Following is the transcript of the Allied Health Assistants event held by CSIA and AHANA. Watch the full event recording here.

 

Matthew Gillett:

Good morning everyone, and welcome. My name’s Matthew Gillett. I’m acting CEO at Community Services Industry Alliance, and it’s my pleasure to emcee today’s event. So welcome everyone to our session on allied health assistance. Introducing allied health systems into your NDIS workforce. I’d like to begin by acknowledging the traditional custodians of all of the lands in which we meet today. For me, that’s the Jagera and Turrbal people here in the central part of Brisbane. And I pay my respects to elders past, present and emerging, and extend my thanks and respect to all Aboriginal and Torres Strait Islander people joining us today. We’d love to know who’s in the room and we’re also really keen to know whose Aboriginal land you are on today. So if you’d like to pop open the chat and say, hello, let us know who you are, where you’re from, and also what lands you join us from today.

Matthew:

We’d really enjoy hearing about that. So thanks for coming along today, just by way of background. Community Services Industry Alliance has been working for the last three, four years with our colleagues at Queensland Council of Social Services and National Disability Services on a range of research under the banner of WorkAbility Queensland. The work’s been funded by Jobs Queensland, and it’s looking at the workforce impacts of the NDIS, and trying to develop practical solutions to the workforce issues that are being identified.

Matthew:

Way back in 2005, our first set of reports identified allied health professional roles, as very much in need and a real skill shortage in that area. As we probably all know, that hasn’t gotten any easier over time. In fact, for some professions that’s gotten more difficult. So one of the areas of work that we’ve focused on in this project over the last 12 months has been looking at allied health assistance and how a greater use of allied health assistance in the NDIS could help to extend the roles in NDIS support, create career paths for more people in the NDIS but also alleviate some of the skill shortage we have with key allied health professions.

Matthew:

So today we’re going to hear about the results of some of that work through the development of a good practice guide. We’re also going to hear current research from Dr. Kim Bulkeley on governance arrangements related to allied health assistants. We’ve got a panel with a couple of current allied health assistants. So we can hear a little bit about the experience of being an allied health assistant. And also we’ll be hearing from Chantelle Robards, who’s going to talk through a range of resources that are available to help organisations and individuals to think about establishing allied health assistant roles and how to support the roll out of these roles across our industry.

Matthew:

So just a little bit of housekeeping. We do ask that you keep your microphones on mute. I’ll try to remember to take mine off before I start speaking, and we’re very keen for this to be as interactive as possible. So if you would like to ask a question along the way, we’ll try to build those in as we move along. We’ve also got a little bit of time at the end for some general questions, a bit of a Q&A session. So, without further ado, I’d like to move to our first speaker is Dr. Kim Bulkeley. Dr. Kim Bulkeley is a senior lecturer at the University of Sydney in the workforce leader at the Centre for Disability Research and Policy.

Matthew:

Her program of research is focused on service models for people with disability, particularly in rural and remote areas and other areas that experience poor service access. She’s passionate about the development of innovative service models through partnerships with people, with disability, communities, service providers, and policy makers to develop responsive research approaches, and translation of research into practice. Welcome Dr. Kim.

Dr Kim Bulkeley:

Thank you, Matt. I appreciate that introduction. So if I could just have the slides shared Renee, when you’re ready. Great. Thank you. So I am at the Centre for Disability Research and Policy at the University of Sydney, and I’ve been there for over 10 years now. But I have a history as an occupational therapist working in the disability sector. And in that time, when I worked in the disability sector, I worked with therapy assistants most of my career. I also spent some time working in England and worked with the assistants there. So they have been part of my context; therapy assistants have been part of my context. So while I’m looking at this with a bit of a new lens with the NDIS as part of our newly developed or developing disability sector, there’s things to bring from the past with that.

Kim:

Could I have the next slide, please? So before I begin, I’d like to acknowledge the tradition of custodianship and the law of the country of the people whose land we’re on today. And that’s many lands. And I pay respects to those who have cared and continued to care for country, and particularly extend that respect to elders past, present, and emerging, and any Aboriginal people who are with us, Aboriginal and Torres Strait Islander people who are with us today in this meeting. Next slide, if you wouldn’t mind. I’d also like to acknowledge that the information that I’m sharing with you today is not generated by me. It’s generated by a large team and that the work would not have happened without the input of that team. So particularly this information today is based on a project that was done in partnership with Aspect. And so the team members from Aspect are listed there.

Kim:

I also involved an honours student in this work, we had a collaboration with SARRAH in doing this work, and also the librarian at the University of Sydney; was very helpful for some parts of it. But also the research participants who engaged, generously gave us their time in talking with us or engaging in different ways in the project. This project was also funded by a jobs and market fund grant from DSS. Go to the next slide, thank you. So Matt alluded to this a bit when we first started, when he opened the conversation here today, and there’s a lot of reasons why we care about therapy in the NDIS context. And basically, for me, the biggest issue is that there are too many people who don’t get the therapy services that they need, too many people with disability who don’t get the therapy services that they need.

Kim:

I’ve been particularly focused in rural and remote areas, but it’s not only in rural and remote areas. It’s an issue across the board. We also know, and some of that is really emphasised by the data that we see from the NDIA about service, a plan utilisation and under utilisation. So that’s something that it’s not just hearsay. There’s actually some fairly strong data about plan under utilisation and therapeutic supports is one of the areas that is noted as being underutilised. We also know that there are not enough therapists. So the state of the disability sector report, the most recent one, which is based on a survey of NDIS providers conducted by National Disability Services, highlights that therapy workforce is a significant and ongoing issue for NDIS providers and is predicted to continue to be so. So their difficulty with recruiting and retaining therapists is something that’s not new, but it is something that is perhaps getting more attention, and is something that’s predicted to continue along into the future.

Kim:

So there is a significant demand for therapists and yet the workforce prospects are not looking great. So we have to be thinking a bit differently about how we are responding to this. And then, thirdly, there are policy drivers to try and increase therapy service access, and they particularly speak to the therapy assistant model. So in the NDIS national workforce plan that’s looking forward from 2021 to 2025, therapy assistance are specifically noted as a model of service that needs to be expanded, explored, adapted, worked with, to make it answer some of these workforce issues that have been identified. I think one of the things that I just want to flag here is language and terminology. So I do use the term therapy assistant as I go through this presentation, because that’s the language that we used in our project.

Kim:

But I think there’s a conversation that needs to be had about whether in fact, in a disability space assistant is the right word. Therapy assistance, as they’re called now, really are like a support worker plus that are part of a team. They’re not just assisting the therapist. They’re part of the collaborative team around the person with disability. So I guess I’m just throwing that out there as a conversation starter to perhaps have people think about what might be a more appropriate term that positions this role in the way that it really exists in a disability context. If you can go to the next slide, please, Renee. So to put this information in a context, it was a much bigger project that I was involved in and I was fortunate to be invited by Aspect, Autism Spectrum Australia, to partner with them in wrapping some research around a jobs and market fund project that they had. The full report on this project is available on the Aspect website.

Kim:

So if you Google Aspect Therapy Assistance Project, that full report will come up. There’s a lot of very detailed information in that report about how Aspect delivered the services. So that sort of phase two, that’s on this slide here. It will be in that report. I won’t speak to that today. I’ll be speaking to the phase one of the research that we did. So if you want more of that detailed information where they talk about their onboarding, some of the goals and approaches that were taken, some of the business considerations, that’s in the full report.

Kim:

So just to make sure that you’re aware that it’s in that context, I guess, again, to acknowledge the wide range of work that happened to come up with these ideas, and I’ll talk to you about today. Next. Next slide, thank you. So one of the things that we did was a scoping review and this scoping review was done in partnership with SARRAH, Dr. Anna Moran at SARRAH partnered with us to have a look at understanding what was there in the existing literature, because that’s always a good place to start. What do we already know about this? And Elaine Tarn, the faculty librarian helped us with developing the search, because it’s not easy, actually. There is not a lot of information that is in the peer-reviewed literature that is specific to allied health assistance therapy assistance in a disability context.

Kim:

So we decided to try and broaden our scope a bit and to incorporate sort of four concepts. So an assistant who delivered therapeutic supports, any information about governance of these workers and a disability setting. So that’s the third one. And then we added in a rural and remote setting because we were more focused on a rural and remote setting in this project. So we ended up coming up with 26 papers, 18 of which covered all four concepts, and eight did not specifically address rural concepts, but the Australian literature dominated the conversation. So one of the things that was a very consistent finding was that soft skills were a key part of successful implementation of a therapy assistant role. So it’s not necessarily having particular clinical or therapeutic skills. It was the soft skills, the capacity to communicate well, to problem solve, to seek assistance when you need it to relate to someone, to have strong therapeutic alliance and relationship.

Kim:

So those soft skills were the biggest finding, really. Competencies were something that did come up and were absolutely needed, but in relation to specific client need or specific context. So some of the competencies there, there wasn’t such a broad range of them, but more specific and related to individual context and client groups. The term supervision is up there but I think the literature showed us that it was actually more about having access to the therapists who were developing programs or advising on programs, and maybe supervision isn’t the right term. It was really about support, collaboration. So again, this is another terminology question, I guess, that’s come up for me from this literature review rather than being answered by the literature review. There is no hard and fast thing of you must see somebody, you must speak with the allied health assistant every Friday.

Kim:

That’s not what came out of the literature. It’s actually about it being a collaborative and mutually agreed process in relation to the nature of the task, the competency of the therapist, and the context in which you find yourself. So yeah, that’s another question, I guess. Another concept that came up was the need for an evidence base. The evidence base isn’t strong in terms of how different models work or how things can be applied in a disability setting. So, sorry, something’s come up on my screen. So growing this evidence based specifically in a disability context, and this review is looking at a rural context, was something that we really felt was important because there are some things we can learn from the health literature, but there are some things that are unique and different from the disability perspective, particularly given the nature of the disability policy context in an Australian setting where there are now different drivers, which we’ll talk a bit more about later.

Kim:

So that context is a key thing. There has to be a responsibility to context. The nature of an allied health assistant role in one organisation will be very different to another organisation depending on the context. So that might be contextual things like geography, where the therapy assistant is located remotely from the therapist, from being located in an interdisciplinary team, to all sorts of different issues around the nature of the organisation that you work for, the client group, your experience, etcetera. So the context really matters. Care plans was a term that was pulled out of the literature, but it actually really refers to documentation and the importance of documentation as an essential part of clear communication between all team members, including the therapist and the therapy assistant, but not only, it actually was really important for that to be clearly documented for the client or the other team members. So that everybody’s very clear about what’s going on. Next slide, please.

Kim:

So another part of this study, we did some interviews with 16 stakeholders from six states and territory across Australia. So we didn’t have representation from the ACT or WA, but so we did talk to 16 stakeholders who were implementing a therapy assistant model in the disability context in Australia now. And it was a larger number of occupational therapists in that group, but we also had therapy assistants, managers, speech pathologists, physio doctor, and then other sort of HR managers. So some of the things that came out of those conversations and business considerations is at the top for a reason; it was a very loud theme that came out of those conversations. And that’s quite different to any of the other therapy assistant guidelines that exist in other contexts.

Kim:

So the business considerations included aspects around risk and quality as well as financial viability insurance; all those sorts of things, which, you’ve got a bit more information now in the new practice guide and Chantelle will speak to as well late. But that’s a very different factor that hasn’t been in previous conversations when you’re talking about a therapy assistant model in perhaps other contexts like health and aged care. Scope of practice was something that was really interesting with the variety that people had expanded.

Kim:

And so, I think really it’s about understanding that there is a very broad scope of practice for therapy assistance when working in a collaborative person-centred model in a disability context, support and oversight was something that we, again, heard about. It was absolutely a concern. It did link with the business consideration aspects in relation to risk management and responsibilities. But it also was talking very much more about how to calibrate that support and oversight, depending on the individual context, the individual therapy assistant, the therapist, the nature of the condition of the client group.

Kim:

And so the issues there were around collegiality, teamwork, shared learning, task sharing. Those were the sorts of concepts that were coming through in relation to support and oversight. The workforce capability issues came up and that talked about training and the need for induction and ongoing skill development, career pathways, a pipeline to bring people in. So workforce capability is a key issue, and there are lots of unanswered questions there around existing training, existing resources and the cost of that, right? And how that can be built into the business modeling of these approaches. We asked a specific question about tele-practice because we knew it was an emerging area. And we found that not very many people were having therapy assistants deliver their services via tele-practice, right?

Kim:

So that’s where the therapy assistant is remotely located from the client. But we did hear more about therapists supporting therapy assistants using tele-practice. So the therapy assistant might be with the client in a remote location, and the therapist would provide support in that tele-practice way. It’s still emerging. And there’s still lots of issues that people are trying to understand and deal with in that area. But it was certainly a way of extending the reach of therapists in the therapy assistant model. Okay, could we go to the next slide.

Kim:

So I combined the literature from the scoping review, the themes from the interviews that I’ve just gone through there. I also was keeping in mind the code of our framework, which people are probably familiar with and if not, have a look at it. It was developed in the UK around therapy assistant models, and then the international classification of functioning, which is something that is fairly heavily lent on in relation to the NDIS legislation and approaches. Where we look at a bio-psychosocial model. So we are looking at more of a social, the participation and impact of disability rather than a diagnosis and the medical condition. So I was trying to bring all of those ideas and concepts together. So participation seems to be the key thing that drives the need for therapeutic supports and therefore the therapy assistant model.

Kim:

So that was where I felt this model differed from some of the other models that we are really focusing on participation and looking at a person-centred approach. So that we’re really keeping the team as a flat team, that is centred around an individual with disability. So I organised it in my mind into these sort of principles and factors that would guide anybody who was thinking about introducing a therapy assistant model. So the key principle for me, and the number one thing is around participation so that the focus has to be person-centred and participatory. So you really look at where does the therapy assistant therapy support worker, task share. I don’t know what the word is going to be, but where does this role sit in relation to supporting the participation of the person with disability, and then who does that role need to connect with in order to make that something that is assisted and promoted. The team needs to be that respectful reciprocal team relationships, rather than seeing the therapy assistant, as only connected with the therapist.

Kim:

It really does need to look at where this sits within the whole team. And so there is also then, this two-way reciprocal learning. So you have contributions that are really essential and insightful from the person with the disability, into how people work or providing insight and advice about the experience, the lived experience of that person. The therapist will provide perspectives from their professional background. The therapy assistant will provide perspectives from their localised, perhaps more connected, more frequent contact with the person with disability and the context.

Kim:

So really looking at flattening those structures so there’s very much more collaboration. And that there is a need to focus in on quality. Sometimes people saw therapy assistant roles as being a second class, a second rate a service because there isn’t enough therapy time. I really challenge that. I think this is a very high quality approach. And looking at maintaining that as high quality, not a second rate, is a key part of making sure this model will work. So, for example, people talked about a much higher frequency of being able to implement strategies and tailor strategies in the context, because the therapy assistant goes to implement and work with the person with disability two times a week or every week, whereas the therapist has much less frequent contact. So by having that combined, you actually get much better outcomes.

Kim:

So those are sort of principles that are there that I think we have to really try and understand how they fit when you’re looking at a context and trying to implement a therapy assistant model. Then some of these other factors were things that are more practical things, I guess. And so absolutely the business model. So insurance, that’s telling me I’ve got five minutes to go, insurance costings, billable hours. All of these aspects are really important things to understand when you’re setting this up to start with and how you might implement a change management process in a business way, because it is a change, right? If you’ve not had this model before, you have to look at how you do it in a planned and considered manner.

Kim:

The way that team members are supported; and this includes training. So this is training for therapists who haven’t worked with therapy assistants before, other members of the team who may not have worked with therapy assistants before, the therapy assistant in relation to different competencies and skills. So it’s really looking at supporting this model of practice in the round. It’s not just about the therapy assistant requiring support. It really is about training at all the way around. And then looking at the scope, the scope will be quite different, as I mentioned before, from the conversations that I had with people, really big range of things that people did.

Kim:

But being really explicit and negotiating that in the particular context is something that I think will really make the role work better when you do that in a considered way. So it’s really important to look at these factors and think them through for your particular situation. So that’s the sort of draft framework that I’ve come up with at the moment based on that bit of research. Can we go on to the last slide. Thanks, Renee. So I’m very passionate about this model. I think it has a lot to add to the disability sector, but I really think we need to build a national conversation about the contribution of this workforce around the-

Kim:

At the contribution of this workforce around the framework that I’ve developed around the other resources and things that have been developed, because we have to be really clear that it is very different from the health system, from the age care system, so we can’t try and shoehorn it into those existing structures. We have to develop our own narrative and our own conversation about what disability therapy assistance models look like. So developing of resources, like the guide that you’re going to hear about today, is something that will help if we have something that is very targeted on an NDIS context in a community setting that really brings in that model, the international classification of functioning model that focuses in on participation rather than the condition, that will change the flavour of the information that we develop into these resources.

Kim:

I also think there’s a place for training to be developed that is more shared and collaborative. It’s been difficult to do that, because there hasn’t been a place where that’s worked strongly in the disability sector. There’s no need for further conversations with the cert for people, but very much at the moment, that’s a dominated by medical model, which I think has some benefits in terms of people’s getting skills that are transferable across a broader sector, but it is not really meeting the needs of the disability sector at the moment. So we need to look at whether there’s some way of developing some broader available training and support resources that could be shared across organisations because it’s inefficient for every organisation to be doing that individually. Okay, so I think that’s all I wanted to say.

Matthew:

Terrific. Thanks Kim. That’s such a great overview of the literature and that framework that you provided I think is a really helpful one as well. If people have any questions, please feel free to raise your hand or pop a question into the chat. Kim, I had a quick question. I just wanted to come around to your final comments there about the medical model and that this is a role that’s more established in the health context and to some extent, particularly residential aged care. I wonder if you could reflect a little bit on what do you see as some of the real differences for the social model of care that is at the heart of disability supports?

Kim:

Yeah, so I think the biggest thing for me, having worked in both sectors because I didn’t work in the health sector for a while but found my home in the disability sector, is that in a health situation there is often a lot more acute conditions, so the need for very close at the elbow oversight of the work of an allied health assistant is greater, right, because there is a lot of fairly rapid change and so the medical condition and the changes in the medical condition dominate the conversation.

Kim:

In the disability sector, we have people who have a particular condition, but it is fairly stable, not entirely there will be changes, but in terms of the changes I could, as an OT, I could write a program that could be implemented for some months in order to achieve a particular goal, whereas perhaps in a health setting that those goals might change in two days. So, the level of oversight and supervision at the elbow kind of connection with the therapy assistant is generally greater in that health setting. So if we transfer that over to disability, we are at risk of having over governance and they’re not making most of the potential in a community setting with longer term goals, so that’s my concern when we bring some of those things without really interrogating them.

Matthew:

Yeah, that’s great. And I think that’s a shared concern amongst others who’ve looked in on this role as well. We’ve got a question from [El 00:32:25]. El’s asking what type of organisations could collaborate to deliver training private, not for profit government and perhaps if you could give an example?

Kim:

Yeah, well I know it’s difficult and I’m not a really good business person, so perhaps I’m not the best person to ask that question right, because monetising things and doesn’t spring to my mind as a first port of call. But for example, I’m part of an organisation called Disability SPOT, that’s a group of therapists and it’s based in New South Wales, but not only. And we run a community of practice and so there are lots of therapists from different organisations who come together. I think there’s a place for that sort of community of practice where you might host some modules on a particular type of condition or technique or on visual supports or something like that, rather than everybody having to develop that for their own staff group. I think there might be a role for the quality and safeguards commission in this, in terms of having some modules or programs that they commission and then have them on their website so that everybody has access to them that it’s not a paid barrier because that can be a real barrier for people.

Matthew:

Yeah, absolutely. And I think there’s the great suggestions about different approaches to training as well. Chantelle’s been very helpful in the chat as well and has pointed out that the human services skills organisation has a guide for working with registered training organisations around how to tailor the training that the cert three or the cert four that they may deliver in this space to particular needs. And I know we also found from the work that we did under the WorkAbility banner, that there’s also a focus on working with students who are undertaking allied health, undergraduate degrees and harnessing their skills in the therapy assistance space as well.

Matthew:

Good. Thanks Kim. Thank you so much. We might move now to hear from some people who are actually in the role of allied health assistance, a really great opportunity to hear from people about their experience and I’d like to introduce, first of all, Tara Intarapanya. Tara is a Carpenteria team leader and senior allied health assistant in the Northern territory. Welcome Tara. I wonder if you can tell us a little bit about your experience and the role that you’ve got and your insights into the role of allied health assistant in your team.

Tara Intarapanya:

Absolutely. Thanks Matthew. So I just to give you a bit of a background about myself, I did a diploma of occupational therapy and physiotherapy assistant in Canada back in 2008 and since then I’ve been practising as a therapy assistant, both in the acute care settings and community settings in public and private health. So that includes acute care settings like in the hospital, but also with children’s development team, supporting the NDIS up here in Darwin with the zero to seven year olds. And as you mentioned, my current role with Carpenteria as team leader and senior allied health assistant.

Tara :

Uniquely about the role here, is that we provide a broad range of supports for therapists and within various disciplines and with the skill sets being applied to participant goals within our day adult day program here. And I also think unique generally about the allied health assistant rules, similar themes will come up to what Kim spoke about that we can provide efficiencies, whether you’re speaking about a length of stay in hospital or meeting participant goals using NDIS funding. As Kim mentioned, it’s not a lesser service, it just is an extension of what, of the therapist’s program. So I think by consolidating the therapy that families, cares or support workers are delivering that the chances of referrals for the same goal become less because they’ve been able to consolidate the information and the strategies they’ve been given. At the adult day program where an operational connection for therapists who want to seek participants there and we support the implementation of individual therapy goals within the adult day program up here.

Tara :

And we’re also champions of modeling active supports and engagement across the lifespan, which I’ve kind of already mentioned, but for families, cares and support workers. But that’s not to say that there’s not challenges in the role at the moment. There are so many things we can do and we can deliver, it can be difficult to determine the scope of the role for an organisation and I know that’s a constant conversation that we have here. And in preparing my thoughts, I had a conversation with our manager of allied health and she fully supports and acknowledges that supporting allied health professionals to have an understanding of delegation and that conversation should never stop and clinical outcomes need to be reviewed regularly. So in their catch ups supporting how to implement the allied health assistant in programs that provide good clinical outcomes is a conversation she has regularly with staff.

Tara :

Also, another challenge is allied health assistance who are new to their role in building confidence to advocate for themselves and be able to present their scope to therapists, that can sometimes be a challenging arena to enter, but it’s very valuable so that therapists know what supports you can offer. Just in my experience, AHA just requires a lot of conversations and collaborations to determine that scope of role and to make sure that the therapies and supports fit the goals that you’re trying to meet. And I’m very fortunate to work with an organization that supports that collaboration, so that’s a little bit about me up here in Darwin.

Matthew:

That’s terrific, Tara, thank you. And what a great way to frame that notion of the scope and delegation is to keep it as an active conversation all the time, and really speaks to what Kim was saying about support and direction being in both directions between the therapy assistant and the therapist as well. Thanks Tara. I’d like to invite Karen in now to the conversation. Karen Eldridge works at GP Plus Healthcare Centre as a physiotherapy assistant in south Australia. Welcome Karen. Could you tell us a little bit about your perspective in the allied health assistant role and particularly I guess as you’re specifically a physiotherapy assistant as well?

Karen Eldridge:

Yeah, thanks for that. I’ve been working as a physio assistant for coming up 15 years this month. So I work in regional south Australia in the public health, and yeah I’ve worked with in the time that I’ve been here over 60 physios and numerous other allied health professionals. So had a fair range of experience with lots of different people. I initially thought about becoming a physio when I was at school, but coming from a small country town, I didn’t know how to financially or logistically go about attending uni, so I dismissed the idea until a few years later when a friend suggested becoming a registered nurse and studying externally. So halfway through my degree, the position for a physio assistant job was advertised and I applied for that and was successful and relocated my family to take the position.

Karen :

So yeah, since starting, I’ve done a lot of on the job training as well as shadowing of the physios. I’ve completed my certificate for in allied health assistant, but I’ve also done more job specific training like hydrotherapy rescue and physio aquatic training, numerous falls and balance and exercise based trainings. I’ve recently done my cert three in fitness, also tie Chi and then things like sort of exploring attachment theory, chronic disease, self management programs and things like that. So I’ve also got experience working within dietetics occupational therapy for dietary. And I’m also currently doing a couple of days a week in NDIS admin as well.

Matthew:

That’s great, Karen. So certainly sounds like the roles provided you with plenty of variety and opportunities for development as well. That’s terrific.

Karen :

Yeah.

Matthew:

Karen, what would you say are the things that you enjoy most about the role?

Karen :

I think just because every day is different, so one day I could be working on site in the physio gym, or I could be at the therapy garden or I could be traveling around town locally or out in the region, so for home visits, doing hydrotherapy sessions, sometimes just going for a walk or taking the client’s shopping and anything that’s pretty much within their therapy plans, working with them towards that.

Matthew:

Yeah, that’s right. And Tara, can I ask you a similar question? I’ve been thinking about your role, which sounds a little different from Karen’s, what are the things that you like most about your role?

Tara :

In my role, I get to support physio speech and OT at the adult day program at the moment. Both, as I mentioned, individual goals but we also get the opportunity to do a bit of program development in modeling engagement for the support workers that work there. So I really enjoy the variety that I get as well, similar to Karen and being able to support the various therapists, but also that valuable multidisciplinary lens that you develop from working with therapists. And I love working with people and seeing goals, outcomes, and quality of life daily.

Matthew:

Yeah. And what about challenges, Tara? Have there been things that have been particularly challenging for you in the role?

Tara :

Yeah, yes. I mentioned before, just determining the scope of the role. So this role started last year in May of 2021. So as you can imagine, it starts out as something and becomes something else and something else, and I, depending on the need and how the management want the program to run. So determining that scope, I think would be the biggest challenge to the role. And there are so many things we can do just tying that into a nice little bow with a package. It would be the biggest challenge, I think.

Matthew:

Thanks Tara. We had a comment, I think, in the chat as well about interchangeably using terms like supervision and support and oversight. Karen, I wondered without trying to pick those notions apart, we heard from Kim that this was a critical aspect of making sure that the therapy assistant role is successful. Could you tell us a little bit about, well, if you had to provide some advice to an allied health practice about what they needed to do to make sure that their therapy assistance were well supported and well developed, what are the sorts of things that you’d recommend?

Karen :

Yeah, I think the support is definitely a big one. So either having a dedicated allied health professional, or a senior AHA that they can liaise with, run things through and just talk everything and be supported. A lot of our work is external, so we do have a lot of regional areas, so we don’t necessarily see a lot of our other staff during the week. So yeah, having that support around you and having that person you can contact is really good. I think a lot of on the job training is very beneficial as well. Yeah. And just having a contact person we’ve recently brought in the clinical supervision, which has been quite beneficial for us as well, having that person you can go to and discuss all your clinical concerns or how you’re going with your therapy and things like that.

Matthew:

Yeah. Fantastic. And Tara, do you have particular advice and how to support and develop therapy assistance?

Tara :

That’s a good question, Matthew. I think definitely. So I’m very keen in Darwin anyway and I think nationally to, for allied health assistance to see themselves as a workforce, I’m not sure if that happens and I think by them acknowledging themselves as a workforce onto their own, that’s what I would like to see as the biggest support moving forward so that the current assistants are supporting the graduates who are supporting the graduates similar to what we would see for degree programs.

Matthew:

Yeah. Fantastic. And I think…

Tara :

I might also just do a quick plug for, I’m also an AHANA board member you’ll hear from our CEO Ben coming up, but definitely that’s on the allied health assistance national association radar as well for training and support.

Matthew:

Yeah, that’s fantastic. And I think that whole notion of raising the professional identity of this as a key role is really exciting. And yes, we’re looking forward to hearing from Ben a little bit later. Look, Karen and Tara, thank you very much, it’s been great to hear from you. We have encouraged people to ask questions in the chat and I noticed you’ve been overachieving and responding as well, so thank you so much for that. We might come back if there’re questions later in this session, but I might now move on our next speaker and thank you both for your contributions today.

Matthew:

So I’d like now to introduce Chantelle Robards. Chantelle is the allied health subject matter specialist for the boosting local care workforce program. And Chantelle’s going to tell us a little bit more about the good practice guide that we mentioned earlier, but also about a range of other resources and supports that you can find that will help you in considering and developing an allied health workforce. And most importantly, you were asked to provide some questions as part of the registration process, so we’ve given Chantelle the job of following up on as many of those as we can in the time available. So thanks, Chantelle. Welcome.

Chantelle Robards:

Thank you. Thank you, Matt. I’ll just make sure this share’s okay, [Renee 00:48:35]. You can jump in and tell me if that’s… Is that okay? I can’t see.

Renee:

So we’re just seeing it as a presentation. If you just want to hit the play from start in the top left, let me know. And now we’re just seeing your presenter slides.

Chantelle:

We had this issue earlier. I had it all fixed up. Just give me one second. I think I needed to do this. I needed to do this.

Renee:

Everyone can stand up and…

Chantelle:

This, sorry. Yes, should give yourself [crosstalk 00:49:10]

Renee:

Do five star jumps and sit down.

Chantelle:

Sort out the technology. Are we sort of fiddled with this earlier and got it working. How’s that?

Renee:

Oh, sorry, Chantelle, it’s still the…

Chantelle:

It’s giving me a few options here, so let me try this.

Renee:

That’s it. Perfect. Okay. Thanks everyone.

Chantelle:

Cool. Apologies. I had a feeling that would happen I closed everything so I could open and find a link to post in the comments. I knew it was going to bring me undone. I had it exactly working right. Anyway, thank you. It’s lovely to see everybody here. I see a lot of familiar names on the attendance list and fabulous. Thank you for joining us. It’s my great pleasure to introduce you to The Allied Health Assisted Good Practice Guide that CSIA have developed in conjunction with their research partners. Matt, would you like to jump in at this point and just link all that together?

Matthew:

Yeah, absolutely. Thanks Chantelle and my apologies for not doing that earlier. So as part of the WorkAbility consortium project, as I mentioned earlier, we’ve worked with support from jobs Queensland and the University of Sunshine Coast to develop the good practice guide, so we also did a literature review, when I say we, the university did a literature review and also identified, I think it’s nine case studies of allied health approaches. So the lead researchers, Denise Woods, and the team at University of Sunshine Coast. Thanks, Chantelle.

Chantelle:

Brilliant. Thank you so much, Matt. I just didn’t want to make any mistakes and leave anybody out. I was very fortunate to be a part of the process of this research as just a contributor and linking a number of businesses in to have a chat with the team. The good practice guide, oh, actually, where I’m going to start. There we go, is having a snapshot at our allied health workforce, this is 12 months old, this data, and I actually think the data would look worse than it does here. What this graph represents is the number of seek ads for, and the exceptional increase in positions vacant across just a few disciplines and of course we know that this is quite extreme across more disciplines than what I have represented in the graph here.

Chantelle:

As Kim said earlier, the workforce is about the thinnest I’ve ever seen it in my 20 plus years of being an allied health professional and getting thinner. We don’t have enough data as to where the gaps are and why they’re there, the life cycle of an allied health professional, there’s a lot of questions that we have that sit behind this data. And we’re hoping that there’ll be a national allied health workforce plan emerging at some point in the coming years so that we can try and approach the workforce shortage at an allied health professional level, at least partway. But right now, obviously with the four year degree, this is not something that’s going to turn around quickly and we have to look at other solutions and that’s why we’re here today as allied health assistant, as one of those possible solutions to this quite critical issue that we have right now. And most of these jobs being advertised are in the disability sector.

Chantelle:

So The Allied Health Assistant Good Practice Guide is a guide that was pulled together as a result of the research that was conducted by the team collaborating with CSIA. Now what the guide does is it takes us through a number of areas and really, I guess, gives us some things to ask ourselves as primarily as business owners, or I guess as managers. And then with some tips as to some strategies that you might want to implement in an effort to find solutions for some of these things that we know are challenges, I’m having this conversation regularly with businesses, a lot of businesses want to give this a try, just can’t figure out how to make it work. And this guide is a really good starting place to start at least getting those thought processes going and some really great case studies at the end so that you can really dig in and have a look at how other businesses are making work.

Chantelle:

I think Renee posted the link to the guide earlier in the chat, but it might be worthwhile another post there, Renee, while we’re talking about it. So, the case studies are structured like this and I threw in a screenshot here so that you can get a feel for what the case studies look like. Just sort of looks at the… And again, back to what Kim was talking about context, so each of the case studies are quite, they’re quite different context and the benefits and challenges and strategies, they’re all different depending on those contexts. So really worthwhile looking through seeing if any of those case studies align with your business and how you work and where you work and see if any of those strategies would be applicable to your business.

Chantelle:

We know we have some gaps currently in the allied health assistant role, Kim named them in terms of an appropriate governance and delegation structure for our particular sector, for the care and support sector. There are a number of frameworks that you can find that are relating to health, but we all know that the infrastructure within those systems is very different and the risk profile as Kim raised earlier is really different. So what I like about this good practice guide is it gives you, it really talks to the power that you have as a manager or a business owner in taking control of some of those things where we do have a gap in terms of legislation or a governance framework, or a rule or a guideline. We do this constantly in business for all sorts of challenges that we have. We do independent risk assessment and we find mitigations and we find solutions.

Chantelle:

So this guide is really, really encourages you to do that. You think through where the problems are for you in your context and how you might find solutions in your context. So I really encourage you to have, it’s an easy read too, double bonus. So I would encourage you to have a look through and see if there’s some helpful little tip bits in…

Chantelle:

And see if there’s some, some helpful little tidbits in there, if you are considering implementing allied health assistant. And we hope, Kim, that one day we do have those frameworks and governance structures in place that will give everybody a bit more hard and fast place to sort of plant their flag, I suppose. And instead of everyone having to do this individually, which is what you are, you really do need to do right now, but it’s not impossible. Just yesterday, I have started another community of practice because hey, you can never have too many communities of practice. I have opened a page called Implementing Allied Health Assistant Community Of Practice on Facebook. When I did the screenshot, 48 members, but we’re up around a hundred already. So please feel free to jump in and join that conversation that is supposed to be supportive, place of sharing information and ideas and asking questions. So anybody, all welcome in there.

Chantelle:

I’ll also make sure, as I become aware of any other initiatives or events that they’re posted in there. So you’ll be able to see what’s coming up. The boosting team will be running a series of workshops to further this work, that CSIA have done. We’ve got one coming up the beginning of September on viability and business modeling, one on HR considerations in October running one on how to become a delegator and for us control freak, allied health professionals in doing some of the letting go that we need to learn to do when we’re delegating and working with an AHA. And then I’m just in the process of organising one on risk as well. So those links, I will post into that community of practice as soon as they are live. The viability and HR ones will have very limited numbers because they’re designed to be interactive workshops, not throw information at you webinar, but they will be recorded. So if you miss out, don’t panic. At a later date, they’ll be available.

Chantelle:

I thought of something else I wanted to raise there, but it’s gone. So when it comes back, I will come back to it. I would also like to let you know about the research that Monash have done. Now, fabulous research that, Lucy Wells on this call today, I just saw her name pop up in the list and I’ve asked her if she’d like to speak to this. So Lucy, if I get any of this wrong, please raise your hand or jump in and correct me. The Monash have done a really great project looking at again, implementing AHA and have produced a report that is really quite thorough. So I actually really think it’s a very good report with a series of recommendations and links to resources in that report. Lucy said she would post that link into the chat now.

Chantelle:

So Lucy, if you don’t mind throwing that in, so people can find that report, that would be great. Really worth the read. That one’s quite lengthy, but worth it, but it does cover the whole sector, not just our care and support sector, but there’s lots of relevant care and support sector information in there as well. Now, another resource that I’m just going to highlight now to you before we hit the questions and I’m going invite Shem from Sarrah to speak to this. So I’m just going to mute myself now, Shem, if you’d like to jump on and speak to your slides.

Shem:

Hello, thank you for having me. Can you hear me? Yes. Great. Okay. So yes, my name is Shem and I work for Sarah. We are services for Australian rural and remote allied health. I’m quite new to the team. And I have a background in podiatry where I worked in north Queensland in the public sector and a little bit in the private sector as well. And so, yes, I’m grateful to be here today. And I do have some experiences as a podiatrist working with therapy assistants in varying capacities as well. But I’m here to talk to you about the BRAHAW program or project, which is build your allied health assistant workforce. This is a Commonwealth funded project, specifically targeted at assisting rural and remote allied health practitioners working in private and non-government organisations, helping them build their AHA workforce, also roles and models of service delivery to promote the viability and reach of their practices, which as you would know, has a really positive effect on the surrounding communities, especially in rural and remote areas.

Shem:

And I’ve seen that firsthand, just what an impact and effective AHA or a team of AHAs can have on the community when it’s implemented well. And so there’s a table there just outlining what the financial resources are for the project, which is we would cover the educational funds for an allied health assistant or potential allied health assistant to complete training, a cert three or four in allied health assistance that’s a very flexible, I guess, resource. We can supply that to be trained at the most convenient educational facility. So if there’s a local TAFE or university that offers that course, then that’s where we would encourage you to go. There’s also a workplace training grant that essentially considers the cost of supervision and on the job training so that we can backfill or supply resource to backfill for the trainee while they’re undertaking that supervision and on the job training.

Shem:

And there’s also an allowance for travel and accommodation. And if we just go to the next slide, there we go. This just talks about really the four areas that the project is targeting when we are interacting with organisations or businesses. So obviously what I’ve spoken to mostly is workforce. So it’s whether you create a recruitment role, a training position in your organisation to recruit into an allied health assistant position. And then that person is funded to undertake training, cert three or four, or it’s an existing person. So we’ve had applications from NDIS, organisations that have support workers that wanted to up skill and become certified as AHAs. So it is very flexible in that sense, whether it’s a recruitment or an existing staff member, but also the supervision and support is such a big part of that. And I think that’s been mentioned this morning already, but it is so important for AHAs to have that supervision.

Shem:

And we really try to support organisations in allocating that time for the trainee so that they can have that face to face time. And also that allocated time to undertake their education in a supported way. We also support the organisations in assessing their governance, their policies, and frameworks and competency checklists, to make sure that the structure of their business is supportive of AHAs as they interact with the community and their clients, and also service models. So looking at the service design and project management, and also looking at the allied health practitioners as well and how their service is delivered and designing that in such a way that it really utilises AHAs as much as possible. Because as I said before, I’ve really seen how effective that can be. And I’ve also seen the challenges when allied health practitioners aren’t equipped properly to delegate to allied health assistance. And they don’t have the tools to explain to plan or different things like that.

Shem:

So I think I’ve spoken to the guts of the project and the BRAHAW projects applications have actually closed, but it is something we’re hoping to expand in the future. So if it is something that would interest you or your organisation, I’d encourage you to head to sarrah.org AU and either sign up to our newsletter or become a member or a corporate member. And that’s the best way to stay in touch with us and just keep your finger on the pulse regarding what is going on with Sarrah, what projects we’ve got coming up and whether this BRAHAW or project is something that’s extended in the future, but this is something we’re just starting, the applications closed, I think, a week or two ago. And so we’re really looking forward to walking this project through and seeing what outcomes we can deliver.

Chantelle:

Amazing. Thanks Shem so much. And thank you for jumping in, for me, it’s so much better that you explain it and I don’t. Okay. We’ll move along. Now, before I talked to funding, I remembered two things that thing I thought I wanted to tell you before. I wanted to let you know that the NDIS workforce plan is being redone. So I’m hoping in my heart that allied health gets a little bit higher profile in the new version, but just so you know, that’s happening in the background under the new government. So, these things tend to take a while, but hopefully within the next year, we’ll see where they’re going to prioritise workforce and allied health assistant hopefully will stay where it is. And we might even get a little bit more of a profile for allied health in general.

Chantelle:

The other thing I meant to mention back when I was talking about Monash, Monash run an annual allied health assistant day, and that’s coming up in November. Lucy might post the link again for that. If you’d like to register or send someone along from your organisation to pop their head in and on, it’s all online on allied health assistant day. Some really good speakers and presentations. So that’s worth a look as well. So, jump in and have a look at that. All right. So now onto your questions, and I’ll have to move through these quite quickly, because we’re nearly out of time.

Chantelle:

Now there was a question around funding options and obviously in the NDIS this is around the NDIS price guide and prices for our plan and agency managing NDIS. Participants are capped at the levels that are listed in that price guide. There is a little bit of loading for the remote areas, far, rural and remote. And there is an option within the NDIS for in this scenario that I think Kim spoke to earlier where the allied health assistant might be with the client in a remote area and the allied health professional is zooming in or telehealth thing into the session. There is an option for both of those roles to charge out for that hour. I know that’s a very practical thing, but I have it in writing now. That is actually okay. So that’s just within the NDIS obviously. I just wanted to cover off on that.

Chantelle:

Unfortunately, the only way that price within the NDIS is movable is if a participant is self-managing their funds. In the aged care sector, I’m not sure how in home care, it would come out as an hourly rate, just like therapy does, and residential age care, their funding model is changing right now. So that’s a bit watch this space. And what we are watching a little bit of is when allied health assistant roles are advertised in aged care, making sure that there is adequate supervision for those AHAs in there, because when not sure that’s always the case, and we are concerned that people are just being a bit left out on a limb. So just watching that with one eye open at the moment.

Chantelle:

In terms of supervision, there are loads of questions about supervision. Kim has touched on these, the AHAs that spoke earlier have touched on these. There’s lots of frameworks that are available, but then nearly all health facing. Now, of course, health operate with a different model, often within clinic, often with a very thorough infrastructure of governance sitting around it. So they’re worth a look to give you some guidance, but be aware they’re probably not completely suitable for the care and support sector.

Chantelle:

So if you are building your own framework, you would probably do this as part of your risk management process. Just be aware that they would probably need a fair bit of tweaking to make them suitable for the care and support sector. And I’ve posted all of those links to the ones that I could find anyway, into that Facebook group that I posted earlier, so that you can find them, but if anyone doesn’t want to join or isn’t on Facebook, just reach out and I can email those to you.

Chantelle:

Oops, here we go. So there’s regulation is an issue, but is in the process of not being an issue. Thank you, Ben and AHANA. So AHANA are doing some good work and I’ll let Ben speak to what they’re doing. I think that’s putting us on the road to some self-regulation within allied health assistant profession, which is really great news. And I think that will help the sector get their heads around that risk element and governance and how everything kind of fits together.

Chantelle:

But I just wanted to remind business owners, because there’s so many questions about this as well. Don’t forget that if you’re a business operating in Australia, everybody is subject to all that legislation as already. Privacy WHS, Fair Work, Fair Trading, Anti-Discrimination. There’s a range of law that we’re all operating under and that applies to AHAs as well. So it’s just like any new employee into your business. All of this applies to everybody. So while I think we see it as a role that’s not very well regulated from a clinical perspective, certainly in AHANA in the process of trying to type that up, but please don’t forget. There’s a range of legislation in place that certainly does some of that. And of course we all have our own code of ethics as well, so that we’re operating under and that should be guiding a lot of our decisions as well.

Chantelle:

In terms of KPIs, billable hours, lots of questions about this. Yeah. It’s based on business model, skill level, experience level, just like anyone in your business. It does require a bit of number crunching, hearing varying stories about whether businesses can make based on the NDIS price capping, how successfully they can make this an arm or a successful revenue stream for their business. I’ve spoken to a couple of providers just in the last couple of weeks, community based work, hearing you talk about that, Karen, earlier, because the AHAs, obviously in the NDIS world, is paid for all of their time, plus their kilometre rate and the hourly rate from the NDIS doesn’t cover that, especially in further in regional areas where that travel is quite high. So, we are looking at ways, solutions to make the AHA model works, especially in rural areas where the workforce is thinnest in terms of AHPs. We need to find a solution. And so we’re just playing around with some business modeling there.

Chantelle:

And the supervision provision, which is, of course you’ve got your on costs that we are working with any employee and AHAs supervision is in line with the intensity of their KPIs. So if you’re setting really high KPIs, then that person’s obviously, likely to need a bit more support. So it’s getting that balance right’s really important, or you’re just going to be doing the churn that everybody’s kind of doing right now in people coming in, people going out.

Chantelle:

In terms of attraction and recruitment. I see this as so closely linked to the viability question. Obviously, the more skilled and experience the person you recruit, the more autonomous they’re going to be more quickly. And that’s going to make sure that it works in the business, but there’s more and more positions for AHAs being advertised. There’re loads on SEEK right now. So the competition for talent is on the increase here. So really be thinking about who you are targeting in your recruitment processes and what those processes look like to make sure that you’re screaming well and not setting the person up, the allied health assistant up for failure or the business up for failure at the same time. So I think this is a really critical part of bringing IHA into the business is how you’re going about that attraction and recruitment process.

Chantelle:

And then of course, we’ve got a wide range of qualification in terms of none being required for the NDIS, so what are you going ask for a certificate III or an AHP undergrad or somebody who is unqualified, but might have lived experience or have worked in an alternative or a parallel kind of industry like has been a teacher’s aid or a disability support worker with a load of experience or a parent of a child who has a disability who’s going to have really great skills, potentially as well. So really be thinking hard about that attraction and recruitment.

Chantelle:

In terms of awards, I don’t have expertise in this part of the world so I will just leave it. The two awards I know people are using the health professional support services award and SCHADs. So I would be talking to HR specialists about making sure you get that one, right, because we don’t need that coming back to bite you. If you accidentally underpay somebody, you can land in some hot water there, as some providers have found out lately.

Chantelle:

Insurance liability risk, as Kim said, one of the biggest questions I get all the time. I had a quick chat to a lawyer yesterday, just to give you some questions to ask yourself largely around how the health assistant is engaged. Are they a contractor? Do they come from one of the platforms? Are they a direct employee? Just make sure that however you’re engaging them, that you have a very tight written employee agreement that states all the expectations that you have from them and that they have from you. So that is locked down on paper. And if the worst case scenario happens and something goes amiss, you’ve got everything absolutely locked down in terms of what everybody’s responsibilities are. Due diligence, of course, make sure everybody’s screened check for whatever qualifications and experience, make sure they go through a good induction, make sure your insurance is in line with what you need. Make sure if they’re a contractor, they have their own insurance. Make sure you see their certificate of currency. These are just all basic business stuff, but it’s definitely doable.

Chantelle:

The other thing my lawyer friend said is when you make sure you log all of your supervision and make sure the quality of supervision is there so that you have a number of people within the business who can potentially supervise. And that supervision quality is quite good. And then how are you reviewing that? Make sure there’s sort of evidence of review. This is in case of worst case scenario work, cover come in, or if there’s an incident, you’ve got evidence to say that everything was in place to make sure that this didn’t happen. And really tight risk assessment mitigation. And this is what you would do for any role in your business. So this isn’t just specific to AHA

Matthew:

Chantelle, sorry to interrupt, but not surprisingly, insurance has created a little bit of-

Chantelle:

A buzz? Yeah.

Matthew:

Question chat. Can I just step in for a minute?

Chantelle:

Please.

Matthew:

So Deb, her impression was that AHAs had to be an employee under the allied health professionals’ insurance. And it was a question I was going to toss in. You’ve talked about independent contractors having their own insurance, but I think possibly the other issue is for the allied health professional to ensure that they understand the implications for their own insurance and whether… So I know some of the business models involve AHA needing to be covered under the AHP insurance. So just wondered if you had any thoughts or insights into that area as well.

Chantelle:

The wording within the NDIS price guide changed this year, and it did say, or it has to be insured by the allied health professional or their employee. The wording in that pricing arrangements document is slightly changed. So it might be re worth a little look that, but the second part of your question, Matt, is definitely talked to your insurance company about what they need. Sometimes they just need the name of the person on your policy. You’re not actually paying for their insurance, but they’re a named kind of. It’s a bit like who else is going to drive the car. On the policy, they just have to be named there. I am trying to track down an insurance company that will come and speak to us as a group on this exact topic because of the confusion. So that information I gave you was from a lawyer speaking to a generic kind of employee or contractor kind of employer situation, but whether or not there’s something very specific about allied health assistant.

Matthew:

And so Tara’s just popped into the chat as well that AHANA are looking into this issue as well.

Chantelle:

Fabulous. Yeah.

Matthew:

Yeah. So I think the message is keep an eye on the Facebook group as well.

Chantelle:

Yeah. And AHANA, that would be great. Yeah.

Matthew:

Thanks, Chantelle. Sorry to interrupt.

Chantelle:

No, not at all. It’s a really important one. And there were loads of questions on it and that’s why I actually picked up the phone and called somebody just to make sure that I was not telling you [inaudible 01:20:18] as well. Kim, did you want to jump in?

Kim:

Yeah. I just want to throw in, I’m not an insurance expert, but in terms of a professional responsibility. As an OT, right, I’m an OT background. I’m responsible for the advice that I give and the oversight that I give, right. So we do this with families. We do this with allied health assistance. We do this with our colleagues when we’re working into professionally. So I’m responsible for that advice. So that’s what my professional indemnity insurance is about. If that person then goes ahead and doesn’t implement things the way that I’ve suggested, or does it in a different way or adds other things to it. I’m only responsible for what I have advised. So the report that I’ve written, the evidence that Chantelle was talking about of the supervision or advice that I’ve given. So that’s what I’m responsible for.

Kim:

The liability issues around an employee of, so say an allied health assistant or a teacher’s aid at a school, then is covered by their employers’ own general insurance. So there’s sort of two questions. And I think, at times, they’re getting conflated here in this conversation, right. So I do have professional responsibility for my advice and recommendations, but then there’s the employment of someone else. If I employ the AHA, I then have employer responsibilities. If I don’t employ the AHA or the teacher’s aid or whoever else, then it’s a different level of insurance. So this is being conflated at times. And I think we have to be really unpacking this a bit more.

Chantelle:

Yeah. Agree. Thanks, Kim. And I think that was really helpful to split those apart. I think that’s what my lawyer friend was kind of explaining as well. But as long as you’ve done your due diligence and making sure that if… He said always imagine the worst case scenario, and this goes with anything in the business, not just talking about AHA and just make sure you’ve got evidence that you’ve done your due diligence in trying to prevent the worst thing from happening. So I think that’s the point I was hoping that we could take away is we shouldn’t be thinking about this as any different to any other business relation, like employer relationship, really. We’re getting a bit stuck on it, but it’s just about having solid agreements in place, solid systems in place, good due diligence and then good quality supervision that you’re logging and onwards.

Chantelle:

Viability, big question. And it’s tricky because we’re working with that cat pricing. So it’s about careful business modeling, good risk assessment, care for recruitment and effective supervision. They’re the key points that I’m hearing, make all the difference. And I would just remind you that we’ve got some events coming up on this specifically where we’ll really drill down into some technical or technical business modeling, look at actual numbers and how we can make it work. Okay. Nearly there. There’re questions around training and skills options. Whoops, I’ve gone too far. And I think we’ve kind of covered these along the way today, but there’s more and more talk about these skill sets now as well, rather than full certificates. So just…

Chantelle:

…as well, rather than full certificates. So just again, keep your eyes… The training space is getting a lot of attention at the moment from government. There’s a lot of money in the space. There’s a lot of opportunity in the space around training. HSSO is a good one to follow, like join their newsletter for updates. CSIA are often all over this stuff in terms of updates. Those kind of newsletters can keep you up to date with what’s happening in the vet space really effectively. I know we’ve got this at the moment, a lot of businesses using undergrads because it’s a workforce pipeline for them, and I understand why that’s happening and it’s working really quite effectively in a lot of cases. So there is that opportunity to provide undergraduates with really great almost traineeships while they’re still studying.

Chantelle:

Lived experience: I think sometimes they make the best AHAs, because they’ve had all that practice before, but often they need a little bit of upskilling on the theoretical side of things, and then parallel work histories are a good place to target for recruitment. So that was really, really fast. And there’s my contact. Please reach out. I know I’m in touch with a lot of you already. Any other questions or comments, or Matt? Where did you want to go from here? Or we hand over to Ben?

Matthew:

Thanks Chantelle. Thank you for covering all of that territory. Just really appreciate it. And also, thanks to Shem. That’s a really exciting program. And I have to say BRAHO is my new favourite acronym, so thanks for that. A little disappointing to hear that the first round is closed, but very much looking forward in hope that there is a second round and also…

Gemma:

Sorry, could I interrupt there? This is Gemma, also from SARA.

Matthew:

Hi Gemma.

Gemma:

Yes. Thank you to Sham. We actually, our first round has closed and we’ve been very oversubscribed, oh, oversubscribed is a good thing, for most of the positions. However, we do have 15 positions allocated to [inaudible 01:26:18], or AMSs, or organisations specifically existing to service the Aboriginal and Torres Strait Islander communities.

Matthew:

Great.

Gemma:

So please, if any of your organisations or contacts or stakeholders fit that bill, we would still love to hear from you and have that conversation.

Matthew:

Thanks, Gemma. That’s terrific news. And so perhaps if you’re able to put a link into the chat, we’ll certainly pass that around to our Aboriginal and Torres Strait Islander colleagues as well. Look, thanks again, Chantelle. I’m pleased to be able to say that many of the issues in the questions are covered in the good practice guide. We’ve certainly not got all of the answers to the questions, but certainly have provided some guidance across those areas. And some, as I said, some case studies. Particular thanks also to Lucy who was very helpful in the background providing lots of links as well. Lucy, I’ll extend an invitation if you’d like to talk a little bit about your work as well in a moment.

Matthew:

But before I do that, Chantelle, I know that we haven’t had the chance to talk more about the Boosting Local Care Workforce program, but it is an exciting program. CSIA is part of it as well. Chantelle has put the information about the Facebook link as a great place to keep up to date. But I also wanted to say that part of the program is that there are regional coordinators across the country whose role it is to help NDIS, aged care, and veterans affairs organisations to improve their business and particularly focused on workforce. So we’ll make sure that we send a link to the boosting website out, following this meeting as well. And if anyone on the call is interested to touch base with their local coordinator, I know many of them are on the call again today as well. So they’re fully briefed on this work as well. Lucy, did you want to speak at all about some of the work that’s been happening in Victoria?

Kim:

Sure. Thanks, Matthew. Chantelle offered me the opportunity just before and I said, no, you’ve got it covered.

Matthew:

And now I’ve called you out publicly.

Kim:

No, that’s fine. Look, there’s so much work and so much enthusiasm in the AHA space at the moment for disability, but also for health [inaudible 01:28:48] care. And I think it’s a really exciting time. I know you’ve got Ben Turnbull and other AHANA representatives online, and I’m really excited to see that peak body taking hold. It’s lovely to see the good practice guide up and going. And Kim Bokley, we spoke to right at the beginning of our project and it was wonderful to have her wisdom. Victoria’s getting to the end of what we are calling the Workforce Plan Project. We have 18 recommendations out there which are absolutely aligned with some of the things Chantelle was saying. It’s lovely to see those things already being implemented. I think our recommendations will be old hat by the time they’re out there because people are getting onto this and we are seeing the innovative care models that can be provided utilising allied health, or I should say therapy assistance in this context. So it’s just wonderful to see the enthusiasm AND appetite, and please check out our resources on the webpage that’s in chat.

Matthew:

Many thanks, Lucy. That’s great. And it looks like you’ve done some fantastic work and a really nice compliment to the things that we’ve been talking about today. Kim, I can see you have your hand up. Just quickly in the chat, Tara’s asked if Sham and Jenna could provide a link to the rural generalist training. And also, Elizabeth has asked Chantelle if you could put a link to the Facebook group up on the chat as well. Kim, can I come to you now?

Kim:

Sorry. No, that was a clap for Lucy. That wasn’t a hand up.

Matthew:

Oh, sorry. Oh dear. Thank you. So look, thanks very much Chantelle. That’s been a great way to cover off a whole lot of different topics and really appreciate all the work that you do in this space as well. Look, I might move to our next speaker now. We’ve mentioned Ben a couple of times, so we’re all sitting in anticipation, Ben. Ben Turnbull is the CEO of AHANA, the Allied Health Assistant Network of Australia, and also the founder of the New South Wales Allied Health Assistant network. He’s a grade three allied health assistant. He’s passionate about disability, neurological conditions, and developing and supporting an individual’s quality of life. He has a strong interest in the development of allied health assistant workforce, both nationally and internationally. And I’d like to hand over to Ben now. Welcome.

Shem:

Thank you, Matt. Okay. So my name is Ben Turnbull and I’m the CEO of AHANA. I started my allied health assistant journey after suffering a motor vehicle accident at the age of 18 years old, 2011. And required extensive rehabilitation from a range of allied health professionals and allied health assistants. And then in 2014, I began my professional working experience, after completing my Certificate IV in Allied Health Assistance, then began working in this field. The Allied Health Assistance National Association supports, promotes, informs, and advocates for the allied health assistant workforce in Australia. Through the work we do, the association looks to benefit both assistants and the professionals who provide delegation and or supervision across all disciplines of allied health. This includes, but is not limited to, physiotherapy, occupational therapy, speech pathology, dietetics, podiatry, recreational therapy, social work, and exercise physiology.

Shem:

AHANA aims to raise the awareness of how allied health assistance can support and resource AHPs to meet the increasing demands on the health, disability, and aged care systems in both the public, private, and not-for-profit sector. AHANA continues to seek members from all states and territories to assist in this development and to continue to reflect on our national collegial collaboration. What we do. We are recognised as the national peak body for allied health assistants. We provide regular and national AHA professional development for forums and or events. AHANA supports, promotes, informs, and advocates for the allied health assistants (AHAs) in the areas of, but not limited to, peer support, professional development, research, consultation and benchmarking, and scope of practice and recognition nationally.

Shem:

Our strategic goals. To be recognised as the peak accrediting and registration body for all health support service sectors across Australia; to have members from all sectors, including aged care, disability, community, in both the public, private, and not-for-profit sectors; to develop a framework for recognising and regulating the broad range of competencies the AHAs and associated workers bring to their role, which would incorporate a competency library, and for a marketing strategy. And that is all.

Matthew:

Many thanks Ben, and such a great opportunity. I’d like to take this opportunity to thank you and the team at AHANA for real support in bringing this event together today as well. I encourage you to reach out to AHANA through their website and to have a look at the things that they do. I think one of the things that we know in community services is that, as occupations become more professionally recognised, they’re better supported, they’re often better paid, and they’re certainly better skilled and recognised. And so it’s great to see the work that AHANA are doing to bring that kind of recognition to this really important part of the workforce.

Matthew:

So I know we’ve got quite a variety of people on the call today, so I’m going to do the risky thing and say, we’ve got a bit of time now and we’d be really keen to hear thoughts and comments from all of the people on the call today. If you have a contribution you’d like to make, or if you have a question that we haven’t covered already, please put your hand up or jump into the chat as we’ve suggested. And as we do that, I’d just like to come back. Karen and Tara, without notice. So thanks for being brave. I just wondered, it’s been great to hear all of these different information about the research, the different supports that are available, etc. As people doing the allied health assistant role, what are some of your reflections on what you’ve heard today, and any other comments that you might like to make? Karen, can I come to you first?

Karen Eldridge:

Yeah, that’s fine. Probably the main thing I wanted to just raise with everyone is the thing that sets the role apart, I forgot to mention earlier, is probably the opportunity to connect with the clients. I think we’re in quite a good position where quite often the allied health professionals or the clinicians there have time restrictions, they need to do their assessments, fill in the forms, create programs, set goals, and develop and update programs. We’ve got the capacity where we can work with those clients to get to know them, find out what their goals are, and help them work towards it without the time limits that sometimes the clinicians have to work with the client. So I think we’re quite privileged in that area. And I think that it’s quite important to get to know the client and find out what their goals are and things like that.

Karen :

I think quite often when clients come into the session, they have an understanding of what they think they need to tell the clinician, they need to try their hardest and they need to do their best. And that’s not necessarily what their normal life is like. So when we see them, we get to pick up on all that sort of stuff, and then feed that back to the clinician where they might be having issues and things like that. I think we’re quite well supported here with the physios and things like that. But I think we are quite privileged in the role that we have. Being able to work with the clients where other roles may not be able to do that.

Matthew:

Yeah, really nice opportunity to have that really deeper connection with the clients. But also as you say, it speaks to that extending the practice as well. You’re able to give richer information to the clinicians so that they’re better able to do their role as well. That’s terrific. Tara, did you have any reflections you’d like to share?

Tara Intarapanya:

Not really. I think Karen put it quite well and it’s so exciting to hear the work moving forward with the allied health assistant role. I’m a real advocate for the work we can do and to have so many great people on that journey is pretty exciting, and being able to bring it to a national level.

Matthew:

Thanks Tara. A couple of things that have come up in my mind as we’ve been talking today, one is in relation to mixed roles. So I think we’ve talked about allied health assistance as being a new role, but often in practice, it can also be a support worker with particular experience who might also do some therapy assistance or allied health assistance as part of their day-to-day work. So it’s important to think about whether that’s a suitable model for the service that you’re in. And the other thing that we’ve touched on as well is that some assistants work with just one particular allied health profession, whereas others may work for a variety of allied health professionals in a single practice, for example. And so those two things really do indicate what kind of training pathway and what kind of supports will be required.

Matthew:

So just to pick up on some of Chantelle’s comments, the Certificate III in Allied Health Assisting and the Certificate IV in Allied Health Assisting are the standard pathways. Cert III is very much an entry level. Cert IV is a little bit more focused on delegated practice and independent work. You don’t need to do Certificate III before Certificate IV, but there are some entry rules to those qualifications. And then as Chantelle mentioned, there are also skill sets that focus on supporting particular allied health professions. So you might do a skill set in podiatry assistance or a skill set in physiotherapy assistance. And so there’s a range of ways in which you can package up the training depending on the skills and background and qualifications of the person who’s taking on the role. And so for example, you could have a senior support worker who’s going to work with a podiatrist. Perhaps they only need to do a small skill set in podiatry assisting, so that they’re well suited to the role.

Matthew:

So again, quite a complex space, but really interesting amount of work happening at the moment. I think all the stars are aligning for the growth and development of this role, and particularly within the NDIS context. Chantelle mentioned that the NDIS Care and Support Workforce Plan is under review, but I think it’s fairly clear that as that review takes place, there’s a couple of areas that the Commonwealth government would like to progress. And I was in a conversation earlier this week, which suggests that allied health assistance, and maybe looking at some of the governance arrangement and supervision arrangements, might be something that they would prioritise while that other review process happens. So I think we can all be very encouraged that this is an area that policymakers are keen to progress and that the industry is clearly in support of. Kim, I see you’ve got your hand up, or are you applauding me? No, just kidding,

Kim:

A bit of both, there you go. Matt, I just wanted to flag that in our research, and I think other conversations that I’ve been involved in, the involvement of allied health professional students has been another thing that’s come up in terms of the qualifications or background that people may bring to these roles. And so I think there’s just some different considerations that people need to think about in that role, in that circumstance. And so, one of the conversations I had in our research with one of the organisations was that they preferred not to use allied health professional students, because they had more difficulty getting their scope of practice right, because they were training to be an allied health professional. So there needed to be much more attention paid to that boundary around what are you up for doing. So I think it certainly worked very well in other areas, and that was only one person who described that issue to me. But it’s certainly something to think about when you are looking at engaging students, allied health professionals, to really do that good appraisal of the role and the scope of practice.

Matthew:

Great. Thanks, Kim. I think that’s a really important point. Just keeping an eye on the chat here as well. I could see there’s been quite an interesting conversation about AHANA, so it’s really terrific to see people’s interest there as well. If there are anything I’ve missed in terms of questions that haven’t been asked, please let me know. And then Nazreen mentioned that he has done the cert IV in allied health assistant course with physio and OT skillset, and asking how to upgrade to work in podiatry as well. So Nazreen, you can go to the training provider who did your certificate level course, and see if they have scope to deliver the podiatry skillset. It’s an add-on to the certificate qualification, if you’ve already completed that. I think from memory it’s three, maybe four competencies. So it’s not a big chunk of work. But if you ask the RTO if they have that available, you would be able to complete that skill set through the same arrangements.

Nazreen:

Okay. Do I need to do the cert IV course again?

Matthew:

No, no, no. You’ve already got your Certificate IV, you can just add those extra competencies and that issues you with the skillset as well.

Nazreen:

Oh, okay. That sounds good. Thanks a lot. And one more thing is, I have done bachelor degree in physiotherapy back over in India. I do have the anatomy and physiology background, which works. I have already worked as a physiotherapist all day. And I do have an understanding of the anatomy and physiology of foot. Does these skills add on to work as an AHA in podiatry?

Matthew:

Look, as we’ve talked about, there’s no mandatory qualification related to that work. So that would really be something that you could approach particular podiatrists about and ask them if they… Provide some details of the studies that you’ve done overseas and they may well think that there’s no need for you to do a skillset if you’ve got that level of knowledge and skill in the background. So it’s a question for the podiatrist, or the organisation employing the podiatrist, to talk with you about.

Nazreen:

Okay. Okay.

Shem:

Perfect. Matt, could I just jump in quickly?

Matthew:

Yeah, absolutely. Thank you, Ben.

Shem:

Perfect. We are speaking to quite a large range of professional associations to see how we can work with them and how, say for example, if you want to become an allied health assistant and have an expertise in podiatry, say for example, you can actually be working with us, but then also have those extra credentials.

Nazreen:

I see.

Matthew:

Terrific. And Nazreen, Lucy’s also mentioned in the chat that Mayfield in Victoria offer the podiatry skillset as a standalone, if you decide to be interested and happen to be in Victoria. Thanks for your question.

Nazreen:

Yeah. I’m following the chat. Thank you. Thank you, Matthew. Thank you, Ben.

Matthew:

Thank you. And we also have another question in the chat. Is it possible for an allied health assistant to become a sole trader or be a subcontractor with various therapists? Yes, that’s certainly possible. Ben, I can see you’ve popped up. I should be asking you to answer this.

Shem:

Yes, yes. That can happen. But there is lots of supervision delegation models that are being developed to support this profession in that endeavour.

Matthew:

Yes. Terrific. Yeah. And there’s also the online platforms that allow people to operate as an independent worker as well. But I don’t know offhand the extent to which they’re popular amongst the allied health field. They’re certainly popular amongst some of the disability service providers.

Matthew:

Look, thank you everyone. That’s been a really terrific conversation and I really appreciate all of the interaction on the chat. I’d like to extend a big thanks to Kim, to Tara, to Karen, Chantelle, and Ben. And also a big thank you to Sham and Lucy for your contributions as well. I do encourage you to join the Facebook chat that Chantelle has mentioned. She’s very diligent about keeping everyone up to date with what’s happening and that’ll be a really useful channel for that. Please reach out to the boosting team, if you’d like to talk to someone in your local area about further support, and we encourage you to jump in and have a look at the WorkAbility Allied Health Assistant Good Practice Guide as well. Thanks also to Renee, who’s been driving all of the work in the background. Really appreciate your support. And thanks everyone for your attendance. Enjoy the rest of your day.