Advanced practice (FS-14)

Focused symposium
Sunday 12 May 2019, 13:45-15:15
Room B

Warren J1Diener I2Finucane L3Tawiah A4 
1Physiotherapy Board of New Zealand, Wellington, New Zealand, 2University of Western Cape, Cape Town, South Africa, 3University of Brighton, Brighton, United Kingdom, 4University of Alberta, Edmonton, Canada

Learning objective 1: To familiarise participants with the potential benefits of advanced practice physiotherapy to the public, the health system, healthcare cost and the physiotherapy profession, including the latest research in this area.
Learning objective 2: To share personal local and global perspectives of the challenges, barriers, and triumphs of advanced practice physiotherapy in developed and developing countries.
Learning objective 3: To stimulate participants to engage in the process of progressing the advanced practice physiotherapy concept or ´brand´.
Description: Over the last two decades, 'advanced' roles have developed to meet a specific service need, but the levels of competency and experience vary and are not internationally consistent. The progression of physiotherapists with 'advanced' education, experience and skills has differed globally depending on the jurisdiction, the specialty area and the respective health funding models. 
A number of terms have been used to describe this practitioner, including 'advanced practice physiotherapist', 'advanced practitioner', 'extended and expanded scope', and 'advanced physiotherapist'. This focused symposium will generically use the term Advanced Practice Physiotherapist (APP) to encompass all these titles, as this title is the most commonly used.1-3 
There is evidence that APPs improve access to care through reduced waiting times, more effective and efficient identification of patient needs, and referral to health professionals best placed to meet these needs.4-6 The APP in musculoskeletal triage roles has increased conservative management referrals and reduced surgical referral with better surgical conversion rates for those referred.7,8There are lessons to be learnt from the development and implementation of advanced practice in the global community.
The purpose of this focused symposium is to highlight the issues surrounding advanced practice. It will provide the audience with examples of advanced practice, the challenges and barriers associated with this role in physiotherapy. The APP has demonstrated tremendous benefits to patients with musculoskeletal conditions with improved access to quality healthcare at both the primary care, secondary care and primary-secondary care interface. It has also reduced the cost of healthcare delivery by reducing unnecessary diagnostic imaging and prescription medication.9 Finally, APP roles have resulted in the advancement in professional image and provided an avenue for professional development. 
For the first time, this session will address the development and implementation of the APP role in developing countries and discuss how the APP could help augment the access and improve rural healthcare delivery in developing countries. It is appreciated that different countries will have different drivers in the quest to provide the best cost effective interprofessional healthcare. 
This session will challenge the audience to consider who should benefit from advanced practice and how this can be achieved despite the pitfalls with the different drivers in the different global communities. It draws on the significant and varied experience of the Chair and presenters representing organisations of various sizes and capacity from four regions of the WCPT and their various roles including clinical, academic, and regulation.
Implications / Conclusions: Advanced practice in physiotherapy, as demonstrated by the research, has the ability to provide benefits to the public, the health system and the physiotherapy profession with a reduced cost in healthcare delivery. There are challenges in different jurisdictions to implement this role. A discussion representing different countries´ needs and barriers may facilitate the process. The APP roles could also augment the much-needed improvement in access to healthcare and rural healthcare delivery in developing countries. This symposium will provide an honest discussion among participants and presenters and serve as a platform to advancing the APP roles.
A consistent global approach to the role in terms of the nomenclature, the brand, and a competency framework will enable implementation of the role. It is recognised that the associated academic and experience levels of the APP will differ from one jurisdiction to another though the competencies should be similar. 
Key-words: 1. Advanced practice 2. leadership 3. patient-benefit
Funding acknowledgements: Nil
Relevance to physical therapy globally: The impact of Advanced Practice Physiotherapist roles has led to reduced waiting times, increased effective and efficient identification of patient needs, appropriate referral to conservative or surgical management. Most importantly, advanced roles have provided early access to quality care for patients with musculoskeletal conditions and a reduced cost in healthcare delivery. This symposium will highlight the challenges and barriers to the development and implementation of advanced practice from the perspectives of developed and developing countries.
Target audience: Physiotherapists, particularly: those working on developing advanced roles within their countries; health policy advisors; health system administrators; educationists; organisational managers; and professional organisation leaders.