Co-designing a methodology for workforce development during the personalisation of allied health service funding for people with disability in Australia

Abstract

Background Internationally, health and social services are undergoing creative and extensive redesign to meet population demands with rationed budgets. This has critical implications for the health workforces that serve such populations. Within the workforce literature, few approaches are described that enable workforce development for health professions in the service contexts that emerge from large scale service redesign in times of industry shift. We contribute an innovative and robust methodology for workforce development that was co-designed by stakeholders in allied health during the personalisation of disability funding in Australia (the introduction of the National Disability Insurance Scheme). Methods In the context of a broad action research project, we used program logic modelling to identify and enact opportunities for sustainable allied health education and workforce integration amidst the changed service provision context. We engaged with 49 industry stakeholders across 92 research engagements that included interviews (n = 43), a workshop explicitly for model development (n = 8) and a Project Advisory Group (n = 15). Data from these activities were inductively coded, analysed, and triangulated against each other. During the program logic modelling workshop, we worked with involved stakeholders to develop a conceptual model which could be used to guide trial and evaluation of allied health education which was fit-for-purpose to emerging workforce requirements. Results Stakeholder interviews showed that drivers of workforce design during industry shift were that (1) service provision was happening in turbulent times; (2) new concerns around skills and professional engagement were unfolding for AHP in the NDIS; and (3) impacts to AHP education were being experienced. The conceptual model we co-designed directly accounted for these contextual features by highlighting five underpinning principles that should inform methodologies for workforce development and AHP education in the transforming landscape: being (1) pedagogically sound; (2) person- or family-centred; (3) NDIS compliant; (4) informed by evidence and (5) having quality for all. We use a case study to illustrate how the co-designed conceptual model stimulated agility and flexibility in workforce and service redesign. Conclusions Proactive and situated education of the emerging workforce during policy shift is essential to realise future health workforces that can appropriately and effectively service populations under a variety of changing service and funding structures – as well as their transitions. We argue that collaborative program logic modelling in partnership with key stakeholders including existing workforce can be useful for broad purposes of workforce (re)design in diverse contexts.

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

“…Data for this study were derived from a two-year participatory action research project [ 24 ] that designed, piloted and evaluated allied health placement models for NDIS service providers (see [ 5 ] for a detailed methodology). The project was conducted in South Australia during a period of transition from government-led funding for disability service providers to a participant-led NDIS funding model.…”

“…Allied health practitioners provide many services that participants seek via their funding, but limited attention has been paid to workforce development strategies that support practitioners to develop the knowledge, skills and capabilities for these changed environments [ 4 ]. Workforce development in allied health includes student placements that are critical opportunities for students to develop and apply relevant knowledge and skills under supervision, in practice with clients in contemporary service settings [ 5 ]. However, student placement activities may not readily translate into new service provision models or specific practices developed in response to participant-led funding [ 6 ].…”

“…This marketised environment in turn, requires practitioners to develop knowledge, skills and capabilities that align with participants’ preferences [ 10 , 11 ]. In particular, allied health practitioners, who provide frontline diagnostic, relational and therapeutic services, require new capabilities related to emerging services that differ to those offered with traditional government-led funding [ 5 ].…”

“…However, typical health workforce planning and development strategies are derived from population-level methods that give limited attention to the skills and capabilities needed for emerging service provision and practice [ 12 ]. Further, for students who comprise the future allied health workforce, practice skills and competency development are directed by universities and broader professional accreditation needs [ 13 ], and intentional workforce development strategies that attend to the potential for participants to enact choice and control are not consistently included in learning activities [ 5 , 10 , 11 ].…”

“…These placement experiences are critical for workforce development as they shape students’ professional socialisation, future career and employment aspirations [ 14 , 16 , 17 ]. Service providers often utilise placements as a strategy to engage and recruit future allied health staff and influence their workforce [ 5 , 15 ]. Allied health students are typically supervised by allied health practitioners who work for the service provider hosting the placement [ 15 , 18 ].…”