Exploring the skill level of the Occupational Therapy Allied Health Assistant workforce: The need for a competency framework

Megan Rumble1, Jessie Duncan1, Josh Scott1, Majella Campbell1
Central Gippsland Health1


Background or Problem/ Issue:

Due to an increase in demand for occupational therapy services, it is important that Occupational Therapy Departments are providing an efficient service. Allied Health Assistants (AHAs) can play a vital role in delivering efficient clinical service to clients. It is important to ensure that Occupational Therapy Allied Health Assistants (OT AHAs) have the appropriate clinical skills to provide intervention to clients. Discussions from within the Occupational Therapy Department at Central Gippsland Health (CGH) identified that AHAs were been used in a more administrative capacity than a clinical capacity.

Method or What you did?

A benchmarking survey was sent out to like for like healthcare organisations to determine how their AHA workforce was used both clinically and non-clinically and if a credentialling or competency framework was used regarding the AHA’s clinical skills.

Occupational Therapists (OTs) and OT AHA’s at Central Gippsland Health (CGH) were surveyed regarding the AHAs skill level at completing a range of clinical and non-clinical tasks across the inpatient, community and paediatric setting.

Results or Outcomes:

Three like for like organisations completed the benchmarking survey and shared their credentialing/competency frameworks. All three of the organisations were using AHAs in an increased clinical capacity compared to CGH. Only one of the three organisations competency framework included observation of the AHA’s clinical skills by the OT, whereas the other two were based on self-report of the OT AHA.

There were significant discrepancies between the OT’s and the AHA’s perception of skill level of the AHA’S. The AHAs working within the Occupational Therapy Department self-rated their skills in the moderately high to very high skill range on 97% of occasions compared to the OT’s rating of only 23%. The OTs tended to rate the AHA’s at a higher skill level in completing administrative related tasks compared to clinical tasks.

Conclusion and Implications for Practice

The major discrepancy between AHA self-rated and OT rated scores regarding skill level was of significant concern and could potentially be associated with the decreased use of AHA’s in a clinical capacity. Given this discrepancy, the CGH OT department developed a competency framework based on observation of the AHAs clinical skills rather than self-rated scales alone. The scoring system was based on observation using the SPEF scoring framework to ensure consistent scoring across the OT’s.

The competency framework is currently been trialled with the OT AHA’s. Review of the competency framework is required to determine if it has resulted in improvement in clinical skills of the AHAs and the OT’s confidence in the AHAs clinical skills.


Megan is an Occupational Therapist working at Central Gippsland Health across inpatient, adult community and NDIS. Megan has over 10 years experience working in public health and has a passion for supervision and teaching.

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