There is no standard or agreed definition of "allied health" nationally or internationally. This paper reviews existing definitions of allied health, and considers aspects of allied health services and service delivery in order to produce a new model of allied health that will be flexible in a changing health service delivery workforce. We propose a comprehensive model of allied, scientific and complementary (ASC) health professionals. This model recognises tasks, training, organisation, health sectors and professional regulation. It incorporates traditional and new services which are congruent with allied health foci, allegiances, responsibilities and directions. Use of this model will allow individual organisations to describe their ASC health workforce, and plan for recruitment, THERE IS NO STANDARD or agreed definition of "allied health" in the national or international literature. The most common approach has been to group allied health professions, by name, into a loose collective, which is defined only by exclusion (not being medical or nursing/midwifery). There has been ongoing debate about what allied health services do, who their customers are, how they measure their effectiveness, and how they integrate under one allied health collective banner. Boyce 1 identified relationships between allied health professions as being the core link which sets them apart from medicine and nursing. She noted that this "alliance" reflects not only interdiscipline relationships in terms of customers and activities, but also relationships with the communities they serve. This model of integrated service intent and delivery would appear to be an appropriate framework from which to mount discussions about new nomenclature.Internationally, definitional approaches range from simply listing health disciplines that are not medicine or nursing, to collating and classifying different service types. The listing approach

National Health and Medical Research Council (Australia), Department of Health SA.

BackgroundMental illness is prevalent across the globe and affects multiple aspects of life. Despite advances in treatment, there is little evidence that prevalence rates of mental illness are falling. While the prevention of cardiovascular disease and cancers are common in the policy dialogue and in service delivery, the prevention of mental illness remains a neglected area. There is accumulating evidence that mental illness is at least partially preventable, with increasing recognition that its antecedents are often found in infancy, childhood, adolescence and youth, creating multiple opportunities into young adulthood for prevention. Developing valid and reproducible methods for translating the evidence base in mental illness prevention into actionable policy recommendations is a crucial step in taking the prevention agenda forward.MethodBuilding on an aetiological model of adult mental illness that emphasizes the importance of intervening during infancy, childhood, adolescence and youth, we adapted a workforce and service planning framework, originally applied to diabetes care, to the analysis of the workforce and service structures required for best-practice prevention of mental illness.ResultsThe resulting framework consists of 6 steps that include identifying priority risk factors, profiling the population in terms of these risk factors to identify at-risk groups, matching these at-risk groups to best-practice interventions, translation of these interventions to competencies, translation of competencies to workforce and service estimates, and finally, exploring the policy implications of these workforce and services estimates. The framework outlines the specific tasks involved in translating the evidence-base in prevention, to clearly actionable workforce, service delivery and funding recommendations.ConclusionsThe framework describes the means to deliver mental illness prevention that the literature indicates is achievable, and is the basis of an ongoing project to model the workforce and service structures required for mental illness prevention.

OBJECTIVEBest-practice diabetes care can reduce the burden of diabetes and associated health care costs. But this requires access to a multidisciplinary team with the right skill mix. We applied a needs-driven evidence-based health workforce model to describe the primary care team required to support best-practice diabetes care, paying particular attention to diverse clinic populations.RESEARCH DESIGN AND METHODSCare protocols, by number and duration of consultations, were derived for twenty distinct competencies based on clinical practice guidelines and structured input from a multidisciplinary clinical panel. This was combined with a previously estimated population profile of persons across 26 patient attributes (i.e., type of diabetes, complications, and threats to self-care) to estimate clinician contact hours by competency required to deliver best-practice care in the study region.RESULTSA primary care team of 22.1 full-time-equivalent (FTE) positions was needed to deliver best-practice primary care to a catchment of 1,000 persons with diabetes with the attributes of the Australian population. Competencies requiring greatest contact time were psychosocial issues and dietary advice at 3.5 and 3.3 FTE, respectively (1 FTE/∼300 persons); home (district) nursing at 3.2 FTE; and diabetes education at 2.8 FTE. The annual cost of delivering care was estimated at just over 2,000 Australian dollars (∼2,090 USD) (2012) per person with diabetes.CONCLUSIONSA needs-driven approach to primary care service planning identified a wider range of competencies in the diabetes primary and community care team than typically described. Access to psychosocial competences as well as medical management is required if clinical targets are to be met, especially in disadvantaged groups.

There is insufficient evidence to recommend the routine use of home visits for pregnant or postpartum women with a drug or alcohol problem. Further large, high-quality trials are needed.