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CSP Informal Evidence Session with the Health, Social Services and Public Safety Committee, Northern Ireland Assembly

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The CSP in Northern Ireland gave a presentation to the Assembly Health Committee on 6 October 2011.

The informal session lasted an hour an also included separate representations from the Royal College of Speech and Language Therapy and the Allied Health Professions Federation for Northern Ireland. The CSP presentation focused on the three main themes outlined below.

1   Modernisation & Reform

Chartered physiotherapists play a pivotal role in the delivery of health services. We rely on evidence-based treatment and treat a wide range of conditions from the very young prenatal patient right up to the elderly patient. We need to be readily accessible at local level, working as an autonomous profession in conjunction with our GP and other health professional colleagues. Physiotherapists have a significant contribution to make in meeting the challenges ahead and are committed to a modernised health service, which seeks to provide universal services based on clinical need, responsive to the needs of different populations and committed to reducing health inequalities.

The ongoing review of health and social care in Northern Ireland states that it is seeking to redesign services to provide treatment and care more promptly, closer to home with a view to more cost effective use of public money. Early intervention and support is essential to retain the function and independence of patients who need our services. More effective use of physiotherapy in the acute, primary and community/social care settings is key to achieving these reforms and delivering on health priorities such as cutting obesity, improving cancer, stroke and heart disease outcomes and reducing unnecessary hospital admissions.

Meaningful staff engagement and partnership working should be promoted at all levels across the HSC system to ensure that services are reshaped to meet the needs of patients, carers and their families. To date, however, the inclusion of physiotherapists and other AHPs in the planning and decision making process has been poor and in many instances non-existent. This has resulted in ineffective policy development across the health and social care system where insufficient consideration is given to the views of AHPs in the policy development process or where the inclusion of physiotherapists and other AHPs is sought too late in the process to make a meaningful difference. We need to ensure that the professional skills of physiotherapists are more appropriately managed, understood and utilised for the improvement of patient care.

2   Workforce

The CSP believes that maintaining a stable workforce is crucial to ensuring high quality care for patients. The impact of the efficiency savings on staff, in terms of morale, concerns about job security and terms and conditions of employment, should not be underestimated. Vacant posts are not being filled in many areas and hard pressed staff, are having to cover the work of absent colleagues. The burden on clinical staff, impacts on efficiency and effectiveness resulting in an adverse impact on patient care. Unfilled staff vacancies are directly related to increased waiting time targets and high graduate unemployment rates.

Physiotherapists are vital to reducing costs and maintaining frontline services in Northern Ireland. Physiotherapists working in extended scope and consultant roles can increase access to specialist services that delivers improved outcomes for patients. Physiotherapists working in these advanced roles could bring added value to the delivery of modern flexible services across health and social care services. Their key contributions would be in priority areas such as services to children, older people, people with cancer, mental health and chronic diseases such as stroke. The development of these roles in Northern Ireland has to date been minimal. Extended scope and consultant roles need to be developed within the workforce in Northern Ireland as part of the modernisation and reform process.

3   Value For Money/Role Development

The dynamic nature of healthcare demands that professions continuously review their roles to ensure that services are responsive, flexible and provide positive health benefits for patients. Physiotherapists have developed new ways of working in many specialist fields but require further support to facilitate the development of these roles which will build on core strengths and offer new ways of providing interventions. For example the introduction of self referral and supplementary/independent prescribing for physiotherapists will improve the access and quality of services provided to patients.

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