Congress 2006 - Costs and benefits of services must be demonstrated

Physiotherapy services will not be commissioned unless they can produce tangible results and their costs are known, service managers were told at Congress.

The stark message about the current situation in the NHS came in a session jointly run by the Association of Chartered Physiotherapists in Management and the CSP. Karen Middleton, health professions officer at the Department of Health told physiotherapists they must understand that the government's reform agenda was not going to go away. Ms Middleton said: 'Reform is going to get faster rather than slower I am afraid. We have got to do a lot more to demonstrate our effectiveness and efficiency. People like yourselves focus on the provider side of reform but please do focus on the commissioning and demand side. Good quality care probably saves money and you have got to get that message across.' Ms Middleton said although there were great examples of service redesign around, the costs and benefits of services were often not known. She said: 'Sometimes I find it quite scary how little service managers know about their services.' However, she said allied health professionals were 'in a very, very good position in terms of this reform agenda. It is about rehabilitation, it is about preventing readmissions and getting people out of hospital faster.' Ms Middleton's messages were echoed by NHS North West chief executive Mike Farrar, who said that in terms of providers 'you have to compete for the right to provide care.' However, Fiona Jenkins, head of physiotherapy in south Devon, told the session that even where innovative services had been developed they could be threatened by the payment by results system. Ms Jenkins said such a service for stroke patients in her own area was threatened with closure because it didn't fit the new financial system. To loud applause she said: 'What the Department of Health is doing to us will kill patient care.' During her talk, Ms Middleton told Congress the amount spent on agency physiotherapy staff last year was £74 million. This is almost exactly the sum the CSP calculates has been wasted on training physiotherapy graduates who have not been able to find jobs this year.

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