Advanced practice physiotherapists in primary health care: stakeholders’ views of a new scope of practice

Gill Stotter; Eileen McKinlay; Ben Darlow

doi:10.1071/HC24029

RESEARCH ARTICLE (Open Access)

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Advanced practice physiotherapists in primary health care: stakeholders’ views of a new scope of practice

Gill Stotter ¹ ³ , Eileen McKinlay

² , Ben Darlow

¹ ^*

+ Author Affiliations

- Author Affiliations

¹ Department of Primary Health Care and General Practice, University of Otago Wellington, Aotearoa New Zealand.

² Centre for Interprofessional Education, Division of Health Sciences, University of Otago, Dunedin, Aotearoa New Zealand.

³ Present address: Hutt Physiotherapy Centre, 50 Bloomfield Terrace, Lower Hutt, New Zealand.

^* Correspondence to: ben.darlow@otago.ac.nz

Handling Editor: Felicity Goodyear-Smith

Journal of Primary Health Care 16(2) 160-169 https://doi.org/10.1071/HC24029

Submitted: 23 February 2024 Accepted: 19 April 2024 Published: 8 May 2024

© 2024 The Author(s) (or their employer(s)). Published by CSIRO Publishing on behalf of The Royal New Zealand College of General Practitioners. This is an open access article distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND)

Abstract

Introduction

Advanced and extended primary health care practice roles have been developed in Aotearoa New Zealand (NZ) for dietetics, nursing, pharmacy, and physiotherapy professions. Advanced musculoskeletal physiotherapy roles in primary health care could address escalating health care costs, challenges to workforce sustainability and inefficient primary/secondary care interfaces. Little is known about how stakeholders perceive the recently introduced Advanced Practice Physiotherapist (APP) scope of practice.

Aim

This study aimed to explore health professionals’ perceptions of the APP scope of practice in NZ and how APPs could influence physiotherapy service delivery for people with musculoskeletal conditions in primary health care.

Methods

Qualitative, face-to-face, semi-structured interviews were conducted with 15 participants including physiotherapists, general practitioners, medical specialists and Accident Compensation Corporation case managers. Inductive interpretive analysis was undertaken.

Results

Five themes were identified: perceptions of current musculoskeletal management in primary health care; lack of a career pathway; ways in which APPs might facilitate change and what their role would be; characteristics of an APP; and the implementation of the APP role into practice.

Discussion

Stakeholders were supportive of the APP scope of practice and thought it has the potential to improve patient pathways, health care delivery and health outcomes for those with musculoskeletal conditions. Stakeholders also thought it would fill an important gap in the physiotherapy clinical career pathway. Successful implementation will require assessment of applicants’ personal attributes as well as clinical experience and academic qualifications to ensure all stakeholders have confidence to engage with the service, clear communication, active promotion and specific funding.

Keywords: advanced practice, career mobility, health pathways, health workforce, musculoskeletal, physiotherapy, primary health care, scope of practice.

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