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Listen to patients

As she prepares to bow out as chair of CSP council, Dr Helena Johnson offers a heartfelt message to members

One thing I vowed to do when I started my two-year term as CSP Council chair was that the society should take account of the patient’s voice in its work.

This can only help us raise the profile of physiotherapy and the impact it makes on individuals’ lives.

It’s not always easy to capture patient experience in an effective way.

Sometimes the messages are challenging, even contradictory, but the article on the following pages by David Guthrie shows how a personal story can put across some of the issues our patients can face in accessing appropriate physiotherapy care.

My father died aged 51 from a sub-arachnoid haemorrhage. So when I met David and his wife Rita at a Stroke Association event earlier this year, I wanted CSP members to hear his and Rita’s story. Rita had suffered a sub-arachnoid haemorrhage a few years previously and survived life-saving surgery not available to my father in the early 70s.

Sadly, the Guthries’ story shows the frustrations of someone who appears to have been ‘written off’ in the UK as having no chance of recovery, yet manages to blossom in another country. 

When David took his wife to South Africa for some winter sun five years ago, he also arranged for her to have physiotherapy which was of enormous benefit.

I wonder if members in England and Wales are aware that they should be implementing the latest National Institute for Health and Care Excellence (NICE) stroke guidelines, issued in June.

Whether failure to meet these guidelines is due to cuts, training or just not knowing about them, it’s hard to second guess.

David and Rita were lucky enough to afford the trip to South Africa and the care they received there.

The article highlights the shortcomings in some parts of the NHS – not because staff do not have the skills to provide good care. Sometimes it fails because staff are not aware of – and not following – appropriate guidelines, or do not have the time to deliver the standard of care they would like to.

Maybe Rita was one of the unfortunate ones. Perhaps the clinicians felt they had done all they could and that she would not benefit from further rehabilitation.

But if failure to provide treatment stems from a lack of understanding of the NICE guidelines, or ‘fudging’ a resource issue, it’s one that members need to be aware of – and to speak out about.

If you’re aware of situations in your area where a patient who could have benefited from therapy, but was denied it on cost grounds alone, then contact the CSP for advice about how you can deal with the situation.

And as I bow out as chair, I’d ask you to think about David and Rita’s story.

They were the lucky ones who could afford to pursue care options elsewhere. Not everyone is as fortunate.

How many more stroke patients are out there living their lives with a level of disability they have no idea they can do something to reduce?
Dr Helena Johnson, Chair, CSP Council

You can contact the CSP’s professional advice team for more information on how to deal with rationing. (Tel: 020 7306 6666 or email: enquiries@csp.org.uk).

Get to know the nice stroke rehab guidance

The NICE guidance issued in June 2013 makes some important recommendations on rehabilitation after discharge from hospital in England and Wales.

The Stroke Association is calling for these to be adopted and implemented as soon as possible to ensure that every stroke survivor has the chance to make the best recovery possible.

NICE says people with disability after stroke should receive rehabilitation in a dedicated stroke inpatient unit and subsequently from a specialist stroke team in the community. See NICE: and search for ‘CG162’

CSP’s updated Physioworks on stroke will be launched at next week’s Physiotherapy UK 2013. The neurology strand will focus on these guidelines.

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