APPENDIX 5: ALLIED HEALTH PROFESSIONS PRACTICE MATRIX
The Universal, Targeted and Specialist Role of Allied Health Professionals ( AHPs) working with Education
A model for enabling understanding of AHP roles and ways of working between health and education that applies to a variable extent across the AHPs according to their involvement in supporting learning outcomes for children and young people. See http://www.scotland.gov.uk/Topics/Education/Schools/welfare/partnershipworking for profession-specific examples of the Practice Matrix.
Target Population/ AHP Roles
For all children irrespective of need. Includes preventative or health improvement measures.
For children potentially in need of support but not referred and un-named. Includes general advice for non-specified children but not advice for a named child. This can be post-discharge but the advice will be of a general nature and not specific to any one child.
For children in need of support and have been admitted to the AHP service. (Open duty of care exists if assessment has identified need. Referral may not be accepted if needs can be met through universal or targeted support alone.) Individual or group work.
Individual Child or Young Person - intervention may be provided within a group
Information about the AHP services available and how they can be accessed. Awareness of environments which will optimise a child's development and facilitate identification of need.
AHP support given to school staff to enable them to help individual children within the school to achieve their learning outcomes or a particular group of children with common support needs.
Following assessment of need child requires time limited periods of AHP intervention to achieve predicted outcomes. Effectiveness of AHP support must be evidenced and either further support negotiated or child and family prepared for discharge. Specialist role could include supporting school staff in meeting identified needs.
School/Educational Provision(pre-school to end of secondary school)
AHP support that impacts on the whole school population.
AHP support given to school staff to enable them to help a particular group of children within the school to achieve their learning outcomes.
Local Area/ National Context
AHPs work in partnership with national and local policy makers and planners to develop understanding of AHP contribution to influence best outcomes for children.
AHPs contribute to forward planning and resourcing for children with additional support needs.
PURPOSE OF PRACTICE MATRIX AND DEFINITIONS OF UNIVERSAL, TARGETED and SPECIALIST ROLES28
- Each level within the matrix requires specialist AHP knowledge and skills to develop and support competence in those affecting the change
- An individual may receive support at more than one level/role at one time, or move within the matrix as they develop and progress
- Model recognises impact on functioning/activity/participation and allows for consideration of complexity of need taking into account child's or young person's setting
- Considers the most appropriate people and setting or context to affect change
- Includes concept of "self-management" - supporting child or young person and parents to take responsibility for their own/their child's development/learning
- Supports decision-making frameworks
- Communicates a consistent message about AHP services working within/with education
Universal Role - providing a universal role (if not considered a universal service)
- This type of work is more general and appropriate for all children, irrespective of need/level with a positive impact on whole population/group
- Designed to be preventative or relevant to general health promotion, health improvement and health inequality
- Training and staff development to build capacity and raise awareness in potential referrers, increasing appropriateness of referrals
- Includes developing leaflets on roles, ways of working and referral process, advice sheets and access to web-based resources
- AHP involved in educating referrers, public and other agencies about access, risk and scope of practice
- Working with the whole school to identify and implement school improvement objectives related to meeting the needs of every child
- Parent/teacher training programmes - skills groups, projects and initiatives
- Curriculum differentiation, adapting the learning environment for the whole class
Targeted Role - for un-named children not necessarily referred (no duty of care exists for child/young person)
- Addresses health promotion and health inequalities for child at risk of not achieving outcomes within universal provision
- Promoting participation and self-management - supporting staff to make environmental changes within the class for particular group of children
- AHP provides support for other professional colleagues/parents to enable them to manage the care of a child/group of children
- Discussion of potential (un-named) referrals, which may include joint-planning, co-working and training sessions
- Takes account of the expertise of staff working in the setting, duty to education colleagues
- May be pre-referral involvement or post-discharge involvement/consultation
- No AHP open duty of care. If consent has not been obtained from the parent by education to seek general advice then no identifying information should be shared. If AHP requires further more detailed information about an identified child then referral should be made to AHP service
- A child receiving specialist input may also receive support typical of the targeted role where support is also provided for those working and spending time with the child
Specialist Role - AHP has open duty of care for a child who has been formally referred
- Unique contribution by predicting change of a timed episode of care for child
- Work could be with an individual child or as part of a group or both
- Aims to develop the expertise of others in managing an identified need e.g. giving advice to others about a named child
- Collaborates with professionals and parents to assess the risk and need of individual children
- Support will involve agreed desired outcomes, agreed strategies, joint goal setting and planning how identified goals can be integrated into the child's daily life at home and school
- An AHP programme may be appropriate with specific tasks carried out by an AHP assistant/pupil support worker or others within the child's environment
- A child receiving specialist input may also receive support typical of the targeted role where support is also provided for those working and spending time with the child.
- Some direct AHP intervention may be appropriate, in or out of school to be supported by the school and family
- Effectiveness of AHP input must be evidenced and jointly reviewed leading to either further input or the child and family prepared for discharge