I propose to take Questions Nos. 945 to 947, inclusive, together.
International evidence demonstrates access to appropriate health services for patients is maximised through multidisciplinary team (MDT) working and integration of services. Sláintecare, underpinned by these principles for reform has also identified waiting list management as a key priority.
Physiotherapists, as part of the MDT with expert knowledge of rehabilitation and injury management can make a positive contribution towards improving waiting times for some patients. It is documented that there are selected caseloads of patients particularly in the area of musculoskeletal (MSK) disorders that have gained more timely access to care where clinical teams include specialist or Advanced Practice Physiotherapists. There is also evidence that re referral rates are low and comparable to International rates avoiding system over burden. Longitudinal research of patient outcomes is required in the Irish context to determine the appropriateness of care delivered by Advanced Practice.
Physiotherapists and the impact on waiting lists.
Advanced Practice Physiotherapist in Ireland is a role title rather than a regulated professional role which is governed by legislation. In other professions legislation protects the title of Advanced Practitioner and requires certain extended standards of practice. In physiotherapy, such legislative changes would require definition of the role from the professional perspective and the development of appropriate standards and an education programme to support the change in the level of practice.
Registered Advanced Practitioners are well established in the Nursing and Midwifery professions for example. Advanced Practice in these professions developed over a number of years and followed a recommendation from the Commission on Nursing (1998). The basis of advanced practice is the high degree of knowledge, skill and experience that is applied within the nurse-patient/client relationship to achieve optimal outcomes through critical analysis, problem solving and accurate decision making. The outer limits to advanced practice are set by legislation, policy and guidelines that were developed through an extensive process.