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AOA Convocation 2010 Melbourne Stiofan Mac Suibhne Scope of Practice


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Keynote presentation by Stiofan Mac Suibhne at the 2010 AOA annual conference on the development of the New Zealand scope of practice within the NZ legislative framework with a comparison to the Australian legislation

Published in: Health & Medicine, Education
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AOA Convocation 2010 Melbourne Stiofan Mac Suibhne Scope of Practice

  1. 1. Stiofán Mac Suibhne
  2. 2.  Trans Tasman Mutual Recognition Principle  Scope of Practice in Australian NZ Healthcare Regulation  Scope of Practice Conceptual Framework  Vocational / Extended Scopes of Practice
  3. 3. AUSTRALIA NEW ZEALAND To provide for the protection of the public by ensuring that only health practitioners who are suitably trained and qualified to practise in a competent and ethical manner are registered; The principal purpose of this Act is to protect the health and safety of members of the public by providing for mechanisms to ensure that health practitioners are competent and fit to practise their professions.
  4. 4. Part 1 (9) This Law does not affect the operation of an Act of a participating jurisdiction providing for the application of the Trans-Tasman mutual recognition principle to occupations. Trans-Tasman Occupations Tribunal
  5. 5. Section 158 Application of Trans-Tasman Mutual Recognition Act 1997 Except as otherwise provided in Schedule 4 of the Trans-Tasman Mutual Recognition Act 1997, that Act prevails over this Act Trans-Tasman Occupations Tribunal
  6. 6. The meaning & function of scope of practice is not given in the Act Scope of Practice may be inferred from: • • • • • • General Registration Endorsements Specialist Registration Codes of Practice Registration standards Accreditation standards
  7. 7. Division 2: Section 35 ( 1) Functions of National Boards: (d) to approve accredited programs of study as providing qualifications for registration or endorsement in the health profession
  8. 8. Division 3: Section 39 (2) Subject to subsection (3), a National Board may also develop, and recommend to the Ministerial Council, one or more registration standards about the following: (b) the scope of practice of health practitioners registered in the profession.
  9. 9. Division 3: Section 39 (3) A registration standard may not be about a matter for which an accreditation standard may provide
  10. 10. Schedule 1, Part 2, Section 15 Approval of areas of practice for purposes of endorsement The Ministerial Council may, on the recommendation of a National Board, approve an area of practice in the health profession for which the Board is established as being an area of practice for which the registration of a health practitioner registered in the profession may be endorsed.
  11. 11. Section 11 Authorities must specify scopes of practice (1) Each authority appointed in respect of a profession must, by notice published in the Gazette, describe the contents of the profession in terms of 1 or more scopes of practice.
  12. 12. Section 12 Qualifications must be prescribed (1) Each authority must, by notice published in the Gazette, prescribe the qualification or qualifications for every scope of practice that the authority describes under section 11.
  13. 13. Global Mobility of Osteopaths: challenges in developing a model for assessment of overseas practitioners based on capability not qualification review Caroline Stone, D.O.(Hons), MSc(Ost), MEd, Stiofán Mac Suibhne, BSc (Hons) Ost, PGCE, PG DIp Health Sc.
  14. 14. Registered osteopaths are primary healthcare practitioners who facilitate healing through osteopathic assessment, clinical differential diagnosis and treatment of dysfunctions of the whole person. Osteopaths use various, recognised techniques to work with the body's ability to heal itself, thereby promoting health and wellbeing. These osteopathic manipulative techniques are taught in the core curriculum of accredited courses in osteopathy. The ultimate responsibility for recognition of practice lies with the Osteopathic Council of New Zealand.
  15. 15.  Osteopathy is a weak brand – we need a USP  Field of manual medicine is crowded.  Osteopathy is defined by its philosophy not technique.  Stakes a claim for Osteopaths and their role in the healthcare system.  The formless no scope scope of practice is not serving us well.  The formless scope or a restricted scope statement is a form of prohibition.
  16. 16.  The Osteopathic Council has a legal duty to specify scopes of practice.  No other competent authorities have specified a scope of practice for the Osteopathic profession.  Wide ranging review of the scope began in 2007 prompted by the inadequacy of existing statement. Extensive consultation processes.  Concerns that the restricted nature of the statement was inadvertently placing osteopaths outside of the law.  Concerns over the representing the diversity of osteopathic practice in a single scope statement.
  17. 17.  Single Scope of Practice is unrealistic.  Osteopathy is a maturing and diversified profession – needs to be reflected in vocational scopes.  No clear relationship between training pathways and competency in practice: Vocational / Extended Scopes.  30% of NZ Osteopaths were using needling techniques in practice without standards / minimum training requirements being determined.  ACCORB accreditation standards specify no minimum requirements for paediatric practice.
  18. 18. Western medical acupuncture is a therapeutic modality involving the insertion of fine needles; it is an adaptation of Chinese acupuncture using current knowledge of anatomy, physiology and pathology, and the principles of evidence based medicine. WMA has evolved from Chinese acupuncture, its practitioners no longer adhere to concepts such as Yin/Yang and circulation of qi, and regard acupuncture as part of conventional medicine rather than a complete ‘‘alternative medical system’’. White, A. R. (2009). Western Medical Acupuncture: A definition. Acupuncture in Medicine, ;27, :33–35.
  19. 19. Western Medical Acupuncture and Related Needling Techniques. Prescribed qualifications: Post Graduate Certificate Western Medical Acupuncture – Auckland University of Technology & University of Herts, UK British Medical Acupuncture Society’s Code of Practice adopted.
  20. 20.  The changing demographic – Western societies are graying.  Increased demands on resources means reduced public sector involvement in direct service provision.  Reduced doctor time will require maximising the services delivered in primary care by allied health professionals.  Need to align the osteopathic scope of practice with the strategic direction.  Life long learning. Current trends in tertiary education to distant / block attendance are favourable for osteopaths.
  21. 21. OCNZ Statutory duty to determine scope. Facilitate leadership on scope issues Professional Bodies: AOA, BOA, ISOP, OSNZ. Australian Osteopathic Council Senior students & faculty from Unitec NZ Ministry of Health
  22. 22.  Additional scopes of practice required to formally recognise skills acquired in post pre-professional training through postgraduate study.  Need to reform the pre-professional training pathway and determine minimum skill set to commence professional life.  Formal training ought not to stop at the point of registration. Externally recognised hierarchy of knowledge  Public register ought to allow patients / third party refers to identify practitioners with advanced standing in certain areas of practice
  23. 23. Advanced standing and post graduate study / specialisation in areas of practice that remain within the general scope of practice. There is a continuum of skills / knowledge from novice to expert. Pre-professional training prepares osteopaths to commence practice.       Child health / Paediatrics Gerontology Occupational Health Pain management Rehabilitation Sports injuries
  24. 24. An extended scope of practice is required when it is explicit that pre-professional training does not prepare a registrant for competent practice. These areas are excluded from the general scope.     Western Medical Acupuncture Osteopath Prescriber Injection therapies Advanced Diagnostic Competencies
  25. 25. OCNZ has organised a follow up event November 2010 Preliminary report from the PaediatricsCapabilities Research Project Vocational scopes: Gerontology Pain Management