Journal of Health Services Research & Policy > Volume 11, Number 4 > Pp. 240-247

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Review article

A systematic review of evidence about extended roles for allied health professionals

Kathryn McPherson, Paula Kersten, Steve George, Val Lattimer, Alice Breton, Bridget Ellis, Dawn Kaur, Geoff Frampton

Division of Rehabilitation and Occupation Studies, Auckland University of Technology, Auckland, New Zealand; Schools of Health Professions and Rehabilitation Sciences, and Nursing, University of Southampton, UK; Schools of Health Professions and Rehabilitation Sciences, and Nursing, University of Southampton, UK; Schools of Health Professions and Rehabilitation Sciences, and Nursing, University of Southampton, UK; Royal College of Surgeons, Edinburgh, UK; Schools of Health Professions and Rehabilitation Sciences, and Nursing, University of Southampton, UK; Schools of Health Professions and Rehabilitation Sciences, and Nursing, University of Southampton, UK; Schools of Health Professions and Rehabilitation Sciences, and Nursing, University of Southampton, UK

Objective: Extending the role of allied health professionals has been promoted as a key component of developing a flexible health workforce. This review aimed to synthesize the evidence about the impact of these roles.

Methods: A systematic review of extended scope of practice in five groups: paramedics, physiotherapists, occupational therapists, radiographers, and speech and language therapists. The nature and effect of these roles on patients, health professionals and health services were examined. An inclusive approach to searching was used to maximize potential sources of interest including multiple databases, 'grey' literature and subject area experts. An expanded Cochrane Collaboration method was used in view of the anticipated lack of randomized controlled trials and heterogeneity of designs. Papers were only excluded after the search stage for lack of relevance.

Results: A total of 355 papers was identified as meeting relevance criteria and 21 studies progressed to full review and data extraction. The primary reason for exclusion from data extraction was that the study included neither qualitative nor quantitative data or because methodological flaws compromised data quality. It was not possible to evaluate any pooled effects as patient health outcomes were rarely considered.

Conclusions: A range of extended practice roles for allied health professionals have been promoted and are being undertaken, but their health outcomes have rarely been evaluated. There is also little evidence as to how best to introduce such roles, or how best to educate, support and mentor these practitioners.

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