Public purse, private service: The perceptions of public funding models of Australian independent speech-language pathologists.

PURPOSE: Health funding provisions supported by governments are pivotal for families accessing independent speech-language pathology services in Australia. Little is known of the facilitators and barriers that exist for accessing public funding for speech-language pathology services through independent providers. This study aimed to investigate and describe the perceptions of speech-language pathologists in accessing public funding models (PFMs) for children and young persons with communication and swallowing needs within Australian independent practice. METHOD: Semi-structured qualitative interviews were conducted with twenty independent speech-language pathologists who had experience of PFMs in Australia. Digitally recorded interviews were transcribed verbatim and subjected to thematic analysis. RESULT: Data analysis revealed five superordinate and eighteen subordinate themes. The five superordinate themes were: (a) accessibility in securing funding provisions; (b) time as a commodity; (c) incongruence between funding provisions and speech-language pathology evidence; (d) trust as a multifaceted quality; and (e) consequences of PFMs. CONCLUSION: This original and timely research offers perceptive descriptions of the multifaceted facilitators and barriers for families seeking to access public funding for independent speech-language pathology services in Australia. Research findings illuminate challenges for the speech-language pathology profession. Accessibility to funding was identified as a major issue. Research findings suggest that current funding provisions do not align with the dosage required for evidence-based speech-language pathology management. Further, this research has highlighted the need for funding to be equitable, acceptable to stakeholders, and for services to be delivered in an efficient and sustainable manner. Future research is recommended to understand which Australian PFMs: (a) facilitate consumer access to speech-language pathology services; (b) enrich consumer experiences; and (c) align with scientific evidence to promote optimal outcomes.

Talking EPC - speech pathologists' views of the Enhanced Primary Care items four years on.

BACKGROUND: Allied health professionals have provided services under Enhanced Primary Care (EPC) since 2004; however, the experiences and views of AHPs about the initiative and how it has been utilised have not been well explored. OBJECTIVE: We examined speech pathologists' views and experiences under EPC. METHODS: A survey of speech pathologists in private practice who provide services under EPC was undertaken. RESULTS: Speech pathologists provide EPC services to a wide range of clients with communication and swallowing disorders. The five EPC sessions provide a 'starting point' for therapy for some clients, and supplement existing therapy for others. Speech pathologists expressed concern about the accessibility of the program, and its understanding and use in practice, but noted that the program can be valuable for clients who are able to negotiate the hurdles, and for themselves in terms of increased referrals and collaboration with general practitioners. CONCLUSIONS: Education around eligibility, access, and reporting requirements is needed for clients, GPs and allied health professionals in order to reduce the frustrating aspects of this program, and support its ongoing use.

Playing by the rules: speech pathologists' views about patient suitability for the Enhanced Primary Care Program.

BACKGROUND: Allied health practitioner views about patient suitability may impact on which patients seek to be referred to the Enhanced Primary Care (EPC) Program through their general practitioner. These views have not been previously evaluated. METHOD: Participants were speech pathologists who were both working in private practice in Australia and members of Speech Pathology Australia (SPA). Participants completed an online survey, which was sent via an email link to all eligible members. The email database captured more than 95% of all private practitioner members of SPA. RESULTS: Speech pathologists discuss the EPC Program with patients if they feel it is relevant to them. In determining eligibility, the majority of speech pathologists cited the Department of Heath and Ageing criteria for eligibility as their guide; however, interpretations of these criteria varied. Additionally, speech pathologists frequently considered other factors, such as severity or financial need, as impacting on suitability. Speech pathologists expressed concern about the perceived inconsistency of referrals by GPs under the EPC Program. DISCUSSION: There is an urgent need for clarification, education and interprofessional discussion about eligibility and access to the EPC Program.