The Big Picture

I'm sure it must feel at times like the Department of Health is simply plotting the next phase of your misery.' So said chief health professions officer Karen Middleton at the CSP's Congress last October.

For many physiotherapists, she was not wrong. Indeed, the raft of NHS reforms, each one ground-breaking in itself, and the pace at which change is moving, can be bewildering and disturbing to those at the sharp end. The jargon alone takes some getting used to. Phrases like practice-based commissioning, payment by results and third-sector providers are now common currency in the NHS in England and may well appear in other parts of the UK before too long. But what exactly do they mean? And what are the implications, both for physiotherapists in their day-to-day work and for the profession as a whole?

Frontline graphic Over the past months, Frontline has been reporting on the debate and the developments as they happen. Now in this important new series, we present a guide to the reforms and their implications. Physiotherapists have shown themselves to be natural innovators - but have repeatedly called for NHS reforms to be better integrated and rooted in clear evidence of what works for patients and staff on the ground. We will explain in plain English each major reform and the policy driving it, and present the different standpoints of key groups. Through real-life examples and experience on the ground, we will look also at how some of the changes already introduced are playing out for our members in practice.

Our aim is to inform you, to enable you to steer your way through the changing times ahead and to help you use whatever opportunities the reforms present to improve service delivery and patient care, and to extend your skills and practice. This first article examines the deep background in England, asking why reform and why now? The Department of Health makes its case, while bodies representing NHS employers and patients' organisations give their perspective. We look at what is happening in the other three home countries. And we explain the challenges and proposed solutions in some other countries in western Europe, each with a different model of healthcare.

You can download these articles from our website, discuss the issues on the interactive section, iCSP, or write or email your views to Frontline's letters page.

Please use the PDF download document links at the bottom of this page to find out more about other subjects covered in our first article. Please note that subject content runs over more than one page of each download:

Reform: problems or opportunities?
The government's case
The patient's perspective
The employer's view
Postcard from Europe - how other EU member states manage their healthcare
The Home Front - healthcare across the UK

The Big Picture

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