatry needs to have a prescence in the ED. The knowledge is being greatly under utilised.

  • Posted by andimc74 November 04, 2022 at 14:56

    Agree, AHP's can be developed and there is alot more the AHP's could do if career development was a focus. Reducing inpatient stays and delays, lower limb assessment in not only those with diabetes but for a whole range of conditions that podiatrists could be helping out with diagnosing and treating. Prescribing rights and extended scopes of practice into podiatric surgery could alleviate some of the pressures on vascular and orthopedic teams as well as developing Kaiawhina to work alongside these professions.
    Agree re the moving to a skills based approach for staff rather than a professional title which seems to be used to limit duties rather than encourage expansion of them.

  • Posted by altheacarruth November 04, 2022 at 16:27

    I very much agree with the comment made by andimc74 and feel that if there was more involvement by allied practitioners in the public system alongside pain specialists, diabetic clinics, vascular surgeons, neurologists and rheumatologists there would probably be shorter orthopaedic waiting lists. This can be done virtually or in clinics held together. Allied professionals of all disciplines are not used as effectively as they could be and I have found when I have been involved in clinic collaborations there is a higher patient satisfaction and less surgery. At present allied professionals are often forced into private practice which although is another pathway means that there is a disconnect between the aims of the public health system and the private sector.

  • Posted by GayleR November 18, 2022 at 21:09

    Agree - if you have a foot issue you should be able to book to see a podiatrist if you have a muscle injury you should be able to book to see see a physiotherapist directly not have to book (and pay) to see a GP for referral. Allied Health should be front line in Primary Care practices and in EDs - streamlined cost effective services and patients treated promptly and effectively

  • Posted by DG November 19, 2022 at 16:37

    Sorry, I should make my post abit clearer. In regards to podiatry being in the ED I strongly believe that they are best placed in assessing and providing a comprehensive diagnosis and treatment plan for acute lower limb injuries that present to the ED. Lis Francs, talar dome, fractures can all be assessed and triaged by an experienced podiatrist. Their knowledge in lower limb musc injuries would be invaluable. An experienced physio knees and above they are the best and again their knowledge is invaluable. If we can reduce the load on ED Dr's and have them concentrate on the really sick that would be a start.
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