Extended scope practitioners and clinical specialists: A place in rural health?

Abstract

This review identifies two models of allied health advanced practitioner practice that are currently in place in the National Health Service in the United Kingdom (UK). A review of the background to advanced practitioner status is given for UK allied health professionals and comments made on the outcomes of the UK roles. Description of the work of Clinical Specialist and Extended Scope Practitioner is given. Alignment with senior physiotherapy staff roles in Australia is commented upon. Some barriers or impediments to implementation of such a system in Australia are discussed with respect to registration, funding and support. The feasibility of such advanced practice roles for physiotherapy is discussed while benefits and cautions are identified. The potential for such a model of health service to be used in Australia, particularly in rural and remote areas, is identified for debate.

Measuring the quality of allied health services in Australia: is it a case of “the more we learn, the less we know?”

“…These activities are promoted as a way to enhance the skills of experienced AH practitioners and to subsequently unload medical practitioners of routine activities. 29,30 Extension of scope for AH practitioners may or may not be supported by formal training, credentialing, and legislation.…”

Conversion Rates and Perceived Barriers to Referral: Views of Extended Scope Physiotherapists in the Primary Care Setting

“…The number of specialist physiotherapists [now called ‘extended‐scope physiotherapists’ (ESPs)] working in musculoskeletal care has grown rapidly, as has the number of interface services. They are defined as clinical physiotherapists, working at an advanced level, after taking further training in tasks or roles which are recognized as being beyond the normal scope of practice for the physiotherapist, such as requesting X‐rays, making referrals to specialists and performing some injection procedures (Ruston, ). There are no published data identifying the number of CAT services in existence, their specialism (i.e.…”

Skills escalator in allied health: a time for reflection and refocus

“…1 Role extension is viewed as a skills escalator, where practitioners move up the skills escalator within the scope of their discipline, to advance it and then, with training, extend it (which often means adopting roles usually undertaken by other health professionals). 2,3 Discussions have occurred around Australia regarding the potential for extending the scope of a number of allied health disciplines as a means of addressing workforce shortages and patient demand. A number of pilot projects have subsequently been conducted to operationalize extension of scope in allied health disciplines.…”