• Kathryn McPherson, Paula Kersten, Steve George, Val Lattimer, Alice Breton, Bridget Ellis, Dawn Kaur, and Geoff Frampton.
• Division of Rehabilitation and Occupation Studies, Auckland University of Technology, Auckland, New Zealand. Kathryn.McPherson@aut.ac.nz
• J Health Serv Res Policy. 2006 Oct 1; 11 (4): 240-7.

ObjectiveExtending the role of allied health professionals has been promoted as a key component of developing a flexible health workforce. This review aimed to synthesize the evidence about the impact of these roles.MethodsA systematic review of extended scope of practice in five groups: paramedics, physiotherapists, occupational therapists, radiographers, and speech and language therapists. The nature and effect of these roles on patients, health professionals and health services were examined. An inclusive approach to searching was used to maximize potential sources of interest including multiple databases, 'grey' literature and subject area experts. An expanded Cochrane Collaboration method was used in view of the anticipated lack of randomized controlled trials and heterogeneity of designs. Papers were only excluded after the search stage for lack of relevance.ResultsA total of 355 papers was identified as meeting relevance criteria and 21 studies progressed to full review and data extraction. The primary reason for exclusion from data extraction was that the study included neither qualitative nor quantitative data or because methodological flaws compromised data quality. It was not possible to evaluate any pooled effects as patient health outcomes were rarely considered.ConclusionsA range of extended practice roles for allied health professionals have been promoted and are being undertaken, but their health outcomes have rarely been evaluated. There is also little evidence as to how best to introduce such roles, or how best to educate, support and mentor these practitioners.

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