Beyond a short trial: Exploring the sustainability of allied health expanded scope models of care

Dr Belinda Gavaghan1, Ms Jennifer Finch1, Ms Liza-Jane McBride1

1Allied Health Professions’ Office Of Queensland, Clinical Excellence Queensland, Brisbane, Australia

Background: Queensland’s public health system has invested in a program of allied health expanded scope activities to assist health services to provide effective, equitable and client-centered care. From 2014 to 2016, seed funding was provided to Hospital and Health Services to support the rapid implementation of innovative expanded scope models using a formal hub and spoke approach. Despite successful outcomes in the short term, little is known about the sustainability and spread of expanded scope models over time. The aim of this study is to explore the sustainability of these models two years after the end of the formal project period.

Method: Seventy short interviews were undertaken with project leads and representatives from all models and sites. Discussion focused on the implementation of new models during and in the two years following the end of the formal project period, as well as the enablers and challenges to establishing new models of care as part of routine practice.

Results: Participants reported that 48 models had been successfully implemented, sustained and were embedded as part of routine practice. A further six models had been discontinued following the end of the project period and 32 did not ever commence the implementation phase. Sites that did not progress to implementation were typically spoke sites that did not receive project funding and who may have been interested but not ready for implementation at a local level. Allied health workforce culture and leadership to support change, difficulties recruiting and retaining skilled staff and access to funding for new services were identified as common challenges to the sustainability of expanded scope models of care.

Discussion: To optimise allied health scope of practice and deliver consistent improvements in patient care, there is a need to build on our achievements and successfully adapt, spread and sustain effective models of care. Findings from this study will be used to develop targeted strategies to build allied health capacity and capability to progress and establish expanded scope models as part of routine practice.


Dr Belinda Gavaghan is currently A/Director at the Allied Health Professions’ Office of Queensland. Her research focuses on allied health workforce reform and redesign, and particularly the development, implementation and evaluation of new and innovative models of care that optimise scope of practice for allied health professionals. Belinda has degrees in speech pathology (Hons) and public health. She has over 15 years experience as a speech pathologist in public and private healthcare settings and is a graduate of the NSW Public Health Training Program.

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