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Can Self-Employed Allied Health Assistants Safely be Delegated Tasks by Allied Health Professionals?

Monday 16, Dec 2024

One of the most common questions AHANA (Allied Health Assistant National Association) receives is whether self-employed allied health assistants (AHAs) who operate as sole traders under their own ABN can safely work under delegation from allied health professionals (AHPs). This article clarifies this issue by addressing key definitions, the relationship between employment and clinical governance, and the role of insurance in ensuring safety and accountability.

What Is an Allied Health Assistant?

AHANA defines an Allied Health Assistant (AHA) as:

A healthcare worker who has demonstrated competencies to provide person-centred, evidence-informed therapy and support to individuals and groups, to help protect, restore and maintain optimal function, and promote independence and well-being.

AHAs work:

  • Within a defined scope of practice in various settings, fostering a safe and inclusive environment.
  • Under the delegation and supervision of an Allied Health Professional (AHP), with the level of supervision (direct, indirect, or remote) determined by their demonstrated competencies, capabilities, and experience.

It is essential to emphasise that AHAs must always work under delegation and within their scope of practice as outlined in AHANA’s Code of Conduct.
 

Employment Models vs. Clinical Governance Models

Can AHAs Work Under Delegation if Self-Employed?

Yes, they can.

The nature of the engagement (e.g., sole trader, contracting through their own business, or employee) is distinct from the clinical governance model, which ensures patient safety and service quality. In healthcare, it is common for workers to operate as contractors or sole traders with hospitals and health services while maintaining their own independent professional indemnity insurance. For AHAs, this principle is no different.

Self-employed AHAs who are members of AHANA are required to:

  • Abide by the AHANA Code of Conduct, which enforces working within their scope of practice and under delegation, and includes similar professional and ethical standards to Ahpra-registered and self-regulated health professions
  • Provide evidence they are covered by their own professional indemnity insurance.
  • Participate in ongoing professional development to maintain and evolve their skills and knowledge.
  • Participate in a complaints process if concerns arise about their practice.
  • This ensures that delegation relationships remain safe and effective, irrespective of employment arrangements.

It is important to note that if a claim were to arise when an AHA is working under the supervision of an AHP, the question of whether the business’, the AHA’s or the AHP’s policy would respond depends on the particular arrangement and circumstances of the claim, and would be considered on a case-by-case basis. Often, a complaint or allegation could be made against everyone involved – the business, the AHA and the AHP. This is irrespective of whether the AHA is an employee or a contractor and why it is so important that AHPs and businesses employing AHAs ensure that their insurance adequately protects the AHA (or that they require the AHA to have their own professional indemnity insurance).
 

Insurance Coverage for Self-Employed AHAs

If I Delegate a Task to a Self-Employed AHA, Are They Covered by Insurance?

Yes, provided the AHA:

  1. Has valid professional indemnity insurance.
  2. Is working within their scope of practice as defined by their competencies.
  3. Adheres to the agreed delegation and supervision arrangements (e.g. follows the treatment plan set by the AHP, and only provides the services which have been delegated to the AHA).

When an AHA performs delegated tasks, they are accountable for the components of care they deliver. For example:

  • Scenario 1: An AHP delegates a falls assessment to an AHA who has demonstrated competency in this area (e.g., through specific training). If the patient experiences a fall during service delivery and decides to make a claim against the AHA, the AHA’s professional indemnity insurance may respond to the claim, provided the AHA acted within their scope of practice.
  • Scenario 2: If the AHA accepts a task outside their scope of practice (e.g., managing a complex condition beyond their training) or which has not been delegated to them, any claim would be subject to the terms of their insurance policy but their insurance policy is unlikely to respond. An AHANA AHA would also be in breach of the AHANA Code of Conduct and the circumstances would likely trigger an investigation through AHANA’s complaints process.

In either case, both the AHP and the AHA carry responsibility in the care being delivered, and the AHP remains responsible for ensuring delegation aligns with the AHA’s competencies.
 

Key Considerations for Safe Delegation

To ensure safe delegation, AHPs should:

  1. Verify Competencies: Confirm the AHA’s demonstrated competencies before delegating tasks.
  2. Define Scope of Practice: Ensure tasks align with the AHA’s training, experience, and the AHANA Code of Conduct.
  3. Establish Supervision Arrangements: Provide the appropriate level of supervision (direct, indirect, or remote) based on task complexity and AHA experience.
  4. Use Clear Delegation Protocols: Document agreed roles, responsibilities, and escalation processes.
  5. Confirm Insurance Coverage: Confirm the AHA’s professional indemnity insurance is active and adequate for the activities which may be delegated to them by the AHP or business according to the delegation framework.
     

Final Thoughts

Self-employed AHAs can safely work under delegation from AHPs, provided they adhere to professional standards, including working within their scope of practice and maintaining valid insurance. 

The distinction between models of AHA engagement and clinical governance ensures that AHAs can operate effectively across various settings without compromising safety or accountability. 

The difference between an employed AHA and a subcontracted AHA is simply whether a claim against the AHA (validly working within their scope, and delegation) would be covered by the delegating party’s insurance or the AHA’s insurance.

By complying with AHANA’s Code of Conduct and maintaining robust delegation relationships, AHAs play a vital role in delivering high-quality care, regardless of how they are engaged to provide services.
 

 

Eligible members can apply for insurance using a secure link via a members-only webpage, after being granted a practising membership. Please note it is a requirement of the insurance policy that you hold an active practising membership with AHANA, are an Australian resident and over 18 years of age.  You must be a current Allied Health Assistants’ National Association Ltd (AHANA) member to be eligible to register for the AHANA Member Insurance program. You must be part of the AHANA Member Insurance program in order to access additional cover. If your membership ceases you will not be offered renewal when your policy expires. In offering this insurance to our members AHANA is a distributor of BMS Risk Solutions Pty Ltd (BMS) AFSL 461594, ABN 45161187980. The insurance is arranged by BMS under binder with Certain Underwriters at Lloyds (the insurer). When acting under a binder BMS acts as agent for the insurer and not as your agent. This is general advice only and BMS has not considered whether it was suitable for your personal circumstances, current objectives, needs or financial situation. Please read the Policy Wording and the BMS Terms of Engagement which contains the Financial Services Guide before making a decision about purchasing this policy. As a distributor, AHANA may receive a percentage of the commission paid to BMS by the insurer and/or a fee per policy in offering this insurance to members.