Leadership in allied health

Key messages

Allied health professionals, as organisation (and system) ‘connectors’, have a key leadership role to play in delivering on quality and safety, and improving health services’ efficiency and effectiveness.
Allied health is an important leadership resource which is currently under-utilised in health services. A multidisciplinary approach to change is needed, with allied health taking on a more prominent leadership role.
Allied health professionals must increase their involvement in the planning, management and leadership of health service delivery organisations to improve decision-making, clinical governance and patient safety.
Access to leadership development opportunities are critical to equip allied health professionals with the leadership skills and tools to successfully lead and contribute, alongside other disciplines, to transformational change in the system.

Clinical leadership is at the forefront of healthcare reforms globally as a strategy to improve decision-making, clinical governance and patient safety. Delivering on quality, safety and productivity is fundamental for public health services, and organisational and systems improvements and outcomes rely on effective leadership. Allied health professionals as organisation (and system) ‘connectors’ have a key leadership role to play in delivering on the quality, safety and productivity, that is fundamental for public health services.

The Department of Health and Human Services is developing an allied health leadership strategy, in partnership with the sector and key allied health stakeholders. The strategy will build leadership capacity and capability at all levels of the allied health workforce The strategy will include a compelling narrative of the type of leadership allied health is aspiring to, and aims to align future sectoral efforts and thinking to build on the platform provided by the strategy.

In 2015, the Chief Allied Health Advisor commissioned two reports to inform the development of an allied health leadership strategy for Victoria.

The first report, Allied health leaders: Australian public sector health boards and top management teams identified that allied health’s poor representation in Victorian health leadership strata reinforces allied health being less visible as a potential leadership resource, and limits their access to organisational leadership development pathways.

The second report: Strategies for allied health leadership development: enhancing quality, safety and productivity is the culmination of extensive literature reviews, qualitative research and consultation with the sector. The report makes recommendations to improve clinician engagement in health reform, and outlines strategies for allied health for leadership development at the system, organisational and individual level.

Report 1: Allied health leaders: Australian public sector health boards and top management teams
Report 2: Strategies for allied health leadership development: enhancing quality, safety and productivity

Allied health leadership development framework

The allied health leadership strategy is underpinned by the allied health leadership development framework. The framework identifies four levels of leadership development across the career continuum including:

Level 1: Transition to Practice
Level 2: Emerging Leaders
Level 3: Growing Leaders
Level 4: Established Leaders.

The framework will underpin the development and delivery of targeted interventions by the sector, in partnership with the department.

Allied health leaders: Australian public sector health boards and top management teams

Governance structures play a critical role in how organisations function. The structures determine where and how decisions are made, how information is shared across the organisation, how budget and risks are managed, and where authority and influence are positioned. The importance of high-level leadership positions in health services through visible allied health governance structures is a trend that has become embedded in health services since the 1990s in Australia (Boyce 2001), although more recently becoming the norm in Victoria. Despite this Directors of Allied Health in Victoria widely reported exclusion from top level decision making forums and very limited ability to input into strategic decisions.

In 2015, the Chief Allied Health Advisor of Victoria commissioned a 10 year follow up study of governance arrangements in health service organisations in Australia to better understand the strengths and weaknesses of particular organisational models on allied health ways of working. An additional arm of the research examined the contribution of allied health in key decision making forums in health services (Top Management Teams and Boards); and the proportional representation across the major health workforces (medicine, allied health and nursing). The research demonstrated that while governance models that deliver positional authority positions for allied health leadership have grown at the organisational level, allied health representation at the top management team and Board levels is significantly less than that afforded to clinicians with medical and nursing backgrounds (Boyce 2016).

These findings are significant in that:

Strategic and budgetary decisions made distant to allied health, and without full knowledge and understanding of allied health, may result in less efficient, effective and strategic use of the allied health workforce.
The absence of allied health input into decision-making where it could make a positive difference to system performance, service quality and patient safety is a lost opportunity. Allied health works in a patient centred care paradigm and this expertise is critical to current health reforms and strategic decision-making.
Allied health’s poor representation in health leadership strata reinforces allied health being less visible as a potential leadership resource, and having limited access to organisational leadership development pathways.

Leading in allied health: tools and resources

Governance and leadership in allied health

Understanding the role of organisational structures in the distribution of both formal and informal organisational authority and power; and understanding the implications of different organisational governance structures for allied health service provision and professional development, is essential for allied health leaders.

This animation condenses three decades of research into health service organisational structures and governance models by Professor Rosalie Boyce, into a short, simple and clear communication that explains the significance of different governance models on allied health’s ways of working and ability to provide best patient care. Her research provides a wealth of evidence and understanding of how allied health is impacted by different organisational governance models, and which models facilitate allied health’s ability to provide best patient care and contribute to positive organisational outcomes.