Regional Network Development Event held at the CSP London offices on 19th March 2013 - presentations - please click on the links below to open and view each one. Report and photos to follow.
Nina White - A clinical commissioner's perspective (Members will need to login to see this content)
Above: Nina White - Commissioning and Redesign Lead, Planned Care, Shropshire CCG
Adele Madin - A service manager's perspective (Members will need to login to see this content)
Above: Adele Madin, Professional Head of Physiotherapy and Director of Adult Services, East Coast Community Healthcare, Community Interest Company
Naomi McVey - Quality standards - NICE and the new NHS (Members will need to login to see this content)
Above: Naomi Mcvey, Commissioning Adviser, National Institute for Health and Clinical Excellence
Regional Network Development event – 19th March 2013 - A summary of the day
Regional chairs, Council representatives, regional communications leads, Branch representatives, students, retired members, associate members and others from across England attended this central event to support regional activity.
The day began with 3 very powerful presentations from each of 3 physiotherapists working in influential roles in the new health care system:
- Nina White, commissioning and redesign lead – planned care, Shropshire CCG
- Adele Madin, professional head of physiotherapy and director of adult services, East Coast Community Healthcare, Community Interest Company
- Naomi McVey, commissioning adviser, National Institute for Health and Clinical Excellence
Nina White, Commissioning and redesign lead – planned care, Shropshire CCG
Nina said that we have to get over our discomfort about marketing and suggested the following key actions
- Go out and market your services – a fantastic tool is all the outcome measures that you have collected
- Assistants and junior staff – you have your fingers on the pulse and are out there as patients’ first point of contact. First impressions count! Make sure everybody has a good experience of physiotherapy
- Plan and prepare – have your ‘ready to go’ summary of your service to hand
- Look over the horizon and think ahead to opportunities
- Engage with your audience (patients and commissioners)
- Leadership is important from first impressions of your service to showing what you’re selling to commissioners.
Nina’s background is in MSK physiotherapy and she has been in her current role for the last 15 months. She works for Shropshire CCG which covers the rural Shropshire area as distinct from Telford and Wrekin CCG.
Nina talked about important issues for physiotherapy from her perspective as a commissioner and in the light of recent NHS changes and the Francis report.
Marketing (Nina said, think of what Spec Savers have achieved when considering the points below):
- We need to know our product (service) and think ahead what opportunities there may be
- Price (i.e. cost per patient) is important but needs to be juggled carefully to ensure quality
- We need to be forward thinking and flexible about place (of service) – remember that we are competing with the commercial sector. Put effort into horizon scanning
- Promote your service effectively. Think about:
- The patient view of your service which is incredibly important. Patients need to be engaged – and this includes but goes beyond satisfaction surveys, it’s about getting patients involved. You can access patient reference group through PALs and through GP patient groups. Quality standards are about satisfaction and engagement.
- Know your audience. In Shropshire CCG the contracting team go out to clinical support units. There is negotiation of contracts and this is something for physiotherapists to know about. CCGs were recently asked to produce a one page summary of their priorities and objectives. In the commercial sector people are ready to go they’ll have their programme redesigns summarised on a few eye catching sheets of paper.
Data
Collect it and use it and have it available to:
- Monitor what you are delivering against your contract
- Give to commissioning leads as required to demonstrate what you achieve
- Share and use to redesign services
Outcomes
Physiotherapists are brilliant at outcome measures! But think how you use them to sell what you are doing to commissioners and managers etc. Remember that doctors are willing to spend large amounts of money on systems to measure and report outcomes and it’s something that you are already doing. But how do you share this? Who do you tell? We have to get over our discomfort about marketing.
Commissioners are looking to see that patients are getting better. We are looking for:
- Clinical outcomes across a health economy such as EQ-5D can provide
- Speciality specific outcomes
- Process measures.
Integrated care
The big emphasis is on working differently. Looking at which activity can be transferred from more expensive secondary care to cheaper primary care. Are we challenging ourselves and taking all the opportunities?
We should understand that physiotherapy is the key to integrated care and tell everybody about this. Specialist physiotherapists have a huge role as the bridge between hospital consultants and GPs (and physiotherapist working in GP surgeries). Self-referral gives this another dimension.
Adele Madin, professional head of physiotherapy and director of adult services, East Coast Community Healthcare, Community Interest Company
This is a short introduction. In September 2013 I’ll come back with some key partners e.g. a commissioner and social care lead. Here are a few words on our physiotherapy services and how we operate.
Key to survival is:
- A strong relationships with our commissioners and understanding the need to sell our service
- An understanding that we are open to competition and that we are a small service
- Working with influential partners e.g. social care leads so that we get rid of boundaries and duplication
- Increasing efficiency and capacity which enables us to protect staff banding and roles.
How to succeed in the current health care system
Team up with colleagues and to build relationships. This puts you in a strong position to work with commissioners. By working in this way I recently got 2 extra physiotherapy posts in acute and community care.
I work actively with the clinical commissioning committee that is immediately under the CCG board. This means that I know where the money is and can challenge decisions and offer alternative solutions. These 2 were successful:
- a new process for exceptional requests for equipment
- I said, ‘if you put in ………(specific resources) we can set up a new AHP out of hospital team. Then when the patient comes in for nursing care they can also have physiotherapy and other AHP treatment’
I attend meetings as much as I can e.g. clinical leads meetings, practice managers’ meetings. I have as much contact formally and informally with as many colleagues as possible.
Looking forwards Adele said:
- GPs are now in the front line and have a lot of influence. Every contact with them counts, make as many links as you can
- Use commissioners language and GPs language
- Be alert and actively listen to give you an understanding of what’s going on, be prepared
- Plant ideas
- Tell everybody that Physiotherapy Works – sell physiotherapy all customers and to all patients
- Demonstrate what you are doing and what you have achieved
- Sell your services
Naomi McVey, commissioning adviser, National Institute for Health and Clinical Excellence (NICE)
Naomi has worked as a Commissioning Adviser at NICE for nearly 3 years. NICE became the National Institute for Health and Care Excellence on 1 April to reflect its new role in developing guidance and standards for social care.
NICE guidance is developed by reviewing and interpreting the research evidence and applying it to clinical practice with a focus on quality and value for money. The NICE quality standards, and there will be 180, are developed from the NICE guidance and other accredited guidelines. They give you concise and measurable statements about clinical practice. These published quality standards are the most relevant to physiotherapy:
- Dementia (Quality Standard QS1)
- Stroke (QS2)
- Chronic heart failure (QS9)
- COPD (QS10)
- End of life care for adults (QS13)
- Patient experience in adult NHS services (QS15)
- Service user experience in mental health services(QS14)
- Hip fracture in adults (QS16)
- Asthma (QS25)
- Supporting people to live well with dementia (QS30)
The quality standards can support physiotherapists to improve services in their local areas. For stroke (QS 2) Quality statement 7 is: ‘Patients with stroke are offered a minimum of 45 minutes of each active therapy that is required, for a minimum of 5 days a week, at a level that enables the patient to meet their rehabilitation goals for as long as they are continuing to benefit from the therapy and are able to tolerate it.’
This is a good thing for physiotherapybecause statements like these can help you to approach managers and commissioners to talk about developing local services in line with the evidence base. If your service is not cunrelty providing care in line with the quality standard you have a clear case for improving it.
There is a wealth of useful information on the NICE website. Keep up to date and sign up for the regular newsletter at www.nice.org.uk . There is also a NICE guidance app for iPhone and Android.
The CSP influencing toolkit is a useful source of information about the new health care system as a whole. It includes actions that you can take www.csp.org.uk/influencingtoolkit
Naomi’s own advice for influencing and promoting physiotherapy includes:
- Plan – what are you want to achieve
- Research – know your local population, commissioners, local plans and priorities, local leads
- Know your service – e.g. how much it costs, how it is commissioned and paid
- Be integrated and patient focused
- Use the evidence-base to support you
- Demonstrate outcomes & quality improvement - think about the outcomes of your services and how these relate to the NHS outcomes framework
- Get marketing!
CSP Grant Group - 11th February 2013
The group met on 11 February to consider 2013 grants for Regional Networks and Country Boards, and their related Branches. All are accountable to central CSP through an annual report and give plans for the year ahead to receive their grant. Grant Group was impressed with applications from across the UK particularly as this is the first year the new system is fully operational. Grant Group’s remit is to allocate central funds as equitably as possible to give Regional Networks and Country Boards autonomy in carrying out their plans.
Grant Group is chaired by vice president Jane Laidlaw. Jane said, ‘We were delighted with the response from the Boards and Networks. The clarity and reasoning for monies made our decisions for appropriate funding easy. We wish all the Boards and Networks success with their 2013 projects’.
Below: Jane Laidlaw
Regional Networks Development Event – 18 September 2012
This event, at central CSP in London, was for English Regional Network leads. Helena Johnson, chair of CSP Council, welcomed delegates and said she was proud of their achievements.
Left: Delegates attending this event
Above left: left to right: South Central representatives Kate Atkinson, Kim Patterson and Cate Leighton
Middle photo: left to right: Carol Robinson (North East), Belinda Fox (East of England), Susan Hoath &Carl Hancock (East of England)
Above left: CSP's Ceri Sedgley with East Midlands representatives Catherine Pope and Jane Carter
Left: Dawn Smith with Sue Browning Dawn Smith, AHP adviser to NHS Clinical Commissioning Community (CCC)
Dawn said use NHS CCC to be noticed. A speech therapist by background, she is AHP lead for NHS CCC which enables multi-professional networking.
You know that Physiotherapy Works and you have the CSP briefings to support this message. Talk about what you do on NHS CCC networks. Emphasise your quality outcomes e.g. increased efficiency, decreased costs and service redesign. The NHS CCC networks enable informal discussion beyond your profession.
In organisations AHPs are increasingly represented by somebody unfamiliar with your offer. If you are buried in your organisation your work can go unnoticed.
- Effective networking gets you noticed
- Educate commissioners so they understand your contribution to the pathway
- Provide robust evidence
- Be accessible
- Form relationships through clinical networks
- Collaborate – commissioners want to commission across pathways
- Offer solutions and demonstrate savings.
NHS CCC is sponsored by the Department of Health (DH) and provides informal networks to promote free discussion and participation that may be missing in formal committees. Some networks are multi-professional and others are regional.
Dawn said, every 6-weeks we scan the networks, analyse the ‘soft intelligence’, anonymise it, and send it to the DH.
Link your CSP Regional Networks with NHS CCC networks to be heard. Register and opt to receive e-mail alerts. Remember that commissioners don’t all know what physiotherapy can achieve. NHS CCC networks enable you to communicate with people you wouldn’t normally speak to. They can give you a national profile. Become an active contributor. We need a physiotherapy voice.
Left to right: Sue Hayward-Giles with Jim McManus
Jim McManus, director of public health
Jim said that physiotherapy has the potential to make a strong contribution to public health in many areas. Now, while much is unclear as a result of policy changes, is a good time to make your case.
The Regional Networks can help raise your profile generally to make way for local managers to come in with specific service ideas. Some top tips:
- Use your CSP Physiotherapy Works briefings – they are excellent
- Aim to influence local directors of public health
- Work directly with your clinical commissioning groups
- Talk about where you can add value e.g. prevention, long-term conditions, and frail elderly.
There are opportunities for physiotherapy in public health. You can help because currently we don’t have all the answers. You don’t need permission to support public health objectives. We need non-pharmacological and non-surgical interventions that are both cost effective and clinically effective. Physiotherapy is an obvious answer in key areas e.g. in returning people to work, keeping people out of hospital, preventing falls. Physiotherapy is a golden egg.
Jim gave some useful background. There have been 3 public health revolutions:
- Poverty and living conditions to 1900
- Communicable diseases to 1950
- Non-communicable diseases today.
Further, health depends on:
- Health behaviour – 30%
- Socioeconomic status – 40%
- Clinical input – 20%
- The built environment – 10%.
Jim was impressed with the energy and commitment of attendees. He said, ‘you are very engaged and engaging’.
Sue Hayward Giles, CSP assistant director of practice and development
Sue gave a summary of current CSP practice and development activity e.g.
- Physiotherapy Works briefings to help you promote physiotherapy to professionals and to patients:
- Marketing and promoting your service:
www.csp.org.uk/professional-union/practice/your-business/marketing-promoting-protecting-your-service
- Survival workshops 2012:
Some points that came up during the discussion
- Sharing is essential, business comes and goes but health care goes on, organisational protectiveness stifles progress
- Find ways to show what you can do and build physiotherapy’s reputation
- CSP members are pragmatic problem solvers – and this is very much needed
- Invest the time, have pride in your profession, sell physiotherapy
- Redesign pathways, show impact, outcome, cost savings, improved patient experience
- Patients are important in influencing the new system, word of mouth is important, build your good reputation locally
- Commissioners are overwhelmed and interested in solutions
- Put your resources and effort into what you do well – let the rest go.
Susan Hoath, independent consultant and Regional Networks’ friend
You have Regional Networks that are successful, inclusive and enable sharing of information and good practice. You are changing much faster than commissioners; keep them updated by talking about what you are doing at every opportunity.
Workshops
In the afternoon workshops, regional teams focused on individual action points. Attend regional meetings to find out what your regional leads are doing. These are open to all CSP members and are advertised through these pages and CSP regional web pages.
Above left: left to right: Associate representatives: Danielle Wright and Angela Brett
Middle photo: left to right: South East Coast representatives Trish Parkin, Melanie Etherton, Prof Ann Moore and Jim Fahie
Above right: left to right: Gerard Greene, Lucy Cocker and Surita Tank
Sue Browning, CSP Deputy Chief Executive
Sue summarised some main points from the day:
- Current instability and change in the health system is set to continue
- As AHPs we often underestimate our offering but strong CSP Regional Networks can support us
- We all have a role in raising the profile of physiotherapy including private practitioners, managers, clinicians, students and associates
- Commissioners think we are scary and they want us to talk to them in simple language
- We have solutions to offer health commissioners and public health leads
- Build on relationships, take every opportunity to promote physiotherapy
- Long-term conditions and older people present huge problems and physiotherapy has many answers, make close links with other professionals, tell them that Physiotherapy Works.
Below left: left to right: South West representatives Heather Hunter with Rachel Pope
Below right: left to right: London representatives Carol McCarthy with Stuart Paterson
Above: left to right: Yorkshire and the Humber representatives Maria Burton, Karen Durrant and Sharon Greensill
Below: left to right: West Midlands representatives Sarah Bazin, Philip Hulse and Jane Toms
Below: left to right: North West representatives Jo Lishman, Nena Mitchell with CSP's Helen Walsh
Presentations at Regional Network development event, 18 September 2012 - please click on the links below to open
Dawn Smith, NHS Clinical Commissioning Community, September 2012
Jim McManus, director of public health, September 2012
Susan Hoath, Regional Networks' friend, September 2012
The CSP Regional Networks support you in challenging times and help you raise the profile and influence of physiotherapy. Current challenges bring opportunities, but only if you speak to decision-makers and promote what physiotherapy can offer. Every patient and professional contact is important, and 50,000 members can make a difference.
Updates and events
At the quarterly English Network Forum, on the eve of each Council meeting, Regional Network leads share their successes and challenges.
Teams can both learn from each other and support each other, and download a selection of summaries and key messages from the bottom of this webpage.
The Regional Network Team meetings are held 4 times a year. Usually around the time CSP Council meetings. Attached at the end of this document is a calendar of the November / December 2012 Network Team meetings. Once the 2013 dates have been fixed these will also be made available to all network members.
What are Regional Networks?
As the voice of the CSP in the English regions, they:
- provide support in challenging times
- help you understand the changes in health care and how they affect you
- give you prompt access to CSP support, briefings and tools designed to help you
- enable you to work together to raise the profile of physiotherapy in your region
- help you create opportunities and take action
- seek to influence CSP decision making
Why are they vital?
There never has been a more important time to be involved and to raise awareness of what physiotherapy has to offer. The Regional Networks:
- help you make the most of the opportunities brought by these challenging times
- give a unique perspective of physiotherapy through the involvement of a cross section of members
- are a forum for progressing physiotherapy in your region
- address local issues through pursuing priorities eg leadership at all levels, outcome measures, increasing engagement with research, Move for Health
- work regionally on a central CSP priority which is currently influencing key decision makers
How do they work?
Each Regional Network is run by local physiotherapy activists and has its own style. All CSP Regional Networks have:
- a core team of activists, who meet quarterly, coordinate activity and promote regional priorities
- regional web pages
- a voice at CSP Council through your regional Council representative
- a voice at the English Network Forum which brings the 10 English regions together
Who should be involved?
To give a strong voice for physiotherapy all CSP members should be involved including:
- clinicians
- educators
- health and safety representatives
- managers
- non-working members
- private / independent sector physiotherapists
- researchers
- stewards
- students
- support workers / technicians
Note that as you progress specific regional priorities, you are likely to work with partners eg colleagues in medicine, health and social care, or in the voluntary sector.
How can I be involved?
Through:
- your web pages: share what is going on in your work place, discuss issues across your region, learn about local issues, see your core team’s minutes and agendas on your regional page via
- Frontline noticeboard: read brief summaries of events and activity in your region and see dates and times of meetings, conferences and activity that you can attend in your region
- attending team meetings: these are quarterly in March, June, September and December each year. They are open to all members and are advertised on iCSP and in Frontline. For further information email your network contact below.
- Becoming an active member of your core team: there are opportunities to be an active core team member across all the regions on an ongoing basis. Find out more at your next core team meeting.
Network contacts
Use the list below to contact your regional core team to find out details of what is happening and advise them that you will attend a meeting.
| region | contact name | |
|---|---|---|
| East Midlands | Keri Barsby | eastmidlands@csp.org.uk |
| East of England | Dorothy Toyn | eastofengland@csp.org.uk |
| London | Matthew Wyatt | london@csp.org.uk |
| North East | Carol Robinson | northeast@csp.org.uk |
| North West | Ababaw Yohannes | northwest@csp.org.uk |
| South Central | Gill Feldman (temp) | southcentral@csp.org.uk |
| Sout East Coast | Stella Spiteri | southeastcoast@csp.org.uk |
| South West | Heather Hunter | southwest@csp.org.uk |
| West Midlands | Philip Hulse | westmidlands@csp.org.uk |
| Yorkshire & the Humber | Maria Burton | yorksandhumber@csp.org.uk |
Which is my Regional Network?
INormally the region in which you work or live but you can be active in which ever Regional Network is most appropriate to you. The table below indicates the cities, towns and counties included in each region and gives links to your Strategic Health Authority (SHA) website.
| Region | SHA website | Cities/towns/counties |
|---|---|---|
| East Midlands | www.eastmidlands.nhs.uk | Bassetlaw Derbyshire Leicestershire Nottinghamshire Northamptonshire South Lincolnshire |
| East of England | www.eoe.nhs.uk | Bedfordshire Cambridgeshire Essex Hertfordshire Huntingdon Luton Norfolk Norwich Peterborough St Albans Suffolk Watford |
| London | www.london.nhs.uk | The 32 London Boroughs |
| North East | www.northeast.nhs.uk | Durham Nothumberland Teesside Tyneside Wearside |
| North West | www.northwest.nhs.uk | Cheshire Cumbria Lancashire Isle of Mann Greater Manchester Merseyside |
| South Central | www.southcentral.nhs.uk | Berkshire Buckinghamshire Berkshire Channel Islands Hampshire Isle of Wight Milton Keynes Oxfordshire |
| South East Coast | www.southeastcoast.nhs.uk | Kent Medway Surrey Sussex |
| South West | www.southwest.nhs.uk | Cornwall Devon Dorset Gloucestershire Isles of Scilly Somerset Swindon Wiltshire |
| West Midlands | www.westmidlands.nhs.uk | Birmingham Coventry Herefordshire Shropshire Staffordshire Warwickshire |
| Yorkshire & Humber | www.yorksandhumber.nhs.uk | East Lincolnshire North Lincolnshire Yorkshire |
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