Aboriginal and/or Torres Strait Islander Health Workers and Health Practitioners play a unique and critical role in ensuring Australia’s health care system responds appropriately to the needs of Aboriginal and Torres Strait Islander peoples.
Despite the essential role the workforce plays, the lack of consistent minimum scopes of practice continue to hinder its growth and impact nationally. Calls for nationally standardised scopes of practice and harmonised supporting legislation have been long-standing. The issue was first formally recognised in the Health Workforce Australia Final Report in 2011 and later endorsed as a policy commitment by the COAG Health Council in August 2018.
These commitments were further reinforced in the National Aboriginal and Torres Strait Islander Health Workforce Strategic Framework and Implementation Plan 2021–2031 (National Workforce Plan), which was co-developed by Aboriginal and/or Torres Strait Islander people and the Australian Government. Specifically, Strategic Direction 1of the National Workforce Plan prioritises the following Implementation Strategies:
- 1.1 : Revising, expanding, and nationally standardising scopes of practice for Aboriginal and/or Torres Strait Islander Health Workers and Health Practitioners.
- 1.2 : Harmonising medicines authorities across jurisdictions, aligned to these defined scopes of practice.
In 2023, consistent with our designated leadership role under the National Workforce Plan, NAATSIHWP secured funding through the Health Sector Strengthening Virtual Funding Pool administered by the National Indigenous Australians Agency, to facilitate a national consultation process. This initiative aimed to define what national minimum scopes of practice and harmonised drugs and poisons legislation should include for the professions.
This national project included four key deliverables:
- Establishment of governance arrangements including a high-level steering committee and advisory group;
- Development of a comprehensive gap analysis to identify the extent to which inconsistency impacts the workforce;
- A broad ranging consultation process to assess current practice, identify barriers and workshop potential minimum scopes of practice to build consensus on an appropriate national approach and;
- The delivery of a Final Report for whole-of government consideration and implementation.
The gap analysis provided a point-in-time desktop review of all policies, legislation and practices affecting the scopes of practice of Health Workers and Health Practitioners working in government, community-controlled and private healthcare settings. It not only confirmed concerns long-held by NAATSIHWP and the national workforce, it exposed the full scale of the systemic underutilisation and undervaluing of the workforce and highlighted the entrenched challenges that continue to limit its impact and potential.
To ensure these findings were grounded in lived experience NAATSIHWP then led a transparent and inclusive consultation process. Using key findings from the Gap Analysis and proposed Professional Minimum Scopes of Practice we facilitated:
- 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;
- Supplementary workshops, meetings and surveys with stakeholders.
Summaries of these consultations are available here:
- Scope of Practice Yarns Northern Territory ;
- Scope of Practice Yarns Queensland, Torres Strait Islands and Northern Peninsula Area ;
- Scope of Practice Yarns South Australia ;
- Scope of Practice Yarns Western Australia ;
- Scope of Practice Yarns Tasmania and Victoria ;
- Scope of Practice Yarn New South Wales .
In December 2024, NAATSIHWP submitted its Final Report to the Australian Government, outlining 22 targeted recommendations across the following six reform themes:
- Supporting national minimum scopes of practice;
- Expanding scopes of practice;
- Enhancing workforce identity and recognition;
- Improving recruitment, retention, and career progression;
- Addressing racism;
- Strengthening monitoring and evaluation.
NAATSIHWP is prioritising three key recommendations for immediate implementation which are directly aligned with Strategic Directions 1.1 and 1.2 of the National Workforce Plan, and include:
- Establishing nationally consistent minimum scopes of practice
- Harmonising medicines administration arrangements
- Developing a National Clinical Care Guideline or Manual for the workforce
These recommendations are evidence based, ready for immediate implementation and endorsed by workforce and key stakeholders. Delivering on these commitments will strengthen the workforce, improve national consistency of care, and ensure Aboriginal and Torres Strait Islander Communities receive the culturally safe and responsive, high-quality health care needed to close the gap in health disparities and achieve health equity and justice.