3 minutes: Sandra Harding setting the gold standard

Sandra Harding used to manage a large private healthcare physio team. Now she audits physiotherapy processes to make sure they are the best.


What motivates you? 

Put simply, it’s the desire to educate and to prove how beneficial physiotherapy can be to the widest possible audience. In the words of Sir Bruce Keogh, cardiac surgeon and medical director of NHS England, ‘Rehabilitation is central to the way that we deliver our health services.’ I truly believe this. I am driven by the desire to be part of a movement illustrating that we are a service that can evidence both our outcomes and processes; one that can reassure the public that when they see a physiotherapist they are in safe hands. 

Why are regulations and standards important? 

They highlight areas that need clear process and evidence. By stating the expectations of the regulatory body/stakeholder/contractor and making the process transparent and clear for all users, regulations should help to mitigate risk, enable cross comparisons and assist in benchmarking services. It is very important that the service we deliver is fit for purpose and that those involved are aware of their professional and legal obligations. 

How did you ensure BMI Healthcare physios passed muster? 

In managing the physiotherapy service for BMI Healthcare, we developed a governance structure involving every member of the team, one that encouraged collaboration and learning between 59 sites and more than 750 physio staff. 
We standardised processes to enhance this. Training was provided to support and develop staff. Audits of departments and staff against internal and external requirements were mandatory for managers and they were all supported through the process. New managers had experienced ‘buddies’ to help them. Regular regional and national meetings and calls were held to discuss any issues and an open culture existed with departments encouraged to share and learn from each other’s experiences. I resigned from BMI, finishing at the end of April 2017, as I was ready for a new challenge and was leaving a service that was well-structured and highly respected. 

Give us three tips 

To develop a service to meet standars and regulation initialy you need to:

  1. Be self-aware. There are many ways to get people to understand why regulations and standards are important. Understand their motivationand be aware that delivery of the message is crucial. 
  2. Listen to, and understand, people’s concerns – you need to engage your team so they want to do this, rather than seeing it as ‘I have to do this’. 
  3. Be passionateand desire your service to be the best it can be. If you don’t feel it and believe it, and want to be able to evidence it, how can you expect others to do so?  

What’s your new role? 

I’m doing consultancy work in the clinical operational sector while I’ve been creating a new business. Research showed me, and a former colleague that the physiotherapy service often evidences clinical outcomes (front of house), but the focus on process excellence (back of house) is often less robust. 
Sarah Tribe, my business partner, and I love physiotherapy and have each spent 30-plus years in it. We realise it needs more process evidence so we set up PAL (Physiotherapy Audit Limited), a business that supports services to do this. 
We use our electronic tool to audit physiotherapy processes, then produce an action plan and a task manager. This reminds the service to gather evidence to meet any gaps. We provide bespoke support throughout, then re-audit and produce another report. These become a portfolio of process evidence to illustrate your service for tenders, inspections, membership requests and so on. 
Physiotherapy has provided us with fantastic careers. This is our way of helping others to promote their service – and it’s us giving our experience back. 

How do you relax? 

I look after our menagerie, cook and have great family time. I consider myself very lucky.
Sandra Harding

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