Occupational therapy framework underpins renewed allied health focus
Last updated on 22 August 2024
A new capability framework released by Occupational Therapy Australia aims to help clinicians build their knowledge and support advocacy of the role within aged care at a time when allied health is commonly being underutilised.
Key points
- Occupational Therapy Australia has released a new Capability Framework for Occupational Therapists Working with Older People to support OTs working across a range of settings
- Its release coincides with widespread calls to better support allied health professionals in aged care as many have seen their roles impacted by care minute mandates that favour nursing
- The Framework is intended to help OTs upskill and develop their capabilities while also providing aged care organisations with more knowledge about how to enable them to work at their full scope of practice
Allied health, including occupational therapy, has long been a key element of health care and aged care. However, it has fallen to the wayside as providers focus on nursing and mandated requirements under the care minute regulations.
With a range of complexities and barriers preventing true workforce development, Occupational Therapy Australia (OTA) wanted to find a way to promote and support occupational therapists working with older people.
“Unfortunately, there has been an erosion of allied health services in residential aged care. There are some issues there,” Christina Wyatt, Professional Practice Advisor – Aged Care, explained.
“Many years of restrictive funding and systemic issues, particularly in residential aged care, mean a lot of providers don’t have any idea of how to work to a full scope with an occupational therapist.
“This Framework can be a useful tool to explain what you can expect from an occupational therapist at different stages in their expertise and clinical pathway. It allows us to share that when you’re working with us, you can benefit from things you may not have been aware of previously.”
The Framework itself delves into five key domains:
- Knowledge of aged care systems, aged care conditions and co-occurring factors
- Assessment, planning of needs, goal setting and outcome measures
- Occupational-focused interventions and therapeutic strategies
- Client-centred practice and continuous improvement
- Working with other health professionals and significant others
Information and specific details of each domain can be found on their website, alongside other relevant frameworks.
More broadly, Ms Wyatt wants aged care providers to understand that the Framework and OTs can be the missing piece of the puzzle when it comes to delivering a quality range of services to older people.
“We wanted to be proactive in educating governments and providers about what they can benefit from if you bring us in,” she said.
She added that many don’t recognise that occupational therapists have such a broad scope of practice. Clinical, quality and compliance elements all factor into a holistic approach to care, whether it’s supporting someone with cognitive impairment to move safely around an environment or focusing on solutions that reduce the need for pharmacological interventions.
Despite the care minute requirements not calling for mandated time from allied health professionals, there are still compliance benefits.
“Quality Indicators are expanding into home-based aged care. One of them will probably be around falls or mobility and occupational therapists can help providers demonstrate that they are delivering evidence-based interventions to reduce the risk and rate of falls,” Ms Wyatt said.
“We know with the Quality Standards that currently exist across both residential and home care, when you offer an occupational therapist to work at the full scope of practice we align with all standards.
“We can also upskill non-clinicians in the workforce so they understand how to support an older person in their interactions. This is how we can build a better, safer workforce and ultimately meet the compliance and regulatory requirements of the provider.”
Promoting OTs in a time of reform
Ms Wyatt is also part of the Technical Advisory Group working on implementing an allied health Quality Indicator for residential care. It’s an addition that could strengthen the foundation for all allied health practitioners within aged care.
However, she warned it’s important not just to bring in another Quality Indicator that “counts widgets” such as how many falls they have experienced. Instead, she hopes it is based on identifying whether a person has received the care and allied health support required as part of a needs assessment.
There is also growing hope that conversations about the combined negative impact of AN-ACC and care minute mandates on allied health are going to result in newfound support for professionals.
The top concern for Ms Wyatt is that AN-ACC was designed as a separate funding classification tool but the combination with the care minute mandates has resulted in providers prioritising the elements they are directly funded for.
She would like to see AN-ACC better used as a tool to identify what support a person needs at their point of entry with further investigation into whether allied health is being funded appropriately.
“We could look at whether AN-ACC is or is not funding people well under certain categories for the breadth of services they have been assessed as needing. Then we can give that data to the likes of IHACPA to say ‘Maybe there needs to be different cost modelling for certain categories because they need allied health in a way that isn’t accounted for in the funding’,” she said.
Recent conversations in Canberra revealed a strong appetite to explore how allied health can be better supported, including through a dedicated needs assessment and identification tool.
The Inspector General of Aged Care has also recognised that Royal Commission recommendations relating to allied health and restorative care have not been addressed. Ms Wyatt said she would like to see more action there as the current Government has “tried to poke at” allied health with their reforms but has failed to produce any targeted outcomes.
“That’s quite a strong sentiment across all the allied health peaks,” she continued.
“So is there an opportunity with the passage of the new Aged Care Act, which is built on a human rights, person-centred care approach, to elevate restorative care and the need to keep people functioning well so they can live the life they want to as they age.”