Health inequalities: tailoring patient care

Addressing health inequalities, and shaping services around the communities physio serve, is vital if the profession is to meet patient needs. CSP assistant director Ruth ten Hove reports


Across the world physiotherapists and rehabilitation services are entering a period of scrutiny and change. Given the ageing population living with more complex needs and facing increasing health inequalities, traditional models of rehabilitation and workforce configuration that focus on a single diagnosis or condition find themselves needing to focus on modernisation. 

Waiting lists, long stays in hospital and escalating demand for emergency services highlight the increasing demand for rehabilitation services, particularly within the community, that can meet people’s current needs. 

Transforming services 

At the same time, these services face increasing financial challenge, with the imperative to do more with less. Population and local service data demonstrates that systemic inequalities impact communities who face barriers to access. 

These challenges and the opportunities they bring are reflected in the ambition of the CSP five-year strategic plan, across four main areas of work. We want to enable members to use the best available evidence to transform services, to improve population health and reduce health inequalities; and to use this evidence to guide clinical decision making, research and leadership. 

Sharing knowledge 

Last year we gathered insight from members to understand their knowledge and confidence to apply improvement approaches to address health inequalities. Our results highlighted a wide variation in members’ knowledge of health inequalities and confidence in addressing it in practice. More importantly, solutions were not confined to resource development, but also addressing the thinking time and headspace members need to bring about these critical changes. Members also told us that our development work needs to be co-designed, easily accessible, useable, scalable and impactful. We will build on this in our upcoming case study series where we showcase some of the great work members are already leading on. 

Indeed, our second focus – following gathering this insight – is on dissemination and knowledge mobilisation, bringing together best practice examples and cutting-edge research and innovation at the CSP 2024 Conference. The theme – ‘Rehabilitation transforms population health’ – will provide many opportunities to understand the issues and build engagement and learning with peers. Sessions will also enable members to explore the need for urgent action and policy change to improve population health and implement measures that help people to make healthier choices. 

Using data 

Our third focus is on the importance of data. Last year the team worked with Keele University, subject matter experts and all the AHP professional bodies to develop an introductory course on informatics for members. This will enable physiotherapists to collect, use and share data that demonstrates the impact of service redesign, improvement, and transformation. These resources are currently being finalised and will be shared in 2024 when they are launched by NHS England.

Preparing the next generation

Our final focus is on our role in the accreditation of university programmes, so that we can prepare a modern clinical workforce to serve the population. This year sees a major review of the current undergraduate curriculum, which will involve working with all universities and key stakeholders. It is so important that the graduating physiotherapy workforce can deliver the best care for people who are older, have more complex needs and present with increasing health inequalities.

Our ambitions are for this strategy to be a catalyst in transformation, so that rehab can be understood and valued through a population and prevention lens, to be embedded as a key solution to many of the really challenging problems that our health system today faces. 

We want to see people kept well and at home, enabled to return to work, to streamline pathways of care across the system and address the longstanding inequities within the system.

Finally, our approach to how we work needs to be aligned and strengthened with a commitment to giving the people who rely on physiotherapy services a voice in how they should be re-imagined, delivered, and sustained. 

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