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Disability and Allied Health

The disability and allied health sectors deliver a range of care and health services to Australians with a broad range of health conditions. Allied health services refer to health professionals who are not doctors or nurses. Allied health professionals represent almost a third of the health workforce and deliver an estimated 200 million health services across the country every year. They often provide services as part of a multidisciplinary health team to maximize patient outcomes. Patients can access Allied health services by paying privately or via national and state-based funding schemes and programs that meet some or all of the costs of these services. The National Disability Insurance Scheme (NDIS) is one of these programs.

The NDIS was created by the NDIS Act 2013 to support people with permanent and significant disabilities under 65, their families, and carers. The Scheme was fully rolled out in 2020. It had more than 450,000 participants in 2021 and is expected to increase to 530,000 by 2025. Consequently, funding for the NDIS is expected to increase by $13.2 billion to keep up with the demand.

The increase in funding and participants means that the number of workers and providers will need to grow proportionally to sustain the sector. Additionally, continued efforts to deliver services across all states and territories, particularly regional and remote Australia and socio-economic disadvantaged areas, will need to be sustained.

Australia's capacity to provide a quality workforce to meet the increasing demands is one of the significant challenges faced since the inception of the Scheme. The NDIS National Workforce Plan (2021-2025) indicates a growing difficulty in filling vacancies across all states and territories and elaborates on the urgency of growing the workforce. The plan states that around 3,750 vacancies were unfilled in 2021 and forecasts an additional 83,000 workers will be required by 2024.

These challenges are compounded by high workforce mobility, an aging Australian population, remote residents' declining health, and insufficient disability services in remote regions. In the face of these pressures, understanding workforce needs and the capacity to meet demand are important to ensure a sustained provision of quality services into the future. Strategic workforce planning is not only critical for addressing current and foreseeable workforce needs but to realise the social and economic independence and participation of people with disabilities.

SERVICES FUNDED UNDER THE NDIS

Source: National Disability Insurance Authority, 2021

ALLIED HEALTH KEY AREAS OF PRACTICE

Source: National Disability Insurance Authority, 2021

There is a shortage of disability and allied health workers providing services to the NDIS clients, particularly in regional and remote parts of Australia.

NDIS Chief Executive, 2020

Sub-Sectors of the Disability and Allied Health Sector

For the purpose of this research, the Australian disability and allied health sector is categorised into the following:

Disability sub-sector: This sub-sector includes but is not limited to providers delivering services to participants with intellectual, physical, vision impairment, neurological, mental/psychiatric, autism spectrum disorder, acquired brain injury, hearing and speech disabilities.

Allied health sub-sector: The sub-sector encompasses providers that offer essential care (diagnosis, treatment, and rehabilitation services) for people of all ages. It includes service providers in the following disciplines: audiology, occupational therapy, nutrition and dietetics, oral health and dental therapy, orthoptist, pharmacy, chiropractic and osteopathy, physiotherapy, podiatry, psychology, social work, and speech pathology.

Disability and Allied Health Sector in the Northern Territory

In the Northern Territory and elsewhere in the country, the objective of disability providers is to provide client-driven and flexible services to build the capacity and independence of people with disabilities. It adopted an innovative and cost-effective model of care to promote the health and well-being of participants accessing services. The characteristics of the Territory add challenges to providing services to the levels the NDIS and other schemes are aiming for.

For Territorians with health issues that are ineligible to the NDIS, the Territory provides support through the Northern Territory Primary Health Network, the Office of Disability (Territory Families), Disability Advocacy Services, the NT Department of Health, Darwin Community Legal Services, and others.

The sector in the Northern Territory is summarised as follows:

Providers: Most services are concentrated in urban Darwin and its surroundings, leaving people with disabilities in remote regions with limited access to services and choices. In Katherine, Barkly and East Arnhem, providers are usually smaller in size, making it difficult to provide services for all participants within catchment areas.

A third (35%) of providers in the Northern Territory have less than five employees and half (52%) have less than 10 years of experience. Although NDIS service providers seem well distributed across the Territory, their capacity and capabilities limit their ability to cater to all the needs in the regions they operate in, particularly in remote areas.

Estimates from the NDIS indicate that 18% of all registered disability and allied health providers in the NT are currently active, which indicates that some providers are not finding clients or participants. Services are generally provided by government or not-for-profit providers through rural outreach programs or mobile and occasional services. Otherwise, participants travel to regional hubs to access services.

NDIS FUND UTILISATION BY JURISDICTION

Source: NDIS Quarterly Report, June 2021

NDIS FUND UTILISATION IN THE NORTHERN TERRITORY

Source: National Institute of Economic and Industry Research (NIEIR), 2019

NDIS FUND UTILISATION IN THE NORTHERN TERRITORY

Source: Department of Health, 2020 and ABS, 2020

Participant Characteristics: According to the 2020 State of Disability Sector Report, 49.3% of the NDIS participants in the Northern Territory are Aboriginal and Torres Strait Islanders, while 26% are from Culturally and Linguistically Diverse (CALD) backgrounds. Most of these participants are located remotely with access to fewer services. Therefore, linguistic and cultural barriers are additional challenges that providers in remote areas must be prepared for.

Workforce: The sector is one of the fastest-growing sub-industries in the NT in terms of job vacancies. However, it is characterised by an uneven distribution of the workforce, workforce shortages, recruitment, and retention difficulties. As a result, families, friends, and the community fill the void by providing informal care for people with disabilities. It is estimated that 1 in 4 (and in remote areas, 1 in 3) Aboriginal and Torres Strait Islander peoples over the age of 14 provide care for a person with a disability, long-term health conditions, or old age. The lack of services and ongoing workforce challenges, together with other factors, explain the underspending of the NDIS funds in the Northern Territory. Although the NT has a good allied health professional-population ratio, available data in 2019 shows that certain local government areas such as Roper Gulf, Victoria Daly, MacDonnell, Barkly and West Arnhem had no occupational therapist and physiotherapist.

SIZE OF PROVIDERS BY WORKFORCE NUMBERS

Source: ISACNT Field Study, 2021

PROVIDERS LENGTH OF OPERATION

Source: ISACNT Field Study, 2021

Source: ISACNT Field Study, 2021

The Northern Territory’s disability and allied health market is thinner compared to other jurisdictions, often leading to reductions in individual participants NDIS funding and under-utilisation of the Territory’s committed annual funds.

NDIS Chief Executive, 2020

Industry Intelligence

The disability and allied health sector is expected to undergo significant workforce and training requirement changes. Preliminary findings from the Disability Royal Commission have demonstrated the urgency to increase workforce numbers and improve existing training delivery to reflect the growing demands of NDIS services. Several reports, including the Disability National Workforce Plan, have also indicated an increase in workforce shortages, recruitment and retention difficulties across many jurisdictions, particularly regional, remote, and very remote areas. Due to the Federal and state government’s decision to increase NDIS funding from 1.3% to 1.7% of Australia’s Gross Domestic Product by 2030, one out of every five new jobs in Australia is expected to come from the sector. Sustaining the sector requires workforce planning that considers contemporary data and contextual issues to forecast the future. Unfortunately, in the Northern Territory, research that investigates the demographic characteristics, training, and skill gaps of the disability and allied health sector together is limited.

Preliminary findings from the Industry Skills Advisory Council Northern Territory’s (ISACNT) year-round data collection activities show that ongoing training and workforce challenges need further exploration. As a result, ISACNT undertook in-depth research to provide a snapshot of the workforce profile and challenges of the disability and allied health sector in the Territory. The study notably covered skills and occupations in demand, and training and skill gaps. 75 disability and allied health providers across all the regions of the NT participated in the study. The sample for this research took into consideration service providers available in the NT across multiple geographical locations, size of providers, service types and service status (active/inactive). The study achieved a response rate of 36%.

In addition, the research team engaged with 10 industry associations or government agencies within the disability and allied health sector to further explore critical workforce and training issues.

Regional response rates

Darwin Region: 27%
East Arnhem Region: 33%
Katherine Region: 43%
Barkly Region: 67%
Alice Springs Region: 58%

Socio-Demographic Characteristics of the Workforce

The demand-driven market model of service delivery under the NDIS means the participant can influence the types of disability services available, the delivery options, and the individuals providing their services. As a result, the sector must have a diversified workforce to enable the provision of culturally appropriate services and ensure the needs of all participants are met.

The Northern Territory's disability and allied health workforce have similar characteristics to that of the national. The sector is female-dominated in all states and territories, however, the NT's workforce is more equally gender distributed. Additionally, many NT service providers expressed having difficulties attracting males into employment.

A notable difference between the NT and the national workforce includes a better representation of Indigenous workers and visa workers. As a result, the sector more accurately reflects the demographics of NDIS clients in the NT, of whom half are Aboriginal and Torres Strait Islanders and a quarter are from CALD backgrounds. Nevertheless, demographic levels are far from representative and require continued efforts to deliver culturally appropriate and comprehensive services.

The 2020 interim report of the Royal Commission into Disability states “organisational and community capacity and capability need to be built in urban, regional and remote communities so that First Nations people can access culturally appropriate services that meet individual and community needs. Some organisations feel that local knowledge and capability should be developed and used to further support and encourage access. They said the lack of these services can result in First Nations people declining services. In the absence of other suitable informal supports, this can lead to neglect”.

To achieve this, in addition to recruiting a local workforce with the relevant background, many stakeholders recommended that cultural awareness and safety should be made mandatory as part of the current nationally accredited qualifications.

GENDER DISTRIBUTION

Source: ISACNT Field Study, 2021 and NDS Workforce Survey, 2020

INDIGENOUS STATUS

Source: ISACNT Field Study, 2021 and Cortis and van Toorn, 2020

TEMPORARY RESIDENCY STATUS

Source: ISACNT Field Study, 2021 and Cortis and van Toorn, 2020

The diversity of the disability and allied health workforce in terms of age, training, qualification, and experience is used for the benefit of the sector. Some stakeholders indicated that having a mixed-age workforce enhances reverse mentoring and mutual support for both younger and older generational workers. The NT workforce is particularly young. On the one hand, this youth has a strong grasp of technology and often supports the older generation of workers in navigating through technological difficulties or adapting to technological changes. For example, care workers are sometimes required to use customised modern technologies such as electronic lifting hoists, robotic limbs, and communication software that rely on digital interfaces. On the other hand, the reduced older workforce in the NT increases the need for adaptation skills among younger workers. This makes gaining workplace interpersonal skills and experience more challenging for new entrants and increases the need for training.

Results from ISACNT’s engagement with stakeholders showed a trend of casualisation across most disability service providers, whereas the allied health sub-sector was mostly employed on a full-time basis. In addition, providers delivering both disability and allied health services had more than two-fifths of their workers as casual. Findings demonstrated a high staff turnover in the sector, however, employing more casual workers helped service providers to fill shifts without significant impact on service provision. Most service providers also acknowledged casualisation as a tool to achieve work-life balance and provide attractive wages.

AGE OF THE WORKFORCE

Source: ISACNT Field Study, 2021 and Cortis and van Toorn, 2020

BASIS OF EMPLOYMENT

Source: ISACNT Field Study, 2021

EXPERIENCE OF THE WORKFORCE

Source: ISACNT Field Study, 2021

QUALIFICATION OF THE WORKFORCE

Source: ISACNT Field Study, 2021

Disability and Allied Health Workforce Challenges

The workforce challenges faced by the disability and allied health sector have been, and continue to be, a subject of discussion among governments, practitioners, and the general public. Notably, workforce challenges have been exacerbated by the NT’s ageing population, increased demand for NDIS services and limited supply of services in remote and very remote areas. ISACNT’s engagement with service providers and industry associations summarises the sector’s workforce challenges as:

Shortages of workers: Generally, mental health issues and chronic diseases are higher in regional areas and the Northern Territory is no exception to this. Despite a growing demand for services, there is an undersupply of workers, including experienced workers to fill management and supervision roles in some parts of the NT.

Between 2018-2020, shortages of workers (undersupply) among providers have worsened year after year. While workforce shortages affect participants’ accessibility to services and inhibit the sector’s ability to meet the rising demand for disability and allied health services, undersupply of experienced workers to fill management/supervision roles impede the quality of student placements. General shortages of workers also impact the participants’ quality of services received, sometimes forcing families and friends to provide informal care and treatment.

Uneven distribution of the workforce: Disability and allied health workers are mostly concentrated in the Darwin and Alice Springs regions with limited numbers in other regions such as Katherine, Barkly, and East Arnhem. Many service providers, through the ISACNT’s engagement, stated that increasing the size of the disability and allied health workforce is necessary; however, consideration should be given to the equitable distribution of the workforce across the NT. To some remote stakeholders, providing better infrastructure options, like housing, would improve the providers' ability to attract and retain the workforce needed.

WORKFORCE SUPPLY TRENDS

Source: ISACNT Field Study, 2021

AVERAGE MONTHS TO FILL VACANCIES

Source: ISACNT Field Study, 2021

High workforce turnover: ISACNT’s consultation with service providers and industry associations revealed that staff turnover rates are higher for casual workers compared to permanent workers. Similarly, staff turnover was found to be higher in remote and very remote areas compared to urban Darwin. Competition between private and public providers is another contributor to staff turnover. For example, some stakeholders indicated the opening of the Howard Springs Quarantine Facility resulted in intense competition for disability workers between private providers and the government. Others also indicated the government’s ability to provide better conditions of services contributed to the loss of workers from the private to the public sector.

Recruitment and retention difficulties: Recruitment and retention of workers are becoming increasingly difficult in both the disability and allied health sub-sectors and across all regions of the NT. The recruitment and retention difficulties cut across all professions of allied health, often resulting in longer waiting times for participants as service demand exceeds the existing workforce and service supply. In the disability sub-sector, several providers stated that it was difficult to fill management roles, such as team leaders and support coordinators. This research also found that providers who are smaller in size found it more difficult to recruit suitable workers and retain them compared to larger ones. Many remote providers also expressed challenges retaining their workforce during the border closure as a result of the COVID-19 pandemic.

Rising workforce casualisation: The nature of the NDIS model of service delivery has led service providers to employ more casual workers. Casualisation of the workforce is more pronounced in the disability sub-sector compared to allied health. The rising casualisation of the disability sub-sector’s workforce often leads to many staff working less than full-time hours across multiple jobs while dealing with unstable rostering arrangements and constant shift changes. Such situations increase the risk of burnout, impacting workers themselves but also the patients.

The current market-based model for disability service delivery intensifies workforce challenges in a jurisdiction with (i) a low population base, (ii) participants spread sparsely across remote areas, and (iii) clients with high levels of disadvantage.

Darwin Community Legal Services, 2019

Industry initiatives

To address the ongoing workforce challenges, many service providers adopted multiple recruitment methods (combination of online advertisement and word of mouth) to fill vacancies. Strategies utilised by providers include employing more casual workers, upskilling and re-skilling existing staff and engaging interstate/intrastate workers (e.g., locum and fly-in fly-out/FIFO). Other providers also used skilled migration initiatives, Indigenous employment programs and disability employment initiatives. In remote and very remote areas, many providers in the disability sub-sector partnered with the Community Development Program (CDP) to access support workers to fill vacancies. Some providers also expressed positive experiences utilising existing workforce initiatives, while others had concerns about the bureaucratic nature of skilled migration programs including the high cost of the overall process.

WORKFORCE INITIATIVES

Source: ISACNT Field Study, 2021

STRATEGIES TO ADDRESS WORKFORCE SHORTAGES

Source: ISACNT Field Study, 2021

Note: Other include being respectful of culture, good appreciation for workers, mentoring and treating workforce like family.

RECRUITMENT METHODS

Source: ISACNT Field Study, 2021

Workforce challenges in the disability and allied health sector across regional and remote areas of Australia is rising, while demand for services is expected to grow. As a result, it is necessary to expand the service provision and grow a capable and responsive workforce to meet both the current and future needs of the sector.

The Growing the NDIS Market and Workforce Strategy, 2019

Successful Indigenous Workforce Strategies

ISACNT uncovered stakeholders in the NT who successfully navigated remote workforce challenges. The key to success for these providers had been firm Indigenous employment policies, which utilised and upskilled the local Indigenous workforce, cultural understanding, and building strong community relations. According to some stakeholders, engaging the Indigenous workforce significantly reduced cultural and language barriers during service delivery, leading to a better quality of services for the participants.

Providers expressed that the key to a high Indigenous workforce inclusion was having a comprehensive cultural understanding and excellent community relations. Having a good insight into cultural challenges, such as “poison cousin relationships”, was also essential to know when to separate certain staff members. Furthermore, training, and mentoring staff to understand and make use of the organisation's human resources (HR) system for their advantage resulted in more staff showing up for work regularly. This helped workers to understand that leave could be taken for cultural reasons. The hiring of Indigenous team leaders was noted to have positive effects on the remaining workforce and contributed to long-term Indigenous workforce participation. In many organisations Indigenous workers have been trained internally and upskilled to take on a team leader position, creating incentives for other staff to aspire to rise within the ranks into management roles. Many stakeholders also stated that to ensure sustainable local workforce development, it was essential to invest in training and utilisation of local people as they are willing to live long-term in these remote areas.

Occupations in Demand

It is essential for the disability and allied health sector to have an adequate and capable workforce to deliver services that meet the needs of the participants. The ISACNT’s study demonstrated imbalances in the disability and allied health workforce as a major challenge in the NT. The labour market supply of most occupations in the NT was found to be lower than the demand for services, which leads to longer waiting times and underspending of NDIS funds. Service providers who participated in the study indicated the following occupations to be in high demand:

Aboriginal health worker
Allied health assistant
Audiologist
Chiropractic assistant
Dental hygienist/assistant
Dentist
Disability support worker
Exercise physiologist
Massage therapist
Nutrition dietician
Occupational therapist

Optical dispenser
Optometrist
Osteopath
Pharmacist
Pharmacy technician
Physiotherapist
Podiatrist
Psychologist
Registered nurse
Social worker
Speech therapist/pathologist

Current State

Strenghts

SOCIO-ECONOMIC

Presence of experienced and well-established service providers delivering high-quality services increase the public’s trust in the sector
Ongoing implementation of new processes and procedures under the NDIS may drive efficiency improvements in the sector
Providing people with disabilities with greater autonomy and decision-making power creates competitive markets, leading to quality support
Existence of advocacy support services for people with disabilities streamlines and enhances the provision of quality services
Collaboration between government and private service providers to construct disability, fit-for-purpose, accessible housing enhances the quality of service delivery
Implementation of the NDIS quality and safeguarding frameworks guide service providers and workers to deliver high-quality support

WORKFORCE AND OCCUPATION

Remote allied health outreach services delivered through the Department of Health and NT PHN provide services to disabled people who do not meet the NDIS access request
Availability of the NDIS workforce plan 2021-2025 provides a blueprint to build a responsive and capable workforce for the sector
Roll out of the NDIS Worker Screening Check reduces the risk workers pose to people with disabilities
Service providers willingness to diversify their workforce enhances the provision of culturally appropriate high-quality services
Implementation of the CDP in the NT reduces the disability sub-sector’s recruitment challenges
Similarities between disability workforce requirements and others (e.g. aged care) ease workers’ mobility from related sectors
Implementation of the Boosting the Local Care Workforce Program builds the capacity of service providers to operate effectively and expand their workforce

TRAINING AND SKILLS

Access to non-accredited training educate providers and workers on the standards and expectations in providing high-quality services
Willingness of many service providers to support student placement programs help to build the skills of early career entrants in a realistic work environment
Existing Community Services Training Package facilitates students’ transition into a real work environment
An updated review of current Community Services and allied health training packages may improve the quality of the training delivery
Strong collaboration between some service providers and registered training organisations (RTO) facilitates student placements/internships and skill acquisition

Challenges

SOCIO-ECONOMIC

Absence of service provision in some areas of the NT limits control and the right of choice of people with disabilities
Substitution of face-to-face service delivery with telepractice models sometimes affects the quality of services provided
Complexity of the NDIS and its bureaucratic processes delay the prompt response needed for participants
Insufficient consideration of travel time and expenses associated with remote services impact service delivery consistency
Limited or unreliable internet access affects the provision of certain services and Local Area Coordinators' (LAC) access to the NDIS’ planning programs
Lack of, or substandard infrastructure (e.g. housing) affect service delivery in remote regions
Delays in NDIS request claims results in significant cash flow difficulties, which impact service provision and sometimes lead to the closure of services

WORKFORCE AND OCCUPATION

Scarcity of experienced and skilled workers in many remote parts of the NT leads to underspending of participants’ NDIS funding
Maldistribution of disability and allied health workforce in the NT results in poorer health outcomes of participants in rural areas
Limited career progression in the disability and allied health sector impedes the desire of people to pursue a career
Difficulty in attracting and retaining CALD and Aboriginal and Torres Strait Islander workers sometimes affect the provision of culturally appropriate services
A lack of professional networks among NDIS workers discourages a culture of peer learning, mentoring and continuing professional development.
Delegation of tasks to allied health assistants without maximum supervision especially in remote areas affect the quality of services participants receive
Geographic isolation of the NT makes it exceedingly difficult to attract and retain suitable staff in the long-term

TRAINING AND SKILLS

Limited allied health training delivery programs in the NT significantly impacts the workforce's size, however training is available in other states
Training of the sector’s workforce pays little attention to preparing students for remote practice, making workers unprepared and hesitant to work in remote areas
No entry requirements for most of the Community Services Training Package courses make it difficult for some students without relevant experience to complete the program
Limited support and supervision from some RTOs during students’ placement/internships affect the quality of the workforce development
Low literacy of some students enrolled in disability and allied health courses affect students’ completion rates
Shortage of experienced disability and allied health workers affect the quality of student placements, supervision, and the service provision
Supervision of students during placement by team leaders/coordinators affect service delivery and productivity

Future State

Opportunities

SOCIO-ECONOMIC

Increasing communities' understanding of the broader disability sector may eliminate some of the cultural barriers to quality service provision
Review of NDIS pricing to reflect the actual cost of delivering services in remote areas will increase participants’ access to services and participants’ wellbeing
Providing access to market demand information on disability services will help providers to identify thin market opportunities and expand services
Extending the provision of the NDIS services to include Aboriginal Community Controlled Health Organisations will increase accessibility to culturally safe services
Incorporation of place-based contextual factors into the NDIS’ current model may increase acceptance and support for the scheme
Aligning the NDIS registration requirements across the human services sector may eliminate registration barriers and expand service provision to remote NT

WORKFORCE AND OCCUPATION

Improved effectiveness of job boards to match job seekers to vacancies in the sector may reduce recruitment difficulties
Introduction of the skills passport initiative in the NT will improve the labour market and occupational mobility of employees as it will recognise non-accredited training
Stronger collaboration between education institutions and professional bodies to increase traineeships and student placements may address existing workforce challenges
Increasing public awareness on career prospects in the sector may serve as an opportunity to attract more people to consider career in the sector
Increasing time and resources to train and supervise workers and students will improve the skills and capability of the existing workforce
Increased funding for the Allied Health Rural Generalist program may improve access to a highly-skilled allied health workforce

Threats

SOCIO-ECONOMIC

Increasing market competition may affect collaboration and information sharing, limiting remote service delivery options
Uncertainty about the NDIS’ pricing policies may result in the closure of service provision in many remote areas
Lack of coordination among LAC in remote locations reduces the visibility of available services to participants
Inadequate support for small and medium-sized allied health service providers to expand services to remote areas exacerbate existing demand challenges
Increased demand for disability and allied health services may put pressure on existing providers and facilities, impacting the quality of services
Reductions in funding within the NDIS participants’ plans may affect the quality of support and care provided to participant

WORKFORCE AND OCCUPATION

Sustained demand for disability and allied health services will exacerbate existing workforce challenges
Introduction of a minimum mandatory qualification requirement to work in the disability sector will also exacerbate the existing workforce challenges across the NT
Increased shortage of an experienced workforce to take up supervision and management roles will impede the quality of service delivery
High staff turnover in the sector will affect the continuity of service provision and further increase providers’ operational cost
Lack of initiatives to increase placements/internships for students in remote areas will exacerbate recruitment difficulties
Reliance on fly-in fly-out (FIFO) and Locums workers to address workforce challenges may impede the development of the local workforce
Building capacity of families, friends and communities providing informal care may allow them to move into paid employment and increase the NT’s NDIS utilisation rates

Skills in Demand

Skills are an important aspect of professional life because they improve career prospects and increase productivity. Working in the disability and allied health sector requires a workforce that is not only equipped with theoretical and practical skills (hard skills) but also personal attributes (soft skills) to provide person-centred care. Providers of disability and allied health services in the NT face considerable difficulty in filling certain critical skills. Findings based on ISACNT’s engagement with service providers revealed the following skills as critical to work in the sector and those skills lacking in the current workforce.

Pathways

Optometrist

Optometrist (ANZSCO # 251411) performs eye examinations and vision tests to determine the presence of visual, ocular, and other abnormalities, ocular diseases, and systemic diseases with ocular manifestations, and prescribes lenses, other optical aids, therapy, and medication to correct and manage vision problems and eye diseases. Registration or licensing is required.

Skill Level: 1

Bachelor of Medical Science
(Vision Science)

Master of Optometry

Doctor of Optometry

OPTICAL DISPENSER

Optical Dispenser (ANZSCO # 399913) interprets optical prescriptions and fits and services optical appliances such as spectacle frames and lenses. Registration or licensing may be required.

Skill Level: 3

Certificate IV in Optical Dispensing

REGISTERED NURSE

ALTERNATIVE TITLES: MENTAL RETARDATION NURSE, PSYCHIATRIC NURSE

Registered Nurse (Community Health) (ANZSCO # 254414) provides nursing care, health counselling, screening and education to individuals, families, and groups in the wider community with a focus on patient independence and health promotion. Registration or licensing is required.

Skill Level: 1

Registered Nurse (Developmental Disability) (ANZSCO # 254416) provides nursing care to people with intellectual and development disabilities in a range of health, welfare, and community settings. Registration or licensing is required.

Skill Level: 1

Registered Nurse (Disability and Rehabilitation) (ANZSCO # 254417) provides nursing care to patients recovering from injury and illness and assists and facilitates patients with disabilities to live more independently. Registration or licensing is required.

Skill Level: 1

Registered Nurse (Mental Health) (ANZSCO # 254422) provides nursing care to patients with mental health illness, disorder, and dysfunction, and those experiencing emotional difficulties, distress and crisis in health, welfare and aged care facilities, correctional services, and the community. Registration or licensing is required.

Skill Level: 1

Certificate III in Health Service Assistance

Certificate III in Individual Support

Certificate IV in mental health

Diploma of Nursing

Bachelor of Nursing

Graduate Diploma of Nursing

Graduate Diploma of Clinical Nursing

Master of Nursing (Nurse Practitioner)

OCCUPATIONAL THERAPIST

Occupational Therapist (ANZSCO # 252411) assesses functional limitations of people resulting from illnesses and disabilities and provides therapy to enable people to perform their daily activities and occupations. Registration or licensing may be required.

Skill Level: 1

Certificate IV of Allied Health Assistance

Diploma in Health Science

Bachelor of Occupational Therapy

Bachelor of Health Science/ Master of Occupational Therapy

Master of Occupational Therapy

Master of Occupational studies

PHYSIOTHERAPIST

ALTERNATIVE TITLES: PHYSICAL THERAPIST

Physiotherapist (ANZSCO # 252511) assesses, treats, and prevents disorders in human movement caused by injury or disease. Registration or licensing is required.

Skill Level: 1

Certificate III in Allied Health Assistance

Certificate IV in Allied Health Assistance

Diploma of Health Science

Bachelor of Physiotherapy

Bachelor of Applied Science (Physiotherapy)

Master of Physiotherapy

EXERCISE PHYSIOLOGIST

Exercise Physiologist (ANZSCO # 234915) assesses, plans, and implements exercise programs for preventing and managing chronic diseases and injuries, such as cardiovascular disease, diabetes, osteoporosis, depression, cancer, and arthritis, and assists in restoring optimal physical function, health, and wellness.

Skill Level: 1

Diploma of Exercise and Sport Science

Associate Degree of Exercise and Sport Science

Bachelor of Exercise and Sport Science

Bachelor of Clinical Exercise Physiology

Master of Exercise Physiology

AUDIOLOGIST

Audiologist (ANZSCO # 252711) provides diagnostic assessment and rehabilitative services related to human hearing defects. Registration or licensing is required.

Skill Level: 1

Bachelor of Psychological Science

Bachelor of Science

Bachelor of Biological Science

Bachelor of Biomedical Science

Bachelor of Physiotherapy

Bachelor of Applied Science (Physiotherapy)

SPEECH PATHOLOGIST

ALTERNATIVE TITLES: SPEECH THERAPIST

Speech Pathologist (ANZSCO # 252712) assesses and treats people with communication disorders, such as speech, language, voice, fluency and literacy difficulties, and people who have physical problems with eating or swallowing. Registration or licensing is required.

Skill Level: 1

Bachelor of Speech Pathology

Bachelor of Health Science/ Master of Speech and Language Therapy

Master of Speech Pathology

DIETITIAN / NUTRITIONIST

Dietitian (ANZSCO # 251111) applies the science of human nutrition to help people understand the relationship between food and health and make appropriate dietary choices to attain and maintain health, and to prevent and treat illness and disease.

Skill Level: 1

Nutritionist (ANZSCO # 251112) integrates, disseminates, and applies knowledge drawn from the relevant sciences to enhance positive effects of food on the health and well-being of human populations.

Skill Level: 1

Certificate IV in Allied Health Assistance

Bachelor of Nutrition and Dietetics

Bachelor of Nutrition Science

Bachelor of Health Science/ Master of Nutrition

Master of Nutrition and Dietetics

Master of Nutrition and Dietetic Practice

THERAPY AIDE

ALTERNATIVE TITLES: THERAPIST'S ASSISTANT

Therapy Aide (ANZSCO # 423314) assists therapists in providing therapy programs and in the direct care of their patients in a variety of health, welfare, and community settings. Registration or licensing may be required.

Specialisations: Diversional Therapist's Assistant, Occupational Therapist's Assistant, Physiotherapist's Assistant.

Note: Therapy aids can also work as a Speech Pathology Assistants and Nutrition Assistants,

Skill Level: 4

Certificate II in Health Support Services

Certificate III in Allied Health Assistance

Certificate III in Health Services Assistance

Certificate IV in Allied Health Assistance

PERSONAL CARE ASSISTANT

ALTERNATIVE TITLES: AGED OR DISABLED CARE WORKER, PERSONAL CARER, PERSONAL CARE WORKER

Personal Care Assistant (ANZSCO # 423313) provides routine personal care services to people in a range of health care facilities or in a person's home.

Skill Level: 4

Nursing Support Worker (ANZSCO # 423312) provides limited patient care under the direction of nursing staff.

Skill Level: 4

Aged or Disabled Carer (ANZSCO # 423111) provides general household assistance, emotional support, care, and companionship for aged or disabled people in their own homes.

Skill Level: 4

Disabilities service officer (ANZSCO # 411712) works in a range of service units which provide education and community access to people with intellectual, physical, social, and emotional disabilities.

Skill Level: 2

Certificate II in Community Services

Certificate III in Individual Support

Certificate III in Community Services

Certificate IV in Disability

Certificate IV Community Services

Diploma of Community Services

SOCIAL WORKER

Social Worker (ANZSCO # 272511) assesses the social needs of individuals, families, and groups, assists, and empowers people to develop and use the skills and resources needed to resolve social and other problems, and furthers human wellbeing and human rights, social justice, and social development. Registration or licensing may be required.

Skill Level: 1

Bachelor of Social Work

Master of Social Work

COMMUNITY WORKER

Community Worker (ANZSCO # 411711) facilitates community development initiatives and collective solutions within a community to address issues, needs and problems associated with recreational, health, housing, employment, and other welfare matters.

Skill Level: 2

Certificate III in Community Services

Certificate IV in Alcohol and Other Drugs

Certificate IV in Community Services

Certificate IV in Mental Health

Diploma of Alcohol and Other Drugs

Diploma of Community Services

Diploma of Counselling

DENTIST

ALTERNATIVE TITLES: DENTAL PRACTITIONER, AND DENTAL SURGEON

Dentist (ANZSCO # 252312) diagnoses and treats dental disease, injuries, decay and malformations of the teeth, periodontal tissue (gums), hard and soft tissue found on the mouth and other dento-facial structures using surgery and other techniques. Registration or licensing is required.

Skill Level: 1

Dental Hygienist (ANZSCO # 411211) carries out preventative dental procedures under the direction of a Dentist. Registration or licensing is required.

Skill Level: 2

Dental Technician (ANZSCO # 411213) constructs and repairs dentures and other dental appliances. Registration or licensing may be required.

Specialisation: Dental Laboratory Assistant

Skill Level: 2

Certificate III in Dental Laboratory Assisting

Certificate III in Dental Assisting

Certificate IV in Dental Assisting

Certificate IV in Equine Dentistry

Diploma of Dental Technology

Bachelor of Dental Science

Bachelor of Dental Surgery

Master of Dentistry

Doctor of Dental Surgery

Doctor of Clinical Dentistry

HOSPITAL PHARMACIST

ALTERNATIVE TITLES: COMMUNITY PHARMACIST, DISPENSARY TECHNICIAN

Hospital Pharmacist (ANZSCO # 251511) prepares and dispenses pharmaceuticals, drugs, and medicines in a hospital pharmacy. Registration or licensing is required.

Skill Level: 1

Industrial Pharmacist (ANZSCO # 251512) undertakes research, testing and analysis related to the development, production, storage, quality control and distribution of drugs and related supplies. Registration or licensing is required

Skill Level: 1

Retail Pharmacist (ANZSCO # 251513) dispenses prescribed pharmaceuticals to the public, educates customers on health promotion, disease prevention and the proper use of medicines, and sells non-prescription medicines and related goods in a community pharmacy. Registration or licensing is required.

Skill Level: 1

Pharmacy Technician (ANZSCO # 311215) fills and labels patients' prescriptions under the supervision of a pharmacist. May record details of place orders for, take stock of, and store medications and medical supplies and deliver them to patients.

Skill Level: 2

Certificate II in Community Pharmacy

Certificate III in Community Pharmacy

Certificate III in Hospital/Health Services Pharmacy Support

Certificate IV in Community Pharmacy

Certificate IV in Community Pharmacy Dispensary

Certificate IV in Hospital/Health Services Pharmacy Support

Bachelor of Pharmacy

Master of Pharmacy

CLINICAL PSYCHOLOGIST

Clinical Psychologist (ANZSCO # 272311) consults with individuals and groups, assesses psychological disorders, and administers programs of treatment. Registration or licensing is required.

Skill Level: 1

Bachelor of Psychological Science

Bachelor of Psychology

Master of Psychology (Clinical)

Master of Professional Psychology

PODIATRIST

Podiatrist (ANZSCO # 252611) prevents, diagnoses, and treats disorder of the feet. Registration or licensing is required.

Skill Level: 1

Bachelor of Podiatry

Bachelor of Podiatric Medicine

Master of Podiatric Practice

Master of Podiatric Medicine

Doctor of Podiatric Medicine

CHIROPRACTOR

Chiropractor (ANZSCO # 252111) diagnoses and treats physiological and mechanical disorders of the human locomotor system, particularly neuromuscular skeletal disorders, and provides advice on preventing these disorders. Registration or licensing is required.

Skill Level: 1

Bachelor of Chiropractic Science

Bachelor of Health Science/Applied Science (Chiropractic)

Master of Clinical Chiropractic

Master of Chiropractic

ABORIGINAL AND TORRES STRAIT ISLANDER HEALTH WORKER

Aboriginal and Torres Strait Island Health Worker (ANZSCO # 411511) liaises with patients, clients, visitors to hospitals and other medical facilities and staff at health clinics, and works as a team member to arrange, coordinate, and provide health care delivery in Aboriginal and Torres Strait Islander community health clinics. Registration or licensing may be required.

Skill Level: 2

Certificate II in Aboriginal and/or Torres Strait Islander Primary Health Care

Certificate III in Aboriginal and/or Torres Strait Islander Primary Health Care

Certificate IV in Aboriginal and/or Torres Strait Islander Primary Health Care

Certificate IV Aboriginal and/or Torres Strait Islander Primary Health Care Practice

Diploma of Aboriginal and/or Torres Strait Islander Primary Health Care

Diploma of Aboriginal and/or Torres Strait Islander Primary Health Care Practice

OSTEOPATH

Osteopath (ANZSCO # 252112) diagnoses and treats tissue strains, stresses and dysfunctions which impede normal neural, vascular, and biochemical mechanisms, and provides advice on preventing these disorders. Registration or licensing is required.

Skill Level: 1

Bachelor of Health Science/Applied Science (Osteopathy)

Bachelor of Science (Osteopathy)

Master of Osteopathy

Master of Health Science (Osteopathy)

MASSAGE THERAPIST

Massage Therapist (ANZSCO # 411611) performs therapeutic massage and administers body treatments for relaxation, health, fitness, and remedial purposes.

Specialisations: Chinese (Tui-Na) Masseur, Remedial Masseur, Shiatsu Therapist, and Sports Medicine Masseur

Skill Level: 2

Certificate IV in Massage Therapy