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Physiotherapists welcome challenges of the NSF for Older People

5 July 2005 - 9:10am

As Health Secretary Alan Milburn launches the NSF for Older People, one chartered physiotherapist gives her views on the current position and hopes for the future

'A big cultural change', is how Vicky Hackett, physiotherapy and dietetics services manager at Camden and Islington Community Trust, describes the launch of the first ever National Service Framework for Older People.

Chartered physiotherapist, Vicky Hackett, is talking about services in the country as a whole, not just the older people's services at St Pancras Hospital - the place chosen by health secretary Alan Milburn to launch the NSF.

And the cultural change she refers to is that of building multi-professional services and teams around patients' needs, with everyone working to the same definitions and goals.

She said: 'Camden and Islington Health Authority has had a strategy for older people for some time and has carried out extensive consultation on this. We are confident that what we have been doing will fit in with the national service framework.

'We have always tried to offer a service that reflects the needs of patients, regardless of their age. It's about the patient's clinical need, not how old they are.'

Ms Hackett has high hopes of the NSF.

She said: 'I hope the NSF will lead to a much more integrated service - a co-ordinated service delivered to explicit standards and care pathways, clarifying the service to be expected, not just for the patients, their relatives and carers, but also all staff delivering the care. I hope it will help to put a sense of order into the service and help everyone to develop clear goals, with the patient at the centre of everything we do.

'We need to try to prevent avoidable admission by identifying problems at an early stage before things go wrong. There are things we can do to prevent people from falling, for example.

'I also hope it will lead to more transference of skills between health and social services - at the moment everyone understands something different by rehabilitation. The NSF will put a framework around everything we do and help us to all pull together around the patient.'

However, Ms Hackett warns that there will be challenging times ahead.

She said: 'We need to know that the money set aside by the Government for intermediate care will find its way into the service. It sounds a lot, but when it is spread out among all the trusts it is obviously much less, and everyone is under immense pressure.

'It will also take a lot of resources to train people in the workplace - training is very resource hungry and it takes time.'

At St Pancras Hospital, training of rehabilitation healthcare assistants to NVQ level 3, has already begun. A one-year programme, now in its second year, of on-the-job training, it includes modules on both physiotherapy and occupational therapy.

Ms Hackett said: 'We decided we needed more vocational training to develop a more enabling rehabilitative approach by all staff working on the wards. We have a clinical specialist in older people at superintendent III grade, and are about to appoint to a rehabilitation consultant nurse post.

'Currently we are developing two community rehabilitation teams for older people. These teams will deliver an integrated model of rehabilitation working with social services staff and acute services staff to focus on patient needs. This is joint therapy in its true sense.'

Ms Hackett has no doubt that dedicated intermediate care beds, with a strong emphasis on rehabilitation, will benefit patients enormously.

'Older people - as we all do - need help and encouragement and they need to hear the same messages from all members of a service. They also need time, and acute trusts just haven't got this. Intermediate care and rehabilitation services are designed to give patients the opportunity to regain their maximum independence.

'For some people this will be a big cultural change, requiring new skills and different ways of working. This is a challenge that therapists have recognised for some time and embrace.'


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The Chartered Society of Physiotherapy is the professional, educational and trade union body for the country's 35,000 chartered physiotherapists, physiotherapy students and assistants. Physiotherapy is Britain's fourth largest health profession after medicine, nursing and midwifery.


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