Introduction

This chapter describes the way the health support workforce interfaces with allied health professions, first through an international perspective, and then with greater focus on the UK and Australian contexts. Allied health practitioners have been working with support workers since at least the mid-20th century (Salvatori 2001), with evidence of formal training for occupational therapy assistants in the United States as early as the 1950s – while several professions saw a proliferation of assistants during the early 1970s in Canada and the UK (Robinson et al 1994; Webb et al 2004). Since then, despite varying levels of opposition from professional bodies and inconsistent access to training and professional support, support workers are now a key component of many health and social services contributing to the care provided by a wide range of allied health disciplines (Farndon and Nancarrow 2003; Saks and Allsop 2007; Salvatori 2001). As a result, support workers are a growing and increasingly diverse group of practitioners supporting the delivery of various allied health services.

Allied health support workers have been introduced primarily as a way to increase allied health capacity to meet the needs of an expanding and ageing population and to account for a shortfall in professionally qualified practitioners (Salvatori 2001). They have also been seen as an economically effective way to deliver safe and skilled care, while enabling the professional workforce to upskill to provide more specialist services (Foster 2006). The support worker role is therefore seen as a way to free up the time for allied health professionals to carry out more complex tasks by maintaining or increasing the capacity of care previously delivered by professionally qualified practitioners (Pullenayegum et al 2005; Stanmore et al 2005). Consequently, the expansion of support workers has been a focus of recent health workforce reform in the UK and various Australian states with policies targeting growth in numbers, expansion of roles and the introduction of new types of roles (Saks and Allsop 2007; Wanless 2002).

One challenge of understanding the support workforce associated with allied health is the lack of central coordination. Consequently numerous roles, models and worker titles have emerged (Bach et al 2008; Buchan and Dal Poz 2002; Lizarondo et al 2010; Saks and Allsop 2007).