Physiotherapists in advanced and extended practice roles working in emergency departments and in elective surgery settings should be considered as part of South Australia’s health reforms, according to the Australian Physiotherapy Association (APA).

In its submission to the South Australian Government’s Transforming Health plan, the peak physiotherapy body highlights the work of physiotherapists in EDs, from assessing patients and treating minor injuries to prescribing medications.

“We’re disappointed the Transforming Health plan had little focus on the skills and expertise of physiotherapists and other health practitioners in advanced and extended practice roles,” APA president Marcus Dripps said.

“Advanced scope physiotherapists working in the emergency department have been proven to be effective in reducing wait times and freeing up medical specialists to manage more serious life-threatening presentations.”

The government has received about 2000 submissions to its proposed reforms, which outline a super emergency department at the new Royal Adelaide Hospital.

The plan includes transforming the Flinders and Lyell McEwin hospitals into ‘super sites’ for major emergencies with 24/7 senior medical staff, while the blueprint recommends scaling down emergency services at the Queen Elizabeth and Modbury hospitals.

Under the plan, the Repatriation General Hospital and Hampstead Rehabilitation Centre face closure, with their rehabilitation services to be shifted to other hospitals.

Noarlunga Hospital has been earmarked to become the state’s centre for single day elective surgery and an expert palliative care site, while The Queen Elizabeth hospital will move to focus on multi-day elective surgery.

The government also proposes establishing a walk-in emergency clinic at Noarlunga Hospital, on the site of the GP Plus Super Clinic.

In its submission, the APA has called for advanced and extended scope roles for physiotherapists and allied health practitioners in rehabilitation, such as in managing hypertonicity/spasticity with Botox injections.

The association suggests the government also consider a single state-wide point of entry for elective surgery, where physiotherapists working in advanced or extended scope roles can carry out initial triaging of referrals for musculoskeletal conditions and face-to-face screening and assessment of some patients.

“The APA encourages the expansion and sustainable resourcing of evidence-based models of musculoskeletal pre-surgical rehabilitation, led by physiotherapists, which would reduce surgical length of stay and avoid the need for inpatient sub-acute rehabilitation.”

The APA has urged the government, as part of its reforms, to invest in physiotherapy and other allied health to improve patient flow, provide alternatives to inpatient treatment and minimise wait times.

Mr Dripps said the government must boost physiotherapy and allied health resources in a bid to provide rehabilitation at the proposed new major acute hospital settings.

“At the moment, patients must wait until they are well enough to travel to these standalone rehabilitation facilities,” he said.

“We know this is suboptimal, with well accepted research showing that patient rehabilitation including physiotherapy should start as soon as possible after surgery to ensure the best treatment and recovery.

“So while we support patients having access to rehabilitation within the acute hospital setting as soon as possible after surgery or stroke as set out in the Transforming Health plans, the currently available physiotherapy workforce may not be enough to meet the targeted health and cost efficiency outcomes.”