Welcome to the Scope of Practice Review Resource Hub
The Australian Physiotherapy Association is proud to support the transformative recommendations presented in the Unleashing the Potential of our Health Workforce – Scope of Practice Review Final Report.
This landmark report proposes significant reforms designed to address long-standing barriers in healthcare, moving Australia towards a future where every health discipline is empowered to work to its full potential within an integrated, multidisciplinary framework.
This resource page serves as guide for APA members to understand the key reforms, access supporting resources, and share insights with peers.
Breaking down the recommendations
The Scope of Practice Review outlines 18 key recommendations aimed at empowering healthcare professionals to deliver best-practice care. The recommendations were organised into four themes, and we explore what each recommendation means for physiotherapy below.
Theme A: Workforce design, development, education, and planning
Reform A1: National Skills and Capability Framework
Develop a National Skills and Capability Framework.
The review recommends developing a framework to make the skills and capabilities of the primary care workforce explicit and transparent at a national level. The Matrix offers a strategic approach to address challenges associated with limited recognition of primary care health professionals' skills and capabilities. This reform is a sensible step aimed at elevating the visibility of essential competencies, ensuring the full workforce is adequately recognised and utilised.
Reform A2: Strengthen the capability of the primary care workforce
Establish a primary care workforce development program.
A proposed primary care workforce development program aims to enhance the primary care-specific curriculum, training, and career development for professions in primary care, supporting a skilled, stable, and collaborative workforce. This reform will highlight primary care training and development across healthcare professions, resulting in knowledgeable practitioners who provide quality, safe care, while also strengthening training capacity and addressing workforce inconsistencies.
Amend the National Law to provide a consistent authority of the Health Ministers' Meeting to give policy directions on registration and accreditation functions.
The reform aims to enhance national clarity on health professionals’ scope of practice, fostering collaboration within primary care teams. This reform prioritises the development of the primary care workforce, allowing Health Ministers to provide direct input to accreditation authorities on relevant matters. We view this as a positive change that will enable timely and effective reforms, leveraging the full health workforce and directing team-based care.
Develop principles for Interprofessional Education (IPE) and interprofessional capabilities in primary care, collaborative practice, and First Nations healthcare to foster consistent cross-professional learning and practice.
The proposed reform aims to establish cross-professional consistency in skill and capability development in common practice areas, identifying shared scopes in primary care, collaborative practice, and First Nations healthcare to support a unified approach to education and training. While we await further detail, ensuring consistency could enhance cross-professional certainty and elevate the overall quality of care.
Remove unnecessary barriers to supervision in primary care education and training.
This reform, if implemented, would represent a significant step forward, though it could be further improved by including PHI. Private practices will gain access to relevant MBS item numbers for students during clinical placements and supervised practice, unlocking growth potential. This change would enable private practices to offer more clinical placements, providing high-quality, practical training in primary care.
Theme B: Legislation and regulation
Reform B1: Initiate a more balanced and consistent approach to regulating scope of practice
Progress activity-based regulation of scope of practice to complement the status quo protection of title approach.
The review suggests Health Ministers should advance activity-based regulation of scope of practice, moving beyond the current title protection approach. This would apply to activities regulated outside the National Law or NRAS, shared across multiple professions, meeting risk thresholds, and serving the public interest. By implementing this, future legislation could reduce reliance on protected titles, allowing for more flexible and innovative practices. This change aims to enhance service provision across various professions while ensuring public safety. However, without legislative and funding adjustments, barriers for physiotherapists working at the top of their scope may persist.
Program of review and potential harmonisation of existing legislation and regulation.
Streamlining legislation for better practice to remove barriers that prevent professions from working to their full scope of practice. This would commence with a review of the Drugs and Poisons Acts, Radiation Safety Act, and Mental Health Acts. The adoption of this recommendation, particularly in relation to the Drugs and Poisons Acts, will hopefully limit confusion regarding physiotherapists’ engagement with medications and allow them to work to the top of their scope of practice both now and into the future.
Strengthen and standardise the regulatory model for health professions currently operating outside of the NRAS.
This recommendation focuses on self-regulated professions, aiming to strengthen and standardise their regulatory model. A rapid impact analysis is recommended to review three options for amending the NRAS, ensuring self-regulated professions can work to their full scope while maintaining public safety. The review is welcomed to enhance regulation and ensure public safety for those outside the NRAS. However, two options might grant protections under the NRAS while allowing professions to remain self-regulated. The APA is concerned that this could provide advantages, such as title protection, without full NRAS oversight and adherence to the National Law.
Reform B2: Independent, evidence-based support for health workforce innovation, access and productivity
Establish an Independent Mechanism to provide evidence-based advice to Health Ministers, government, and key stakeholders on workforce innovation, emerging healthcare roles, and significant changes in workforce models.
This Mechanism will support health workforce design, improve system responsiveness to legislative changes, and enable efficient translation of practice innovations. This sensible reform, with adequate funding and administration, will fill a critical gap in health workforce planning. It will develop and scale proven care models, allowing non-medical professionals to work to their full scope. This approach will foster multidisciplinary teams, shared outcomes, and collaborative, efficient patient care based on evidence-informed practice.
Theme C: Funding and payment models
Reform C1: Funding and payment models enable and support health professionals in multidisciplinary teams to work to full scope of practice
Introduce a blended payment model to enhance access to multidisciplinary care in primary settings.
This will enable health professionals to work to their full scope, overcoming funding barriers and fostering integrated care teams. As funding mechanisms are the largest barriers to reform, this recommendation is crucial for building and supporting coordinated care, aligning with the APA’s push for comprehensive healthcare reform. However, reform will be limited if we continue to prioritise an ineffective and financially unsustainable gatekeeping model. We must move beyond current ineffective measures. As we transition, we’ll advocate for reforms that expand leadership roles for physiotherapy, nursing, and psychology, ensuring meaningful change.
Introduce a bundled payment model for maternity care to ensure consistent funding for midwifery and shared care models, enhancing accessibility and integration in both primary care and hospital settings.
This includes both public and private sector models. The APA acknowledges the critical role of midwives in collaborative multidisciplinary maternity care but notes the proposal’s lack of clarity on broader MDT team integration. The reform is narrow, overlooking early intervention, prevention, and ongoing post-birth pelvic health and musculoskeletal care. Despite its limitations, the recommendation offers potential improvements in the structure and funding of private health insurance within the private hospital setting.
Reform C2: Direct referral pathways supported by technology
Implement new direct referral pathways for consumer access to specified non-GP specialist MBS items.
In driving the required system-level change to advance health and improve care, the APA is particularly pleased to see that the potential of the physiotherapy workforce has been acknowledged and prioritised for direct referral pathway reform and is in scope for priority changes to MBS payment rules. This recommendation and its accompanying criteria will ensure the measure is contained to the right disciplines, including physiotherapy referral to orthopaedic surgeons, while ensuring the treating team, including the patient’s GP, is notified.
Theme D: Enablers and other key considerations
Program governance and reform structure to oversee reforms.
The Review recommends fostering a culture of understanding and trust between professions to improve primary care access and continuity. To achieve this, it calls for interprofessional collaboration among all stakeholders. Governments and key stakeholders should commit to a reform program and governance structure that supports culture, leadership, implementation, and evaluation. The Australian, State, and Territory Governments are advised to incorporate the Review’s recommendations into the National Health Reform Agreement (NHRA). Aligning leadership and commitment across governments and primary care services is essential to overcoming professional siloes and promoting genuine multidisciplinary teamwork.
Develop a new capacity-building and implementation support program for the 31 Primary Health Networks (PHNs).
This program provides a key enabler to support the capability uplift required to drive these reforms. It will enhance PHNs’ ability to support local primary care systems consistently, tailored to community needs. PHNs will lead in areas such as workforce capability, funding models, referral pathways, culture and leadership, governance, and rural and remote healthcare. This initiative will complement PHNs’ existing roles in planning, integration, practice support, and commissioning, ensuring effective delivery of reforms within local contexts.
Develop and implement communications and training strategies.
The Review emphasised the crucial role of consumers in implementation and the importance of evaluation and monitoring. To progress reforms and foster a positive system-wide culture, large-scale changes across all levels are essential, requiring a dedicated change management strategy. A coordinated approach to communications and training will enable all stakeholders to understand the change required, why it is needed, and their role in driving it. Consumer input is essential, as outlined in the recommendation, as is input from the entire health workforce.
Commit to a shared definition of cultural safety across primary care.
The report recommends that a shared definition of cultural safety be adopted as a foundational shared capability in the National Skills and Capability Framework and Matrix (Recommendation 1). The APA supports this measure as a means of supporting a culturally safe health workforce, which is essential in ensuring First Nations Australians receive care that meets the needs of their communities.
Mandate primary care providers’ participation in an approved accreditation program to ensure quality, safety, and accountability in private physiotherapy practices.
Supported by PHNs, this program will enhance clinical governance and quality improvement. The National Safety and Quality Primary and Community Healthcare Standards (NSQPCHS) provide a robust framework for quality care. Transitioning from voluntary to mandatory standards will require significant time and resources and pose challenges for private practices. The reform includes a support program to assist all primary care providers in participating in accreditation schemes, with PHNs playing a key role in strengthening clinical governance. Additionally, a national accreditation process could streamline and potentially eliminate the need for other registration and accreditation processes, such as the NDIS registration process.
Prioritise implementation of reforms in rural, remote, and underserviced areas.
The Review has suggested reforms with a rural focus within various recommendations of the report. This includes specific support mechanisms for student training (Recommendation 2), an innovation assessment process for rural workforce models (Recommendation 9), and funding models that support multidisciplinary team care by allowing healthcare professionals to work to their full scope of practice. Although the APA welcomes these recommendations, addressing the current shortages in the rural health workforce cannot be achieved unless reforms are extended beyond medicine.
Keep the conversation going
The APA has actively contributed to this review and advocates for its robust, evidence-based recommendations. Our response emphasises the need for continuous legislative support, tailored funding models, and the removal of unnecessary barriers that restrict physiotherapists from delivering high-value care.
Moving forward, we are committed to collaborating with the government, healthcare professionals, and key stakeholders to bring these recommendations to fruition.
Explore the resources below to deepen your understanding of the review and its implications for the physiotherapy profession:
- Full Scope of Practice Review Report – Dive into the comprehensive findings and recommendations.
- APA Submission to the Review – Understand the APA’s advocacy efforts and key areas of focus.
- Media Release – Read the APA’s latest media statement welcoming the report and its key highlights. Reform starts here -APA welcomes final report scope of practice review and its potential to transform primary care.
- Social media toolkit – Download and share the evolving social media toolkit. Stay informed through APA’s channels for updates where we will unpack further what these reforms mean for our profession and for the future of healthcare in Australia.
President’s commentary
Watch APA National President Scott Willis discuss the review’s impact and the role of physiotherapy in shaping healthcare reform.