A healthy primary care system is underpinned by a diverse health workforce that is accessible and equitable for all consumers regardless of location.

Allied health professionals are an important part of the primary health care team and have essential roles in the prevention, early intervention and management of chronic disease.

AHPA and its member organisations strongly support primary care reform and improved funding to better integrate allied health services into rural and remote Australia.

Undertake consultation to expand diagnostic imaging pathways to support accessible and effective care for consumers regardless of location.

The problem

Burden of chronic disease

Australian Institute of Health and Welfare data shows that 61% of the population live with at least one chronic condition, with 94% of people aged over 85 experiencing chronic conditions. Around 4 million people in Australia experience ongoing back problems, making it the third leading cause of disease burden.

Back problems disproportionately impact those that live in more regional or rural areas, those experiencing financial disadvantage, and people with disability with the latter group four times more likely to be living with back problems.

More than 1.3 million Australians live with diabetes, representing around 5% of the population. However, 10% of total hospitalisations are associated with diabetes and diabetes contributed to 11% of all deaths.

Workforce Shortages

Access to allied health services is impacted by persistent workforce shortages and a lack of fit for purpose workforce initiatives to support development and improve the geographic distribution of allied health professionals. The 2024 Occupation Shortages List shows national shortages in 13 allied health professions with local shortages in a further three professions.

The recent review of the Workforce Incentive Program – Practice Stream (WIP) found that the Commonwealth government’s major workforce initiative for the allied health sector is not working effectively and is primarily supporting employment of nurses.

Undervalued, under-funded allied health workforce

On average, all undergraduate allied health students undertake between 1000 and 2000 unpaid clinical placement hours. This compares to 400–800 hours for nursing. Average salaries for allied health professions such as occupational therapy and physiotherapy are also around the same as those for registered nurses (based on Seek data). Clear workforce shortages apply to allied health. Yet only social worker students are eligible for Commonwealth Prac Payments to assist with the cost of clincial placements.

Lack of direct referral and impact on specialist access

Australia is experiencing a critical shortage of general practitioners, particularly in rural and remote communities. This can result in lengthy delays to see a GP which further compounds the delay in seeing a specialist. The Scope ofPractice report recommends in-scope direct referral for relevant allied health professions to alleviate system demand and improve consumer outcomes by enabling timely access to specialist care.

Limitations with student observation rules – Medicare and DVA

Clinical placements are an essential opportunity for students to translate therory into practice and an important means of ensuring that students are safe and ready for practice. Successful placements require that students not only observe but are actively integrated into service provision, undertaking clinical assessments and codesigning care plans and implementation.

While this approach is well-established in hospital settings, funding schemes such as Medicare and Department of Veteran’s Affairs explicitly exclude allied health student involvement.

Allied health services are essential to ensure older Australians maintain function, enjoy health and wellbeing and preserve high quality of life.

Access to allied health services minimises unnecessary hospitalisations and adverse outcomes and enables older people to live independently in the community for as long as possible.

The Royal Commission into Aged Care Quality and Safety found that allied health services are essential for older people’s reablement, and that insufficient access to allied health in residential aged care contributes to substandard care and neglect.

The Royal Commission concluded that allied health is underused and undervalued across the aged care system, calling for allied health to be embedded in aged care, provided at a level appropriate to each person’s assessed needs, and generally paid for by aged care providers.¹

The asks:

Fund the development and implementation of an assessment and care planning tool for all aged care providers to ensure a nationally consistent approach to aged care service delivery.

Require that aged care providers use residential aged care funding for direct care service delivery only and spending by providers is publicly reported.

Adequately cost and fund allied health time to prescribe and implement assistive technology and home modifications

The problem

Despite ongoing aged care reforms, there is no guaranteed needs-based provision of allied health. There remains no mandatory benchmark for allied health in residential aged care, unlike the mandatory care minutes required for nursing and personal care.

Allied health professions such as osteopathy, orthotics/prosthetics, chiropractic, art therapy and orthoptics are being left off clinical service lists or omitted altogether from the Support at Home program due to commence on 1 July 2025.²

Under the new community-based Support at Home program, aged care consumers will need to access allied health services via Medicare before they can use aged care funds for some services. It is not clear whether the new Sup-port at Home program will provide sufficiently for aged care consumers’ assistive technology (AT) and home modifications (HM) needs.

AT and HM funding must cover both the products and the associated allied health time to ensure that older people use the prescribed AT and HM’s. The lifetime cap on HM is likely to leave consumers worse off than under previous aged care programs.

While residential aged care providers are expected to pay for allied health services through the aged care funding provided for each resident by the Australian government, many are using those direct care funds for other, non-care purposes.³ Residents and their families report providers advising that allied health services are not available or not funded through the aged care system.

The new Aged Care Act commits the Australian Government to funding 100% of clinical care, including allied health services. However, residential aged care providers are not currently required to pay for some types of allied health services, but only to provide ‘access’ to them.⁴ Other funding mechanisms such as the Chronic Disease Management MBS Item is limited to five annual allied health services and grossly inadequate to meet the clinical care needs of older people.

In addition to the significant funding and access issues, current aged care arrangements do not reliably ensure that care needs associated with allied health services are identified and clinically assessed. In the absence of effective assess-ment and care planning protocols, there is no way of delivering the allied health that is needed and meeting Australia’s commitment to quality aged care for older people.

¹ Royal Commission Recommendations 25, 36–38, 69.

² Department of Health and Aged Care, Consultation Draft of Aged Care Rules 2024 (Service List) https://www.health.gov.au/resources/publications/new-aged-care-act-rules-consultation-release-1-service-list

³D Gibson & S Isbel, Reform and reverberation: Australian aged care policy changes and the unintended consequences for allied health https://-doi.org/10.1111/1440-1630.12953 ; UTS Ageing Research Collaborative, Australia’s Aged Care Sector: Mid-Year Report (2023–24).

⁴Schedule 1, Quality of Care Principles 2014.

A healthy digital ecosystem enables timely sharing of clinical information between health care professionals. There is a critical need to better connect health data across all parts of the health system to enable coordinated team care and improve consumer outcomes.

There has been significant underinvestment in strategies to strengthen capacity and capability of the allied health sector to access and adopt fit for purpose digital products which enable information sharing between health professionals.

AHPA and its member organisations strongly support primary care reform and improved funding to better integrate allied health services into rural and remote Australia.

In 2024 AHPA in collaboration with Australian Digital Health Agency (the Agency) surveyed the allied health workforce to understand awareness, use and readiness to use My Health Record and Electronic prescribing. Thirty-nine Clinical Information Systems’ were identified by the sector, with the top 5 products non-conformant with My Health Record (65% of the allied health CIS market).

As the second largest health workforce (~300,000), clinical information generated by allied health professionals must be shared to enable effective care coordination and realise better health outcomes. Allied health profes-sionals also need access to critical health information generated by other healthcare professionals to provide optimal patient-centred care.

Retain AHPA as digital implementation lead for the primary allied health sector.

Fund allied health to accelerate integration and utilisation of allied health clinical data, as part of the CSIRO Sparked program.

The problem

Multiple budget measures have identified the need to expand the multidisciplinary care team to include allied health professionals. Common to the success of each measure is the need for real-time sharing of clinical information using national digital health infrastructure.

In consultation with 1,500 consumers, the Agency found nearly all (87%) consumers agreed they should have access to AHP-generated clinical information, and that their lives would be easier if they did have access (72%).

Without the sharing of information by healthcare professionals, consumers indicated they have to “repeat themselves, maintain their own health data and take responsibility for sharing it with the rest of their healthcare team – a task for which many report to feel ill-equipped”.¹

There has been significant underinvestment in strategies to strengthen the capacity and capability of the allied health sector to access and adopt fit for purpose digital products which enable information sharing between health professionals.

The recently released Allied Health Digital Transformation Survey Report highlighted the need for:

• A sector wide education campaign tailored to the unique and diverse demographic characteristics of the allied health workforce.

• Interoperable digital products fit for purpose to the allied health workforce utilizing nationally consistent terminology data standards.

• Expansion of the type of information allied health professionals can author in My Health Record.

To accelerate allied health adoption of digital products it is critical that AHPA continues to be funded as a key advisor and implementation lead. There are system level barriers to digital adoption which need to be addressed alongside sector-wide capability building. AHPA has deep expertise in digital allied health and extensive stakeholder connections.

This collaboration with the Agency is essential to the design and smooth roll-out of tailored education.

¹ Australian Digital Health Agency. Exploring Allied Health information sharing: Healthcare provider and healthcare recipient perspectives. Sydney. 2023.

A healthy primary care system is underpinned by a diverse health workforce that is accessible and equitable for all consumers regardless of location.

Allied health professionals are an important part of the primary health care team and have essential roles in the prevention, early intervention and management of chronic disease.

AHPA and its member organisations strongly support primary care reform and improved funding to better integrate allied health services into rural and remote Australia.

Expand the Commonwealth Prac Placement program to include allied health professions with national shortages.

Undertake consultation to expand diagnostic imaging pathways to support accessible and effective care for consumers regardless of rurality.

The problem

Around 7 million Australians live in rural and remote areas, providing key contributions to the Australian economy. However, rural and remote Australians experience significant health disadvantage when compared to those living in major cities. Australian Institute of Health and Welfare data shows that people living outside major cities had higher rates of arthritis, mental and behavioural conditions, Type 2 diabetes, and chronic obstructive pulmonary disease while having lower usage of allied health chronic disease management services. Yet health expenditure is significantly lower for rural and remote communities. National Rural Health Alliance commissioned research suggests that the gap in expenditure between urban and non-urban populations was $6.55bn in 2020–21.

Like other health professions, allied health professionals are primarily concentrated in metropolitan areas. Rural and remote consumers are less able to access allied health services. Access is limited by inadequate, outdated fee-for-service funding models. The recent review of the Workforce Incentive Program–Practice Stream (WIP) found that the Commonwealth government’s major workforce initiative for the allied health sector is not working effectively and is primarily supporting employment of nurses.

Access is further constrained by significant workforce shortages. The 2024 Occupation Shortages List shows national shortages in 13 allied health professions with local shortages in a further three professions. Allied health professions generally reduce in prevalence per 100,000 population with geographic remoteness, with lowest numbers in MM5 or MM7.¹

As highlighted in the Scope of Practice Review, evidence shows that effective and timely patient care requires allied health professionals to work to their full scope of practice. Removal of funding and legislative barriers is a key enabler to achieving integrated primary care.

¹https://hwd.health.gov.au/datatool/

All people with disability have a right to access the allied health services (therapy supports and orthotics/prosthetics) they need to maintain and improve function, build their capacity and access assistive technology.

To ensure meaningful choice and control for participants, implementation of changes to NDIS legislation and the much-needed reforms recommended by the NDIS Review must centrally involve the allied health sector and make sure that our sector’s diverse range of supports can be provided sustainably.

The problem

Allied health services are vital or many people with disability. To fully realise participant choice and control it is essential that people with disability have access to the evidenced-based, quality-assured, allied health services that they require.

Right now, not all people with disability can access adequate allied health services. Nationally, the utilisation rate for NDIS allied health supports varies between 49% and 62%.¹

Disability services are strained, and both market failure and sustainability are of significant concern. Last year 75% of providers surveyed by National Disability Services, were considering stopping some or all of their disability services given the 2024 price limits.²

Many allied health professionals working in the NDIS report they are considering their ongoing engagement in the scheme. For example, recent surveys found up to 85% of occupational therapists, 74% of exercise physiologists and 60% of registered music therapists were reconsidering their future in the NDIS.³ For many this is because there have been no increases in price limits for most allied health services over five consecutive years.

Services are already under immense pressure. If highly-skilled allied health professionals stop delivering services, the outcomes will be devasting. Insufficient services will mean NDIS participants’ choice and control will be restricted, and access to timely services will be reduced. This will make it more challenging for participants to achieve their goals and live fulfilling lives.

¹Allied health utilisation figures from NDIS Quarterly Report to Disability Ministers Quarter 4 2023-24 (30 June 2024).

²National Disability Services. Annual Price review Pulse Survey shows most providers reconsidering their futures. 11 July 2024. Available from: https://nds.org.au/news/annual-price-review-pulse-sur-vey-shows-most-providers-reconsidering-their-futures

³#4aBetterNDIS. Why we need to be concerned about NDIS allied health services. Available from: https://nds.org.au/images/resources/for_a_bet-ter_ndis_campaign_2024/Allied%20Health%20Fact%20Sheet.pdf