The barriers and enablers for allied health professionals working in aged care and adult disability: A scoping review

Background and Aims
Allied health professionals are essential for supporting the health and wellbeing of those accessing aged care and adult disability services, as allied health’s role in both sectors is focused on improving or maintaining independence and reducing functional decline. Significant shortages of allied health professionals in both aged care and disability in Australia result in poorer health outcomes,
particularly in rural areas. This scoping review aimed to identify and understand the enablers and barriers influencing allied health professionals working in the aged care and adult disability sectors in Australia.

Methods
The review used the Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for Scoping Reviews (PRISMAScR). Six databases and grey literature were searched and the papers found screened in COVIDENCE. The data were categorised using content analysis, followed by thematic analysis to investigate patterns of meaning in the data.

Results
Fifteen articles met the inclusion criteria, incorporating a range of ethodological approaches. A total of 25 barriers and 12 enablers were identified across the papers and related to four areas of consideration for this workforce: (a) supporting clinicians to work in diverse and complex environments, (b) developing the pipeline to build workforce capacity, (c) navigating system-wide challenges, and (d) appreciating the added complexity of rural practice.

Challenges
Due to the limited studies identified, we may there may be enablers and barriers unique to specific allied health groups not uncovered.

Implications/Conclusions
The review offers insights into the factors that enable and inhibit the recruitment, engagement, and retention of allied health professionals in the aged care and adult disability sectors. Allied health professionals expressed the need for better preparation to work in these sectors, as graduates. The absence of this preparation led to the need for additional support in postgraduates which was difficult to provide given the staff shortages and funding structures that are often aligned to direct billable hours. Inadequate funding models limited opportunities to engage with teams which led to professional isolation and burn-out. In contrast, ongoing professional development and mentorship was important for job satisfaction and retention. Overall, factors that facilitated or impeded allied health professionals working in the aged care and adult disability sectors tended to be multifaceted, malleable, dynamic, and interlinked, depending on the complexity of the working conditions, rurality, and organisational setting. This review provides the first step to understanding and managing the factors influencing the retention of existing allied health professionals.