Allied health workforce development for participant-led services: structures for student placements in the National Disability Insurance Scheme

Abstract

Background Health, disability, and community services are increasingly transitioning from government-led to participant-led funding models, which intend to increase choice and control for service users. Allied health practitioners, who provide many frontline services within the resultant marketised environment, must adjust their knowledge and skills to meet participants’ expectations. However, future workforce strategies to address allied health student capabilities to provide these services have received limited attention. This study explored shifting understandings and practices related to allied health student placements during the implementation of a participant-led funding model within the Australian disability sector: the National Disability Insurance Scheme (NDIS). Methods Data for this study came from a two-year disability workforce project exploring allied health placements. Service providers, participants, university representatives, disability advocates and students participated in 48 interviews and two focus groups to provide perspectives on allied health workforce and student placements. The findings result from secondary deductive analysis undertaken following project completion that used Gidden’s (1984) Structuration Theory as a conceptual lens to identify structures and actions related to the marketised service environment that influenced how allied health student placements were undertaken. Results The findings were organised using two Structuration concepts: knowledgeability, and duality of structure. These described how service providers, supervisors and students understood, legitimised and prioritised placement activities, and how these structures influenced and were influenced by the actions of stakeholders across NDIS settings, contexts and time. Initially, existing placement structures were not compatible with new structures emerging in the disrupted NDIS service environment. However, over time, and responding to new knowledgeability of service providers, supervisors and students, placement structures were identified, monitored and adjusted to reflect perspectives of all stakeholders. Conclusions Participant-led funding invoked structural changes in disability service provision that transformed how stakeholders understood placements and the role of students in service provision. Whilst there were new opportunities for placement, tensions were identified in how learning activities can be enacted within a marketised system in which resources are aligned to participant needs, and structures for workforce development and learning activities are less visible. Further conceptualisation of how student learning and workforce development activities can fit with contemporary funding models is necessary to meet participant, service provider and student needs.

Desde las discapacidades con afectación mental hasta la actividad comunal especializada

“…Este estudio examinó los entendimientos y prácticas cambiantes relacionados con la colocación de estudiantes de atención médica durante la implementación de un modelo de financiación dirigido por participantes en el sector de discapacidad de Australia: el Plan Nacional de Seguro de Discapacidad. (Attrill et al, 2023) Síntesis de la cuarta fase de actividad comunal especializada Aplicar servicios…”

An integrative review of the impact of allied health student placements on current staff’s knowledge and procedural skills in acute and primary care settings

“…Healthcare professionals have reported that ongoing education and training opportunities have improved their knowledge and procedural skills in client (e.g., patients, residents in aged care homes) care [ 28 ]. Since the COVID-19 pandemic, access to online professional development modules and training has improved [ 29 ]. However, a lingering question persists: can the co-creation of training programs and educational modules effectively contribute to the knowledge and skills development of both allied health students and healthcare staff?…”