Scope of clinical practice

All healthcare providers in your healthcare service must practice within a designated scope of clinical practice. Describing a scope of clinical practice for each healthcare provider, monitoring their practices and reviewing the scope of clinical practice when there are substantial changes will all support the delivery of safe, high-quality health care. 

The scope of clinical practice is specific to a role and describes the extent a healthcare provider’s clinical skills, knowledge, professional registration (where applicable), performance and professional suitability are used in a healthcare service. 

This is distinct from a healthcare provider’s scope of practice. The National Boards, under the National Registration and Accreditation Scheme for health practitioners, expect all registered healthcare providers to practise within their individual scope of practice and the relevant National Boards standards, codes and guidelines of their respective profession, and are reinforced through profession-specific documents such as codes of conduct or equivalent.[i]

Healthcare providers based in rural and remote areas often practice to their full scope with greater autonomy to meet diverse population and consumer needs. This is due to the unique circumstances in which they work, including resource limitations, distance from support and collaboration with medical retrieval services.[ii]

For example, a healthcare provider practising within their individual scope of practice may be qualified to provide services A, B and C. However, the healthcare service they are working within does not have the appropriate equipment or community demand for service C. While the healthcare provider is working in that particular healthcare service, their scope of clinical practice would only encompass the provision of services A and B. 

The description of a healthcare provider’s scope of clinical practice could be a stand-alone document or included in a position description or contract of services. It should include:

• Types of services the healthcare provider is expected to deliver within the healthcare service
• Minimum requirements for professional registration or self-regulation 
• Minimum requirements for working with specific population groups, for example, Working With Children Checks when providing care to children
• Additional training or qualifications required if applicable 
• Any supervision or continuing professional development requirements. 

• Where is a healthcare provider’s scope of clinical practice described? 
• What processes are in place to ensure a healthcare provider works within their scope of clinical practice in your healthcare service? 
• How is a healthcare provider’s scope of clinical practice reviewed when a clinical service, procedure or technology is introduced or substantially altered? 

• Record the scope of clinical practice for healthcare providers within your healthcare service, either in a stand-alone document, position description or contract for services.
• Incorporate a periodic review of a healthcare provider’s scope of clinical practice when a clinical service, procedure or technology is introduced or substantially altered.

The type and comprehensiveness of evidence used is dependent on each healthcare service context, but could include:

• Documented scope of clinical practice described in position descriptions, contract for services or standalone document 
• Review of services provided against the described scope of clinical practice, or records of performance reviews or communication that demonstrate monitoring 
• Planning documents to introduce new services (including workforce, equipment, procedures and the scope of clinical practice amendments required)
• Evidence of a regular review of the described scope of clinical practice, position descriptions or contract for services and any changes made.