November 2021

Building The Orthotics and Prosthetics Workforce of Tomorrow

The O&P Global project: research, investigation and consultation. The foundation for an international body to support national-level regulation of orthotist/prosthetists.

By Leigh Clarke, M.PH, B.PO (hons), c-OP AOPA; Emily Ridgewell, PhD, B.PO (hons), c-OP AOPA; Sarah Anderson, PhD, B.PO (hons), c-OP AOPA; and Michael P Dillon, PhD, B.PO (hons), c-OP AOPA

The global demand for orthotic/prosthetic (O&P) services is set to double by 2050.1 Currently, the O&P workforce is too small and underdeveloped to meet the growing demand. Strengthening national-level regulation of the O&P workforce will be essential to support workforce growth and development, and thereby help meet the demand for access to safe and effective O&P care in the years ahead.2

Practitioner regulation supports workforce growth and development by establishing formal recognition of a profession.3 When government agencies and funding bodies understand a profession’s contribution to healthcare, it becomes possible to establish defined roles and career pathways1 that provide greater employment stability, promotion opportunities, and higher salaries.1,4,5 These benefits help to retain experienced practitioners that provide the necessary mentoring and leadership for high-quality service development. Similarly, it is important that experienced practitioners are retained so that new practitioners contribute to workforce growth, not merely serve to replenish a leaking pipeline of experienced practitioners.

While there are many benefits of a well-regulated workforce, there is little-to-no regulation of the O&P profession globally.6 It will be near impossible for national O&P associations in many countries to develop and implement robust practitioner regulation without support, particularly given the resources and expertise required.

If we are to support national O&P associations to develop and implement robust practitioner regulation, it will be necessary to establish an international body for this purpose. This international body would be constituted of national O&P associations – not individual practitioners – and support these member organizations to implement the core regulatory standards such as: minimum training or education, entry-to-practice competency standards, scope of practice, code of conduct, and recency of practice.6 With the support and guidance of an international body, national O&P associations could adapt these core standards for their own context and in doing so, establish a right-touch or setting-specific regulatory approach.

This type of support and guidance is already available to many allied health professions, which can help define the way forward for the O&P profession. For example, World Physiotherapy is an international organization that assists its member organizations (i.e., national associations) to develop and implement core standards where they do not exist, or to review existing regulatory standards to ensure they are fit-for-purpose.

Introducing the O&P Global Project

The O&P Global project will lead the first step toward the development of an international body that can support national O&P associations to establish national-level regulation. O&P Global is committed to ensuring that any future international body has a solid foundation based on sound governance principles, and strong engagement from the O&P community.

To achieve this aim, we have designed a structured two-phase approach that will allow us to: capitalise on the global expertise that currently exists, use this knowledge to design the organisation’s structure, and ensure the organisation meets the needs of existing and emerging national O&P associations, and the global O&P community.

Phase 1: Research and Investigation

This phase will involve detailed research and investigation to inform the development of a proposed organisational structure and includes:

  • A review of gray literature on organizational governance structures,
  • An environmental scan of governance, membership, and income stream structures of existing national and international bodies,
  • Semi-structured interviews with the executives and/or board chairs of international bodies to identify barriers and enablers to success.
  • Phase 1 will conclude with two outputs:
  • A report describing the results of the literature review and interviews,
  • An issues paper highlighting the key learnings and recommendations.

Phase 2: Consultation

This phase will begin with the public release of the Phase 1 report and issues paper. These documents will inform consultation with a variety of stakeholders including:

  • Future member organizations (i.e., national O&P associations and their members)
  • Broader international O&P community groups including: multidisciplinary societies (eg, The International Society for Prosthetics and Orthotics), academic networks (eg, universities), regulators (eg, National Commission on Orthotic and Prosthetic Education) and commercial suppliers,
  • Stakeholders external to the O&P community including international: agencies (eg, WHO Global Cooperative on Assistive Technology), professional bodies (eg, World Physiotherapy), and assistive technology development organizations (eg, ATscale, Global Disability Innovation Hub).

The Phase 2 Consultation will be conducted using multiple mechanisms including: open-surveys, stakeholder interviews, and public webinars. The findings from the Phase 2 Consultation will be synthesised into a report, and used to refine the proposed governance, membership, and income stream structures of the international body.

At the conclusion of both Phase 1 and 2, a final Recommendations Report will be made publicly available. The Recommendations Report will provide the necessary guidance for the establishment of an international body to support national-level regulation of the global O&P workforce.

Support the O&P Global Project

We are grateful for the support of the international O&P community who have recognized the need for this international body. In 2019, the inaugural meeting of national O&P associations was held in Kobe, Japan. This meeting was attended by representatives from 20 national O&P associations – representing more than 12,000 O&P practitioners globally. At this time, representatives provided in principle support for the establishment of an international body to support national-level regulation of the O&P workforce.

We are now calling for formal indications of support for the O&P Global project from:

  • National Associations who would like to be formally listed as a Supporter on the O&P Global website. Supporters will play a vital role in communicating this important work to their members, participating in aspects of Phase 1 and 2, and contributing to a project Advisory Committee
  • Project Partners who can provide the sustained financial support needed to undertake the two-phases of work. We hope that Project Partners will also contribute knowledge and expertise as part of the project Advisory Committee.

To list your National Association as a Supporter, or to arrange a conversation about Project Partner opportunities, please email: info@op-global.org

You can read more about the need for regulation of the O&P workforce, and the impact this will have on workforce growth, in our recent publications found on our website.

For further information about the O&P Global project, please:

Leigh Clarke is the Chief Executive Officer at the Australian Orthotic Prosthetic Association in Camberwell, Victoria, Australia.

Emily Ridgewell is the Research and Policy Manager at the Australian Orthotic Prosthetic Association in  Camberwell, Victoria, Australia.

Sarah Anderson is an Adjunct Senior Lecturer of Prosthetics and Orthotics in the Department of Physiotherapy, Podiatry, Prosthetics and Orthotics at the School of Allied Health, Human Services and Sports at La Trobe University in Melbourne, Victoria, Australia. She also serves as the Manager of Research Analytics and Insights at the Australia Health Practitioner Regulation Agency.

Michael Dillon is an Associate Professor and Head of the Department of Physiotherapy, Podiatry, Prosthetics and Orthotics at the School of Allied Health, Human Services and Sports at La Trobe University in Melbourne, Victoria, Australia.

REFERENCES
  1. World Health Organization. WHO standards for prosthetics and orthotics (Part 1). Report no. 9241512482, Geneva: World Health Organization; 2017.
  2. Clark L, Puli L, Ridgewell E, Dillon MP, Anderson S. Regulation of assistive technology practitioners to drive workforce training and retention. In Layton N, Borg J, editors. Global perspectives on assistive technology: proceedings of the GReAT Consultation 2019. World Health Organization. Geneva, Switzerland, 22–23 August 2019. Volume 2. Geneva: World Health Organization; 2019:169-90.
  3. Lemaire ED, Supan TJ, Ortiz M. Global standards for prosthetics and orthotics. Canadian Prosthet Orthot J. 2018; 1(2). DOI: https://doi.org/10.33137/cpoj.v1i2.31371
  4. World Health Organization. Financing and economic aspects of health workforce scale-up and improvement: framework paper: GHWA Financing Task Force, October 2008. Report no. 924159828X, Geneva: World Health Organization; 2009.
  5. Chen L, Evans T, Anand S, et al. Human resources for health: overcoming the crisis. Lancet. 2004; 364(9449):1984–90.
  6. Clarke L, Puli L, Ridgewell E, Dillon MP, Anderson S. Regulation of the global orthotist/prosthetist workforce, and what we might learn from allied health professions with international-level regulatory support: a narrative review. Hum Resour Health. 2021;19:8

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