Scope of practice for support workers

Defining healthcare support workers

May work with a range of nursing and/or allied health professions (AHPs) to provide care to patients in distinct clinical settings and/or care pathways. Their work is always delegated and supervised by a registered healthcare professional who retains responsibility for patient care.

The activities delivered by the support worker may encompass a range of basic clinical or care skills required to support patients (such as washing and dressing or basic baseline observations relating to temperature and blood pressure), activities that are part of package of physiotherapeutic care and activities that are part of wider rehabilitation of patients.

Defining physiotherapy support workers

This refers to support workers whose work is to partly or wholly provide interventions in pursuit of physiotherapy within a physiotherapy, therapy or rehabilitation service, regardless of sector or setting.

They provide interventions to support physiotherapy programmes and are an integral part of a physiotherapy or multidisciplinary  team. They may undertake any activity that is in pursuit of physiotherapy goals  provided that the activity is delegated to them by a registered Healthcare Professional with appropriate supervision in place and where necessary or indicated access to support and advice from a registered physiotherapist .

Also to be taken into account is their individual and current competence, as established and maintained through their education, training and continuing professional development.

Defining AHP/therapies support workers

This refers to a blended therapeutic support worker role that provides interventions spanning a number of different AHPs. For example, an AHP support worker may provide interventions to support a combination of physiotherapy, occupational therapy and speech and language therapy services. They may undertake any activity in pursuit of rehabilitation goals as defined by any of the 14 AHPs, the combinations of which will vary depending on setting, sector and speciality.

These activities must be delegated by a registered healthcare professional with appropriate supervision in place provided by the relevant AHPs. In this case, supervision may involve a number of different AHPs depending on the professions being supported in this role. 

The individual competencies for an AHP/ therapies support worker should span all of the professions required in this blended role and may need to be broader than a single profession support worker. 

Scope of practice for an individual support worker

The scope of practice of an individual support worker is defined and limited by:

• The individual contract of employment/contract for services that defines the role the support worker is to perform
• The terms of the job-description linked to the role the support worker is to perform
• The extent of any employer policies and/or formal pathways of care that detail the aspects of the care pathway that the support worker is expected to deliver
• The extent of the activities delegated to the support worker by the registered physiotherapist/healthcare professional
• The extent to which the support worker is educated, trained and competent in the tasks that they are expected to perform
• Appropriate supervision must be in place

The registered healthcare professional is accountable for ensuring that tasks which are delegated are within the education, training, competence and job description of the support worker to whom the tasks are delegated.  The support worker is accountable for accepting the delegated task as well as being responsible for his/her actions carrying it out.

However the following tasks cannot be delegated as the law requires these tasks to be performed by a registered professional:

• Supply and administration of medicines using a Patient Group Direction
• The prescribing of medicines and the directions that others should administer the medicines
• The requesting of diagnostic imaging modalities subject to IRMER regulations

The employer is responsible for ensuring the support worker:

• Has a contract of employment outlining the terms and conditions of the post
• Has an accurate and up to date job description
• Understands the limits to their scope of practice
• Is not put in a position where they are expected to take on duties that only a registered practitioner can undertake
• Understands ethical, professional and employer standards that apply to the support worker
• Understands issues of cultural safety and the principles of cultural competence
• Is clearly identifiable as a support worker by clients, their family and other health professionals
• Has the opportunity to access the necessary training to perform the tasks described in the employment contract and job description
• Understands who their supervising healthcare professional is at commencement in the position and subsequently any changes to this

Liability and insurance relevant to support workers

For detailed information about vicarious/professional liability insurance, please refer to  our insurance pages.