Models of Governance of Disability Therapy Support Workers in Rural and Remote Settings: A Systematic Scoping Review

Anna Moran (), Kim Bulkeley, Genevieve Johnsson, Elaine Tam and Catherine Maloney
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Anna Moran: Department of Rural Health, Melbourne Medical School, The University of Melbourne, Shepparton, VIC 3630, Australia
Kim Bulkeley: Faculty of Medicine and Health, School of Health Sciences, The University of Sydney, Camperdown, NSW 2006, Australia
Genevieve Johnsson: Faculty of Medicine and Health, School of Health Sciences, The University of Sydney, Camperdown, NSW 2006, Australia
Elaine Tam: Faculty of Medicine and Health, School of Health Sciences, The University of Sydney, Camperdown, NSW 2006, Australia
Catherine Maloney: Services for Australian Rural and Remote Allied Health, Barton, ACT 2600, Australia

IJERPH, 2024, vol. 21, issue 6, 1-18

Abstract: The National Disability Insurance Scheme (NDIS) ushered in a transformative era in disability services in Australia, requiring new workforce models to meet evolving participant needs. Therapy Assistants are utilised to increase the capacity of therapy services in areas of workforce shortage. The governance arrangements required to support this emergent workforce have received limited attention in the literature. This review examined the key components and contextual factors of governance in rural settings, specifically focusing on therapy support workers under the guidance of allied health professionals in rural and remote areas. Guided by the social model of disability and the International Classification of Functioning, Disability and Health, a realist perspective was used to analyse 26 papers (after deduplication), mostly Australian and qualitative, with an emphasis on staff capabilities, training, and credentialling. Success measures were often vaguely defined, with most papers focusing on staff improvement and few focusing on client or organisational improvement. Consistent staffing, role clarity, community collaboration, and supportive leadership were identified as enabling contexts for successful governance of disability therapy support workers in rural areas. Investment in capability (soft skills) development, tailored training, competency assessment, credentialling, and supervision were identified as key activities that, when coupled with the identified enabling contexts, were likely to influence staff, client and organisational outcomes. Further research is warranted to explore long-term impacts of governance arrangements, educational program accountability, and activities targeted at enhancing staff capabilities.

Keywords: disability; support worker; assistant; therapy; governance; rural; remote; realist synthesis; allied health; remote; risk; quality (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2024
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