Aboriginal and/or Torres Strait Islander Health Workers and Health Practitioners play a unique and critical role in ensuring Australia's health care system meets the needs of Aboriginal and Torres Strait Islander people.
While training for the workforce is nationally standardised, the range of roles, functions, responsibilities of the workforce (also known as scopes of practice) vary significantly depending on jurisdiction and sector. In many locations, this has led to:
- Workforce being unable to perform the clinical skills they are taught, leading to undervaluing of professions within the health sectors;
- Confusion about ways to include the workforce within models of care;
- Reluctance to complete further study;
- Poor recruitment and retention;
- Difficulty moving between jurisdictions or sectors;
- Misunderstanding and underutilisation by managers and colleagues; and
- Missed opportunities for culturally safe continuity of care for Aboriginal and Torres Strait Islander clients.
The need for a national minimum scope of practice supported by harmonised legislation has been a goal of the workforce for decades. The need was first acknowledged in government policy over ten years ago in the Health Workforce Australia Final Report. It was then made a commitment by the COAG Health Council in August 2018. Following this, the National Aboriginal and Torres Strait Islander Health Workforce Strategic Framework and Implementation Plan 2021–2031 (National Workforce Plan) was developed by Aboriginal and/or Torres Strait Islander people in partnership with the federal government.
Implementation Strategies 1.1 and 1.2 of the National Workforce Plan relate to the harmonisation of legislation and establishment of a national Scope of Practice by 2026:
- Strategic Direction 1.1 - Revise, expand and nationally standardise the professional scopes of practice for Aboriginal and/or Torres Strait Islander Health Workers and Aboriginal and/or Torres Strait Islander Health Practitioners.
- Strategic Direction 1.2 - Harmonise medicines authorities across all jurisdictions for Aboriginal and Torres Strait Islander Health Practitioners, aligned to the defined professional scopes of practice.
In 2023, NAATSIHWP secured funding through the Health Sector Strengthening Virtual Funding Pool administered by the National Indigenous Australians Agency to lead the delivery of a national consultation process to examine what standardised scopes of practice and harmonised drugs and poisons legislation for the professions should include and involve. This project directly responded to the actions identified under the National Workforce Plan and signified the beginning of a concerted national effort to embed minimum scopes of practice for Aboriginal and Torres Strait Islander Health Workers and Health Practitioners across the country.
From April to September 2024, we conducted a national consultation process involving:
- 24 in-person yarns with members of the workforce and direct line managers from each state and territory
- 6 online yarns
- a national workforce survey and
- supplementary workshops, meetings and surveys with stakeholders.
The findings from these consultations were included in a Final Report delivered in December 2024. The Final Project Report shows Aboriginal and/or Torres Strait Islander Health Worker and Health Practitioner scopes of practice are nationally inconsistent and unaligned to the national qualification framework . The inconsistencies disempower the workforce, disincentivise further training, undermine effectiveness, create confusion among colleagues, and mean that Aboriginal and Torres Strait Islander people miss out on receiving culturally safe primary health care. The Report proposes 22 recommendations for whole of government consideration.