Healthcare practitioners' engagement with non-specialists: A scoping review

Health systems worldwide are under pressure, with workforce shortages undermining access, quality and equity of care. Task-sharing with non-specialists who are embedded in the service user's community offers a promising solution. Evidence suggests that their added value brings cultural insight, trust and connection that can improve service user engagement and outcomes. Yet, non-specialists remain underused for reasons that are not fully understood. This review synthesises the literature on healthcare practitioners' (HCP) experiences of engaging non-specialists in client care, across professions and global contexts, to identify what enables or hinders meaningful collaboration between the two workforces.

A scoping review design was utilised.

Systematic searches were conducted in four academic databases: PubMed, Embase via Elsevier, Web of Science and CINAHL via Ebsco. Data was extracted and thematically analysed using an inductive-deductive approach guided by the updated Consolidated Framework for Implementation Research (CFIR).

Seventy-eight studies met inclusion criteria. Most were from high-income countries (n = 61) and used qualitative designs (n = 52). Studies represented a range of disciplines and occupations. Influential factors primarily mapped onto two CFIR domains representing the dynamics of the workplace and characteristics of individuals within the workplace. Barriers (e.g., interprofessional tension, concerns regarding insufficient training or supervision of non-specialists), facilitators (e.g., work infrastructure, relational connections, teamwork and shared learning), and self-reported experiences (e.g., multiple benefits for service users including increased access to care and improved outcomes) offered insights into how HCPs perceive and navigate task-sharing with non-specialists.

HCPs are intermediaries to successful implementation and task-sharing cannot succeed without their support. This review provides the first synthesis of factors that shape engagement with task-sharing and provides actionable insights for policymakers, service leaders and researchers.