Still waiting for allied health to matter: opinion

More support is needed for aged care-specific university training of future allied health professionals, writes…

More support is needed for aged care-specific university training of future allied health professionals, writes Professor Terry Haines.

Despite 148 recommendations in the aged care royal commission’s final report, we are still waiting to see budget allocations for the establishment of multidisciplinary healthcare approaches in aged care and specific training models for professional and skilled workers. Worse still, there have been no details regarding increased access to preventative healthcare services like allied health in residential care.

With an election coming up, policymakers should be under pressure to address these issues rather than continuing to put them on the back-burner. It’s clear how we approach aged care needs a radical rethink.

Professor Terry Haines

With our rapidly ageing population potential workforce shortages are becoming a real concern. Healthcare graduates will be in high demand across all industries, increasing competition for talent — both in Australia and globally.

Skills shortage approaching

Building a strong pipeline of allied health professionals to work alongside nurses and medical staff in community-based aged care will be crucial.

Despite representing more than 25 per cent of the health workforce, allied health is too often overlooked by policymakers. Why? These diverse services including physiotherapy, occupational therapy, podiatry, audiology, psychology and dietetics – to name just some – are vital for wellbeing and quality of life in older age, helping with individual reablement, preventing falls, and encouraging continued independence and good health.

At present, only around 13,000 allied health professionals are employed in residential aged care facilities – most of them on a casual or part-time basis – equating to just eight minutes a day for the average resident. If the government intends to ramp that up, as recommended in the royal commission’s report, we must have more qualified professionals available to work in aged care – and quickly.

Reframing ageing through work integrated learning

The Australian Council of Deans of Health Sciences (ACDHS) are now looking to design better models for immediate training and scaling up of the allied health aged care workforce. The biggest challenge is to make aged care a career of choice for graduates in a market where they could work anywhere.

Research shows the most effective way to address this is to extend the current clinical placement schedule for students to include more hands-on, aged-care specific field work to change perceptions of the industry.

Unfortunately, we are working with a significant ageism bias in many health students who often have a low interest in working with older adults. This is due in no small part to the wider negative view of ageing in our society. Many students have little experience with older people – and if at all, it is often limited to frail and sick patients in hospitals.

As university educators it is important that we reframe views on ageing and demonstrate the complexity of this speciality, as well as the range of career possibilities. To do this we are researching how to extend our clinical placement programs beyond hospitals to community-based settings, including residential aged care facilities. This allows students to see the full impact of allied health in reablement and wellbeing.

Building a new framework for the future

While there has been attention given to building the allied health workforce and enabling new training models in the disability sector, there has been scant progress when it comes to aged care.

Allied health professional training models in Australia are diverse, but they have generally evolved from hospital-based training models. While we have an excellent history of co-operative, multi-institutional research and development programs seeking to understand and optimise models of training in these settings, extending that knowledge to community-based settings has not yet happened.

Interestingly, other countries like Denmark have addressed these issues by placing primary care at the core of aged care provision and reducing reliance on hospitals altogether with a greater emphasis on prevention programs and rehabilitation.

Australia’s training programs in aged care settings are complicated by a distinct lack of full-time allied health professionals embedded within aged care services – particularly residential aged care – with which to supervise students. This is an issue any new models must address.

Collaborations are the key, but more government support needed

Development of undergraduate geriatric placement models will require new collaborations between various university training institutions, partnerships with aged care service providers and practitioners, and consultation with industry representatives and consumers.

Access to skilled staff is the most important enabler of quality care. However, it will require more targeted funding from government to achieve the research and evaluation required to ensure the new programs work and are sustainable into the future.

Ageing is a complex area – just ask those who are interacting within the current system. We can’t let allied health provision and multidisciplinary models of care continue to be the uncosted line in budget papers.

To have any meaningful improvement nurses, doctors, tertiary education institutions, industry, and government need to work together to improve outcomes through skill building and allocating more appropriate funding to multidisciplinary care. This is the only way that tomorrow’s generation of professional health professionals will choose aged care as the career of choice.

Professor Terry Haines, who is the Head of the School of Primary and Allied Health at Monash University, is a member of the Australian Council of Deans for Health Sciences representing Australian universities that provide undergraduate education in allied health. 

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Tags: allied health, council of deans for health sciences, election 2022, professor terry haines,

2 thoughts on “Still waiting for allied health to matter: opinion

  1. The author makes a strong case for embedding allied health in aged care settings, and collaboration of various stakeholders not limited to Government.
    By the same token, we also need to think about psychological support beyond the domain of Health and typically funded organisations to embed psych services including counselling as a real service to support older people’s mental health. Reablement and restoration through allied health is important but people also need some ‘hand holding’ in relation their psychological and emotional health. Not everyone requires a psychologist. While Counsellors are not yet part of the allied health workforce. there’s a valid space for counselling and counsellors in aged care. Working with older adults requires a different skill set, and others ways of working with an older person.

  2. Prof Terry Haines writes: “Despite 148 recommendations in the aged care royal commission’s final report, we are still waiting to see budget allocations…”
    I would like to suggest a minor correction:
    Because of the 148 recommendations provided by the Royal Commission, we didn’t see much improvement yet.

    A skilled allied health professional like Terry should know that the more exercise and/or other behaviours are suggested to a client, and the more goals are introduced in one go, the more difficult they are to be implemented, and the less change we are likely to see.
    I wish the royal commission would have restricted itself to 10-20 recommendations. I wish it would have set a clear priority order, a strict definition of the most crucial 3 recommendations that should be implemented within 2 years, and mechanisms ensuring a sustainable change.

    I believe that a wise analysis and choice of critical goals can facilitate a wide positive change, disproportionate to the mere number of goals. A few goals are more motivating to implement, more feasible and set much more realistic expectations.

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