Creating an Allied Health Rural Generalist Model of Care by implementing the Calderdale Framework using Clinical Re-design Methodology

Alison Pighills

1Mackay Hospital and Health service, P.O. Box 5580, Mackay Mail Centre, Mackay, Qld 4741


Rural patients receive limited Allied Health (AH) services. Small, disbursed, rural populations do not justify full-time posts for the core AH professions. Historically in Mackay (MHHS), part-time posts were allocated for each profession, which were difficult to recruit to. Vacancies were either unfilled or existing staff, from other professions, informally extended their scope of practice, without the requisite skills, training and governance to ensure best patient outcomes.


A transferable AH Rural Generalist Model of Care (RGMoC), involving a professional skill-sharing and delegation, has been developed, with representation from the core AH professions. Vacancies are advertised as AH Rural Generalist posts (to which a defined range of professions can be recruited, depending on population and service needs). The Calderdale Framework was used to define the scope of each role and potential to delegate tasks.

The AH RGMoC provides a tele-rehabilitation service for patients, particularly those living in isolated areas. Tele-rehabilitation is also used to support professional skill-sharing through real time supervision and joint assessment.

Clinical re-design methodology was used to implement the project.


A strategic vision has been written and a transferable Rural Generalist MoC established. The staffing structure has been re-configured, Rural Generalist role descriptions written and staff recruited. The scope of each role was defined using the Calderdale Framework and a competency based training program developed using standardised Clinical Task Instructions.


The Calderdale Framework provides the structure to develop a Rural Generalist AH workforce, which operates in an expanded scope of practice through professional skill-sharing.

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