ARC motions 2007/1

Annual Representative Conference

Motions for debate

Amendments to motions, emergency motions and references back to Councils responses to ARC 2005 resolutions must be received by the Chief Executive’s Office at the CSP by 12 noon, Monday 9 February 2007.

Primary agenda

Please use the links below to view the content by section:

• Education
• Professional issues
• National health service

Education

Common debate of motions 1 and 2

Composite motion:

1. With the introduction of mandatory CPD in 2006 by the HPC, we call upon the CSP to lobby the Department of Health, Strategic Health Authorities and NHS employers to provide adequate protected funding for CPD, in view of the budget cuts and the variations in funding across NHS trusts.

   Clinical Interest Groups Liaison Committee, South East Oxford Stewards, South West North Stewards, South East Coastal Stewards

2. This Conference calls upon the CSP to lobby the NHS Council to relaunch the KSF ensuring that training budgets are sufficient for its implementation.

   Has the KSF died a death? Although the framework is mandatory there is no one to check that it is being used. We need to ensure that the training budgets are available to trusts so that any relevant training linked to the KSF is provided and implemented. Mersey, Cheshire And Isle Of Man Stewards

Common debate of motions 3 and 4

3. Conference calls on the CSP to devise ‘competency checklists’ which can be used for new graduates in their first posts. These checklists will help to ensure that they are safe to practice in each rotation and will also identify ‘skill gaps’ so that these can be addressed. The checklists will assist with appraisals and CPD, but will also act as proof that managers are ensuring staff competency and development.

   As student numbers are growing, student placements are changing. Graduates may not have experience in all of the traditional ‘core rotations’ due to a shortage of placements and instead develop transferable skills from a whole range of placement combinations. This may leave some skill gaps which need to be identified early on and addressed in the workplace. For instance, students who did not complete rotations in ITU or orthopaedics may need initially intensive support in these areas once they are graduates on rotation.

   Competency checklists will help to protect the interests of staff and managers by identifying skill gaps, logging progress and proving that practice is safe and constantly developing. Thames Valley Safety Representatives

4. Conference requests that, as a part of CSP Learning and Development function’s planned review of the Physiotherapy Undergraduate Curriculum review, a detailed survey is devised and sent to supervising clinicians across the four countries, to investigate whether the current physiotherapy undergraduate curriculum is adequate to produce consistently competent, autonomous practitioners.

   There is rising concern among NHS physiotherapists regarding an increasing variability in the performance of physiotherapy students, and of graduate physiotherapists’ ability to meet basic requirements as autonomous practitioners.

   With the current graduate employment situation it is vital that allthose who start their physiotherapy traing ar given the best possible start to their careers.

   Conference therefore asks that as part of the imminent review of the qualifying curriculum, the CSP actively engages clinical educators in the debate about shortfalls of current graduates, the kind of professional practice and roles that they need to be prepared for an how the curriculum can shape this. London North Stewards

5. Conference calls upon the CSP to promote and encourage members to develop into more diverse roles such as modern matron, case management, or services manager. We call upon the CSP to provide both CPD support and actively encourage physiotherapists to realise their potential to fill these roles and maximise their transferable skills.

   We request encouragement from the CSP to assist physiotherapists in diversifying within the new modernisation agenda. In the current climate of global changes physiotherapists must grasp the opportunities available to NHS staff and move in roles not traditionally offered to AHPs. We would encourage the CSP to advertise these non AHP roles and help develop physiotherapists into them. We often have excellent transferable skills which could be utilised in these extended roles with the right encouragement and support. Northern (North East) Region Stewards

6. This Conference requests that the CSP provides CPD materials and services free to its members.

   The CSP charges members for its “Developing a Portfolio” CPD package. (£25.68 CD-ROM version, £29.18 paper version). CSP members constantly ask “what is the CSP doing for my membership fee?”

   By providing CPD materials and services for free, members would enjoy a useful and tangible benefit from membership.

   The CSP’s CPD unit is currently looking to develop an internet based CPD system.

   In view of the importance of CPD in HPC re-registration, the CSP should support its members by providing all CPD materials and services as part of the membership fee. Association Of Chartered Physiotherapists In The Community

Professional Issues

Common debate of motions 7, 8, 9 and 10

7. Conference commends the work of the CSP in supporting new graduates who are unable to find employment and urges Council to continue to exert pressure on health departments in all four countries to find permanent solutions.

   One of the problems new graduates face is stress and uncertainty when they should be consolidating their skills. Probationary years could be used to allow at least one year of work to consolidate skills. This could also prevent the situation where new graduates one year on are competing for jobs with graduates from this year. Scottish Stewards

8. Conference notes that the issues of graduate unemployment persist at unprecedented levels with devastating consequences for all those directly affected. Conference recognises the need for ongoing support for unemployed gradutes not only in the pursuit of employment but also in maintaining and consolidating knowledge as well as contact with the profession.

   Therefore Conference calls upon the CSP to promote and support all mechanisms to encourage unemployed graduate development including encouraging and supporting where possible access to local, free in-service training programmes in both NHS and non-NHS sector organisations.

   Due to the current issues of employment problems, physiotherapy graduates are becoming de-skilled or are actively seeking alternative professions. To stem the abandonment of physiotherapy by graduates, IST permits them to consolidate their knowledge and maintains contact with their profession and the NHS.

   With support by the CSP, little extra work is envisaged would be placed on current staff. Trust managers have a responsibility to engage in strategies that maintains the competence and standards of graduates. Student Excecutive Committee

9. Conference acknowledges the continued effort of the CSP to address the on-going problem of graduate unemployment. However, we wish to raise our concerns at the increasing use of newly qualified physiotherapists working in a voluntary capacity. Whilst having complete sympathy for those seeking their first job, we urge the CSP to continue to pressurise the government and Trusts to be more proactive in creating substantive posts and to openly discourage the use of ‘volunteers’.

   It appears that some managers are clearly not following the CSP guidelines with regard to volunteer physiotherapists. We believe this to be exploiting the new graduate who is undertaking a caseload with no monetary recompense. This then covers shortages in actual staffing levels and potentially weakens managers’ positions in their attempt to ‘unfreeze’ posts. There is also the problem for qualified staff who are having to supervise the ‘volunteers’ when they themselves are already working at full capacity. We believe that the use of volunteers is not in the best interest of any of the involved parties. South east Shires Stewards

10. This Conference demands that the CSP immediately campaigns for NHS Trusts to use part-time/weekend contracts for providing physiotherapy services using newly qualified physiotherapists in order to prevent them losing HPC registration or competency due to lack of permanent employment.

    In this time of employment crisis for newly qualified physiotherapists, it is essential NHS Trusts assist new graduates in maintaining registration and competency. Weekend/part-time work would enable these valuable physiotherapists to experience working life whilst seeking a permanent post and would prevent the profession losing new members.

    Many physiotherapists report feelings of pressure with increasing weekend work commitments and this proactive creative approach could relieve this pressure. The CSP should campaign through stewards’ networks and CIOGs to ensure this approach is pursued. Association Of Chartered Physiotherapists In Respiratory Care

11. This Conference notes that the CSP does not have up-to-date guidance on staffing ratios for treating populations or specific client groups. Conference notes that commissioners want this type of information and physiotherapy managers are often required to provide this type of statistic as part of a business case.

    Conference believes that rather than others determining the amounts of physiotherapy which will be commissioned, the CSP should carry out work which will result in guidance that can be used by physiotherapy services to include staffing ratios for qualified, support staff and administrative support for population and patient/client specific areas.

    We are sure that bits of work on this issue are being undertaken around the UK as managers struggle to provide reference and evidence base to their business cases and commissioning advice. What is needed is some central guidance and work undertaken by the CSP to develop a framework for providing this type of data. There should be no ‘set in stone’ ratios however, there does need to be a starting point from which variations can be developed but which still provide a referenced, professional body led steer. Welsh Board

12. Conference calls on the CSP to launch a campaign of Health Promotion in schools to prevent back problems in later life. Large numbers of young adults are presenting in physiotherapy departments with spinal pain. Many have little knowledge of good posture and ergonomics.

    Conference calls on Council to:

    • open discussions with the Department of Education to ensure that all teacher training courses include ergonomics in relation to healthy backs
    • lobby government to include education of back care in school curriculums
    • lobby government to ensure adequate facilities are provided in schools for ergonomic work stations and storage of books.

    Many CSP members are concerned with the apparent lack of encouragement given to young people to help them understand the long term effects of poor posture. This is exacerbated by students routinely and continually carrying large numbers of heavy books between classes.

    We as health care professionals should, through our recogised professional body, the CSP, lead a health campaign to address this issue through education systems. South West South safety Representatives

13. Conference calls upon the CSP to monitor and regulate the membership of its CIOGs, and provide a governance framework for them to work within.

    Whilst we recognise the excellent role CIOGs have to play in the function of the CSP and profession as a whole, membership of them is not limited to CSP members. As they receive a £2 capitation fee, annual CIG conference, and representation at ARC, we feel that they should have a more open structure and be regulated centrally. Northern (North East) Region Stewards

14. This Conference asks the CSP to investigate the implementation of Physiotherapy Direct in order to assess whether it is having a detrimental effect on staff morale, staff satisfaction and whether it results in deskilling staff with the reduction of hands on treatment time.

    With the government’s agenda to reduce waiting lists, more and more trusts are introducting physiotherapy direct services. This often involves staff being taken away from hands on fact to face treatment sessions and being required to sit by a telephone. Patients are screened on the phone to establish if they need a physiotherapy assessment or sometimes are sent exercises in the post without ever being seen. There is a real risk of missing signs and symptoms that may require alternative trreatment. We also need to look at the skill mix of staff being required to provide this service. Eastern Stewards

15. iCSP has been a fantastic development and a success story for the CSP. We now believe that the CSP should provide funding to the iCSP network to be expanded as soon as possible to enable a live discussion/meeting forum for networks. The ability to have virtual meetings and discuss issues this way would be a valuable and efficient development of this excellent system. The CSP Corporate Plan invludes “Building Core Services” and “Putting members at the heart of the CSP” and is proactively trying to assist Board regeneration. This would be an ideal step forward for the CSP to prove it is doing just that.

    Many CSP members give a vast amount of their time to the development and forwarding of the profession. Many meetings are held on a daily basis on CSP business and many miles travelled in various forms of transport, all of which take time, effort and cost money. We all lead busy lives juggling work, home and the CSP and the ability to have virtual meetings would be most welcome, saving time and money which could assist this development. Eastern Board

16. Conference requests that CSP debate the potential for future development of an AHP as a distinct profession and that the Society takes a position on this issue.

    In an attempt to involve physiotherapists from all the countries (and apart from English-driving policies that seem to set the agenda), does there need to be a debate held hy the members on the future direction of the profession. Association of Physiotherapists in Management

17. Conference requests that in light of continuing Government Policy directives, the CSP work with managers, union representatives and commissioners to promote seven day service delivery of physiotherapy as the new service delivery model.

    In light of strategic Government documents there is a drive to move towards greater patient access to seven day services. Association Of Physiotherapists In Management

National Health Service

Common debate of motions 18 and 19

18. This Conference believes that the CSP should campaign for the ending of the Band 5 to Band 6 ‘run through’ under Agenda for Change, especially at present when new graduates are finding jobs so difficult to obtain.

    The run through is supposed to be automatic, in that a Band 5 therapist can go up to Band 6 after two years, providing they have reached the final gateway levels under KSF. No manager has the budget to increase their Band 6 staffing levels, so the only way of funding this is to take out Band 5 posts to part fund the increase, and to reduce other posts to fund the rest.

    New graduates will therefore have even fewer jobs to apply for in years to come. Hydrotherapy Association Of Chartered Physiotherapists

19. This Conference calls on the CSP to undertake work towards making Band 5-6 runthrough a reality rather than a concept, as current implementation could be described as patchy at best with some Trusts refusing to recognise that this applied to Physiotherapists. Furthermore, with the results of Agenda for Change implementation becoming clear, the CSP should establish whether CSP members still value the Band 5-6 run-through as much as they once did. This is with reference to member concerns about grade compression and erosion of pay relativities.

    The band 5-6 runthrough was a significant part of the selling of Agenda for Change to the membership by the CSP in the pursuit of a “Yes” vote. However the terms and conditions of Agenda for Change and the NHS Employers Q&A have not succeeded in achieving roll out nationally. Some Trusts have actively blocked this part of the agreement stating that it applies only to Midwives. Many Senior 1 grade physiotherapists have found themselves in pay band 6 after Agenda for Change implementation, this has altered their perception of the band 5-6 runthrough which they fully supported when they anticipated band 7 for themselves. West Midlands Stewards

20. Conference notes the move to more NHS patients being treated in the Private and non-NHS sector. This could lead to an increasing inequality in the burden of training provision left to NHS provider organisations with an ever decreasing budget. This will, in the medium term, lead to a decrease in the scope, quality and availability of professional training as the training providers struggle to cope with this inequitable situation.

    Conference therefore calls upon the CSP to:

    • work collaboratively with other public sector representative bodies to highlight this issue
    • lobby the government for an element of the tariff payment to be ring fenced for professional training and development of staff
    • continue to use its voice in the NHS Together campaign to highlight inequalities in the current tariff system and to seek a level playing field for provider organisations involved in professional training for staff.

    The competitive NHS market place encourages non-NHS service providers to tender for contracts to treat NHS patients. Much NHS work is now being done outside of the traditional NHS structure, for example through enterprise schemes and in private hospitals.

    However, there is no requirement for these service providers to contribute to the training of NHS staff, and thus, they avoid the time and financial costs associated with this obligation. This creates an unfavourable position for NHS organisations and an unsustainable future for the health care workforce. A possible solution wold be to include a tariff for training and development that is ‘ring fenced’ within the cost of each NHS treatment per capita. As training costs are built into existing NHS tariffs this would come at no extra expense to the government but would ensure parity of financial obligations between NHS and non-NHS organisations when bidding for NHS contracts. Student Executive Committee

1. We are dismayed that the Government's "Commissioning a Patient-Led NHS" is already seeing the outsourcing of nursing and therapy services. We believe that whatever the terminology outsourcing is privatisation of the NHS. We therefore ask that the CSP not only ensure that members are fully involved in any plans to outsource their jobs but also strongly oppose the suggested changes in line with CSP policy against privatisation of the Health Service.
   
   Commissioning a Patient Led NHS will affect all PCT members, and is already affecting some CSP members. It is essential that the CSP take an active part in ensuring security for members affected by changes due to this Government's change to the NHS. South West South Stewards

21. Conference calls on the CSP to lobby Scottish Parliament and the Scottish Executive to include an AHP as a full member of every NHS Board at Director level.

    All NHS physiotherapists who work within Scotland are employed by an NHS Board as opposed to an individual Trust, eg. NHS Greater Glasgow and Clyde. In order to have influence at Strategic Operational Level regarding physiotherapy issues within the NHS Board, eg. Local Workforce Planning, Service Re-design, it is essential that Physiotherapists be represented at Board level.

    In order to have a positive impact regarding graduate unemployment and service re-design there requires to be an influence at strategic level in all workforce regions. The only way to achieve this is to have AHP representation at Board level. Ideally this should be a Physiotherapist, but we acknowledge that this may not be achievable, however in our climate of multi-professional working, this post must be an AHP. Scottish Board

Common debate of motions 22 and 23

22. Conference is disappointed with the short-sighted reduction in NHS staffing levels and downgrading of dedicated and experienced staff in order to meet aggressive financial targets. Conference therefore urges the CSP to lobby NHS Trusts to ensure service needs, not financial deficits, are paramount in any restructuring. NHS Trusts should be encouraged to address the unemployment levels of physiotherapy graduates whilst retaining their senior clinicians at an appropriate grade to ensure service quality is not detrimentally affected.

    The combination of the current NHS financial targets and the issues relating to Agenda for Change are leading to staff and students being demoralised and feeling that their work is unappreciated. The appalling unemployment levels of physiotherapy graduates must be addressed positively without the reduction of senior staffing levels, or service quality wil be detrimentally affected. Trent Stewards

23. This Conference is concerned about the skill mix changes in physiotherapy departments since the introduction of AfC. In some cases, when higher banded staff leave, the posts are being downgraded to a lower AfC band to save money. This has the effect of drastically and adversely altering the skill mix of departments including halting career progression for CSP members, with the knock on effect of blocking junior posts.

    This Conference calls on the CSP to provide practical support for stewards and managers in tacking this issue.

    There is a lot of anecdotal evidence to show this is happening across the country. This is a worrying trend particularly at a time of high graduate unemployment. National Group of Regional Stewards

24. This Conference is angry at the nature and speed of NHS reforms. Conference believes the push to ensure all NHS books are balanced within one financial year and repeated changes to NHS structures is fundamentally flawed. The NHS is struggling to cope with this policy.

    This Conference calls on the CSP to continue to play a leading part in NHS Together and to continue to campaign nationally, regionally and locally against NHS cuts, financial savings and redundancies.

    This will be through using the media nationally and locally and supporting stewards and members directly affected by financial cuts and redundancy.

    NHS Together is a campaign alliance of Health Staff bringing together all the health service unions and staff associations (including the BMA and RCN) along with the TUC.

    Its main aims are to raise the alarm at what is happening to the NHS and press the Government for honest and open discussion about its return agenda. National Group of Regional Stewards

25. Conference condemns the emerging trend for Foundation Trust management to unilaterally move away from Agenda for Change terms and conditions to the detriment of its employees.

    Foundation Trust status is granted on condition that issues are taken forward in partnership and with full staff consultation. This trend for Trusts “cherry picking” parts of the national agreement is a threat to national bargaining and equality of terms and conditions.

    Conference urges the CSP to raise this issue at NHS Staff Council and Executive to demand:

    • robust and transparent monitoring of Foundation Trusts at national level
    • curbing the power of Foundation Trusts who are abusing their freedom.

    We are receiving increasing numbers of complaints from workplace stewards in Foundation Trusts that changes are being made to AfC processes and local terms and conditions with little or no involvement of the Staff Side. This threatens the fairness and integrity of AfC and the partnership working on which it wa based.

    Foundation Trusts must be sent a clear message that all changes must be carried out in full consultation with employees. London South Stewards

26. This Conference calls on the CSP to lobby the NHS to raise bicycle mileage rates to at least 50% of the lowest car mileage rate paid for business travel.

    Currently bicycle mileage rates for work travel vary widely throughout the country. The CSP has taken a lead in this area and pays 20p per mile. However, some NHS Trusts pay as little as 3p per mile.

    In order to actively promote physical fitness and discourage unnecessary car use, the bicycle mileage rate should be raised to at least 50% of the lowest car rate. This would fairly reflect the cost of bicycle purchase, servicing, bicycle equipment and clothing costs. This motion would also save the NHS money. Association Of Chartered Physiotherapists In The Community

27. This Conference believes that the CSP should lobby at national, SHA and local level to endeavour to ensure that Commissioning a Patient Led NHS does not present a quick fix solution to current healthcare funding crises and that decisions made under the banner of CPL should be based on patient choice and quality of care issues.

    Throughout the NHS services such as the remaining community hospitals are facing the threat of closure due to the current NHS funding crisis. The concern is that some quarters are suggesting that private companies or the Local Authority take over the running of these essential services from the NHS under the guise of CPL. This suggestion appears as a panacea to the residents of the Towns as the Hospitals will be saved; at least for now. This could be the beginning of a disturbing trend as local communities willingly jump from the frying pan into the fire to save their otherwise stricken services. West Midlands Stewards