The ‘Unleashing the Potential of our Health Workforce Review’ will look into how nurses, pharmacists and physios can work to the top of their scope of training.
The Health Minister has commissioned a probe into expanded scope of practice, but are the results a foregone conclusion?
Titled “Unleashing the Potential of our Health Workforce”, the review was a recommendation made by the Strengthening Medicare Taskforce in its February report.
Health Minister Mark Butler announced yesterday both the title of the review and that it would be led by health workforce researcher and senior public servant Professor Mark Cormack.
While the terms of reference haven’t been released yet, Mr Butler said the focus of the review would be the immediate benefits of supporting more quality service delivery and greater access to primary care.
It seems likely – from the title alone – that the findings will support increased scope of practice for allied health professions; the real question appears to be whether it will recommend models that include general practice at the centre of primary care.
“For too long, too many of our health workforce haven’t been able to work to their full potential,” Mr Butler said.
“Whether it is nurses, pharmacists or allied health professionals, in a global health workforce shortage we need everyone working as close as possible to the top of their scope.”
The review is set to take around a year to complete, but interim findings will be released as it progresses.
An initial round of stakeholder consultation is expected to begin next month.
Both the AMA and RACGP told The Medical Republic that they welcomed the review, but warned against any solutions that further silo or fragment the health system.
“This review must be about more than just task and role substitution,” said RACGP president Dr Nicole Higgins.
“It’s important our health system recognises GPs are highly trained specialists with a minimum of 10 years’ training. “We work directly with patients at every stage of their healthcare, from an initial consultation, to diagnosis, to working as part of a team with other specialists and allied health professionals to deliver high-quality healthcare for all patients.”
AMA president Professor Steve Robson echoed her words.
“We need to build on the strengths of our health care system, recognising the skills that different health care professions bring to the care of a patient, and at the same time make sure that takes place within a well-coordinated model of care that is guided by a medical diagnosis,” he said.
The “real danger”, he said, is that this review becomes an opportunity for a range of health professions to carve out more independent roles.
This possibility is just what Australian Nursing College CEO Associate Professor Kylie Ward says she hopes to capitalise on.
“Nurses have the skills and experience to work independently of GPs, who we know are overworked and too few in number to meet growing patient demand,” she said.
“We are hearing almost daily reports that our medical colleagues are too busy to see patients who need wound dressings, ear infections, urinary tract infections, and other conditions that are well within the scope of practice of registered nurses and nurse practitioners.”
Over the last 18 months or so, nurses, pharmacists and physiotherapists have made individual attempts to expand their roles, but this review will mark the first time that scope of practice is examined health sector-wide at the national level.
Both the RACGP and the AMA have generally opposed the push from these quarters, arguing across the board that GPs play a central role in both diagnosis and coordination of care.
“We are seeing real innovation in general practice, for example, with nursing and allied health professionals working alongside GPs as part of a well-coordinated and collaborative team,” Professor Robson said.
“That’s the type of reform the AMA will be looking for in this scope of practice review, not just rearranging deck chairs at the cost of quality patient care.”
