Allied Health Professional Enhancement Program (ahpep)



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Allied Health Professional Enhancement Program (AHPEP) | Application package


AHPEP application form




Privacy disclaimer: Cunningham Centre is collecting this information in accordance with the National Vocational Education and Training Regulator Act 2011 in order to meet your needs as a client and ensure accurate records are maintained for accreditation purposes. Some of this information may be given to an external agency for the purpose of meeting contractual reporting arrangements. Your information will not be given to any other person or organisation unless authorised or required by law.






Please refer to the application package for details on the admission requirements and application process prior to completing your application form.




Applicant |




Name

     

Position title

     




Discipline



Work email

     




Work location

     

Work telephone

     




Are you in an Allied Health Rural Generalist Training Position?

 Yes

 No




Line manager |




Name

     

Position title

     




Work location

     

Work email

     










Work telephone

     

Placement |




Tick 1




 Individual placement

 Expert clinician visit

 Team placement

 Peer exchange







 Extended placement* (up to 10 business days)

 Reciprocal placement*







*These options require a letter of support from your Director of Allied Health (or equivalent)

Funding requests |

Accommodation

 Require 5 night/s accommodation

 Not required




Travel




 Air

 Bus

 Mileage allowance

 HHS Fleet Vehicle










 Not required







Preferred facilitator/host site |

List any preference/s of clinicians or facilities you wish to visit. Include reasons for your preferences, e.g. unique program or skill available at a particular facility; tertiary referral pathways. A maximum of two different facilities within same geographical area is recommended for split placements – explain why two sites are required to meet goals. As we may not be able to offer a placement to all applicants, please do not pre-arrange placement dates with your preferred facilitator/host site. Should your application be accepted your AHPEP placement coordinator will liaise with the host site.

Please note: Preferred facilitator/host site cannot be guaranteed.

     





If you wish to request a placement outside of Queensland Health, you must have a professional indemnity insurance policy in your name.

Do you have a professional indemnity insurance policy?

 Yes

 No

Comments:




Availability |

For the next six months please list all unsuitable and preferred dates for yourself and your service.

Please note: travel arrangements will not be amended once booked.



     





Professional support |

Do you have a professional support plan, as per the professional support guidelines? If yes, please describe. Have you discussed your application with your supervisor or mentor?

     




Placement proposal (this section onward will be sent to potential facilitator/host site)




Applicant name and title

     




How many days do you expect it will take to meet your learning goals?

     

day/s

Number of years practicing

     




Learning goals:

A minimum of two learning goals are required and must:



  • fulfill the AHPEP objectives

  • be clearly linked to your service requirements and/or caseload

  • be targeted towards outcomes, measurable where possible and achievable within your proposed placement timeframe

  • not include ‘gathering of resources’ of ‘work shadowing’ or ’networking’ which are all accepted as part of the placement process

  • not exceed two different clinical areas (to ensure learning goals are achievable within the placement timeframe)

  • be achieved face to face (videoconferencing would not be adequate).









Background |

Explain how your goals are related to:

  • the AHPEP objectives, and rural and/or remote clients and colleagues

  • your current caseload/service provision and local needs. Clearly explain any urgent clinical practice or service delivery need.

(minimum 150 words, maximum 400 words)







Strategies |

Include:

  • strategies or activities which would assist to achieve placement goals

  • active learning tasks and client based activities.

(minimum 100 words, maximum 250 words)







Outcomes |

Describe:

  • the anticipated outcomes from achieving your learning goals

  • what changes you will implement into your local service or clinical practice and the way that you will implement these changes

  • the transfer of new knowledge, skills and ideas to other staff, e.g. local or remote colleagues, same discipline or multidisciplinary staff.

(minimum 150 words, maximum 400)






Line manager to complete (please type responses, save, print, sign and return to applicant)




Name and title

     




HHS benefit |

Please describe:

  • how the applicant’s proposal meets HHS and/or Queensland Health priorities

  • how their anticipated outcomes fit with operational or strategic service plans

  • how you will be able to assist the applicant to implement their anticipated outcomes

  • how the outcomes of this placement will be sustained locally

  • how this placement will benefit rural or remote clients or staff.

(minimum 100 words, maximum 300 words)









Declaration |




By signing below, the applicant and line manager agree that:

  • they have read the application package, are aware of what is funded and are willing to fulfill their responsibilities

  • this application is relevant to service needs and is not able to be funded through other means

  • they will use the outcomes of this placement to implement genuine improvements to their local service

  • this is the only AHPEP application to be submitted in this round for their team/department

  • AHPEP will be notified of any changes in availability/change to employment (ie resignation). Travel arrangements will not be changed once booked

  • no leave or ADOs will be taken for placement days, e.g. normal wages are required to be paid for the applicant

  • temporary employees have at least six months remaining on their contract in order to fulfill all program obligations

  • the employee meets current Queensland Health and relevant National Registration Board requirements to practise.




Applicant’s signature




Date

     /     /     




Line manager’s signature




Date

     /     /     




Version 2.00 | April 2017

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