Jo Morris has been at the forefront of advanced and extended scope physiotherapy practice in Australia since 2007, when she began working in primary contact roles in the emergency department.

While she has seen progress in this area over the past decade, Jo believes development has been fragmented.

‘It’s evolved in a slightly ad hoc way. Which is similar to what I saw in the UK when I worked there in the late 90s, early 2000s.’

The problem, Jo argues, is structural. Australia’s health system is state- and territory-based and the lack of national consistency means that advanced scope roles are unevenly defined and recognised across the country. 

Where some jurisdictions have secured funding to embed these roles in emergency departments or orthopaedics, others lag behind. 

This patchwork process, Jo says, has slowed progress. For Jo, the most urgent barrier to overcome is language and definitions. 

‘We all need to speak with the same language and be consistent about describing what we mean by advanced-level practice.’

Jo points to the UK as an example, where the National Health Service introduced a nationally recognised advanced practice framework in 2017. 

Under this model, physiotherapists in advanced practice roles are understood consistently across different regions. 

Whether they are working in stroke, musculoskeletal health or emergency care, an advanced practice physiotherapist comes
with a clear description of scope, responsibilities and expectations.

In contrast, Jo says, Australia currently has no uniform framework. 

Jo Morris.

A physiotherapist in an advanced role in Queensland may not have the same recognition or responsibilities as one in Victoria. 

This not only causes confusion but also limits the broader health system’s ability to integrate physiotherapists effectively into advanced roles.

Jo’s early career experience in the UK, where she grew up and studied physiotherapy at the University of Birmingham, was not dissimilar to common practice in Australia at the time. 

After graduating, Jo began her career in the public health system—the standard pathway for new graduates. 

Jo is usually the executive director of Rehabilitation, Aged and Community Services and allied health director at Canberra Hospital but she has recently stepped into the role of general manager there.

International comparisons can provide valuable lessons for Australia. Jo says that early work in the UK, Europe and the US demonstrates how physiotherapists can expand their scope safely and effectively. 

These roles improve patient access and outcomes and help ease bottlenecks in healthcare delivery.

One of the strategies that worked overseas, which was then adopted in 2007 in the Australian Capital Territory, was involving other disciplines from the outset, Jo says. 

‘We would look at the problem we were trying to fix—whether it was long waitlists or extensive waiting times—and then discuss that problem with the medical, nursing and admin teams.’

By engaging medical colleagues, demonstrating safety and presenting international evidence, Jo and her peers helped build trust in advanced practice physiotherapy roles in Australia.

Supervision from orthopaedic surgeons and emergency department consultants provided assurance and opened medical colleagues’ eyes to the diagnostic and clinical capabilities of physiotherapists, she says.

Jo is passionate about system reform and is clear about her underlying motivation: the patients. 

‘My work is primarily about ensuring access for patients, which is a challenge for us now and certainly will be in the future.’

With the increase in chronic disease and healthcare budget constraints, advanced practice roles offer a cost-effective way to ensure that each professional works to the top of their scope. 

For physiotherapists, this means taking on responsibilities that ease pressure on doctors while ensuring that patients receive timely, safe and effective care.

Canberra Hospital has been one of the centres of innovation in this field, thanks in large part to Jo’s leadership. 

Over the years the hospital has piloted and embedded advanced practice roles in musculoskeletal health, orthopaedics, rheumatology and emergency care. 

These initiatives demonstrate the feasibility and benefits of advanced scope physiotherapy within an Australian context.

Jo has also led research that shows the economic and patient benefits of these roles. 

‘From a purely fiscal perspective, physiotherapists are a cheaper resource than an orthopaedic surgeon. 

'If patients can get in to see a clinician and get started on a conservative treatment pathway sooner, we can potentially reduce their years of living with disability.’ 

Early intervention, Jo says, reduces disability, improves productivity and leads to better societal outcomes overall.

This research, supported by projects at Canberra Hospital and conducted in collaboration with private health insurers such
as HCF (through the HCF Research Foundation), continues to demonstrate the role physiotherapists can play in streamlining care and ensuring that patients who do see surgeons are the ones who truly need surgical intervention.

Nationally, the APA has been a strong advocate for advancing scope of practice. 

From lobbying for prescribing rights to developing frameworks for education and credentialing, the APA has pushed for reforms that will enable physiotherapists to deliver care more effectively.

Jo is supportive of this advocacy. 

‘The more we can attack this issue from all angles, the more likely we are to get buy-in for the development of a national advanced practice framework.’

Another critical element, Jo says, is education. 

Physiotherapists entering advanced practice roles must have the right clinical foundations, postgraduate education and supplementary training in areas such as radiology and pharmacology. 

She points to universities such as the University of South Australia, which offers advanced practice programs, opening the door to greater collaboration between academia and health services.

She also references her own experiences. 

‘Completing my Level 3 sports training was essential to being a musculoskeletal advanced practice physiotherapist. Gaining experience in areas like radiology, interpretation of imaging and pharmacology— additional elements that perhaps don’t feature in some of those existing programs yet—was also key.

‘Stepping into some other areas of practice outside of musculoskeletal health would be helpful for the profession. 

'We’ve got a little bit happening in pelvic health but I think we need to start with looking at stroke, acute inpatient care and intensive care too.’

This vision reflects broader system needs. As Australia grapples with an ageing population, high rates of chronic disease and pressure on acute services, physiotherapists are well placed to provide timely, evidence-based interventions.

Jo is realistic about the need for robust evaluation. 

Pilot projects often demonstrate the potential of advanced practice roles, but without hard data on outcomes and cost-effectiveness, securing long-term funding and policy change is difficult.

‘Research is really important as you introduce these roles. 

'Until you can understand how to evaluate a position and demonstrate its benefits, it’s very difficult to roll that out more broadly, gain permanent funding or extrapolate out into something else.

'The evaluation component is important.’

Ultimately, Jo believes the future of advanced practice physiotherapy in Australia depends on achieving national consistency. 

This means a shared framework that defines roles, ensures public and professional understanding and provides the basis for sustainable workforce redesign.

‘In the medical field everybody knows what a junior medical officer, a registrar or a consultant is. 

'Having consistency in language is necessary to know what you are getting from the individual in front of you.’

A health system where physiotherapists work to their full potential, where patients receive care faster and where scarce resources are used wisely is the end goal, Jo believes.

With leadership from clinicians, support from the APA and lessons drawn from international experience, advanced scope physiotherapy is poised for growth in Australia.