Physios in all parts of the UK must market their services in new ways if they want to survive. Graham Clews reports on the changing agenda.
Invisibility is not an option. That is the message to physiotherapy staff across the UK as the NHS, and healthcare more widely, experiences massive change.
Advice from the CSP tells physios in all corners of the UK, and at every level of seniority, that they must be proactive about showing how their skills and services make a difference and change patients’ lives.
The new clinical commissioners that are emerging as part of the ongoing NHS reforms in England, the introduction of the any qualified provider (AQP) system, and the consequent likely wider involvement of the private sector all mean that marketing must be pushed higher up physiotherapy’s agenda.
This issue is particularly high on the agenda in England, where the AQP system being introduced from this month means that local lists will be drawn up of providers deemed able to offer a particular service.
Any qualifed provider
As there will be no restrictions on the range of professions that can deliver these services, it won’t, for example, only be physios who appear on the local musculoskeletal (MSK) services list.
The list could contain private firms, charities, and other providers such as chiropractors and osteopaths, as well as existing NHS organisations. Patients will be able to choose any provider from that list for their treatment.
Local commissioners have been asked to put forward at least three areas within their community or mental health services where AQP will be implemented from this April. So this won’t only affect MSK services.
The CSP briefing on AQP tells any physiotherapy service wanting to go through the AQP process that it must meet four criteria: be responsive to patient and population need; represent value for money; be cost effective; and be clinically effective.
To convey this information, physios will have to understand the four ‘Ps’ of marketing: product; price; place; and promotion. And to conduct formal marketing, they must establish the following: what they want to achieve, when they want to achieve it, who they must talk to, and where to position their service.
The CSP has put together a series of web pages that will help physios begin to market their services, giving them some introductory tips and offering some useful templates (see further resources section). Some services have, however, already given themselves a head start.
Allied health professionals (AHPs) working in north east England are developing their own ‘brand’ to ensure commissioners and providers know exactly what AHPs are able to provide.
Lindsay Courtney, chair of the North East Allied Health Professions Collaborative, says commissioners want to know what AHPs can offer as a whole, and they need a ‘front door’ through which individual AHPs can be accessed.
The collaborative is promoting its brand under the title ‘Back to Health Back to Life’, and a simple-to-understand document has been produced to market what can be complex and multifaceted services to a wide audience.
Ms Courtney says her team initially produced a ‘traditional’ 10-page document to market their services, but soon realised it was couched in ‘AHP-speak’ and that a fresh approach was needed.
The local special health authority communications team stepped in and took the message back to basics.
‘They got about 10 of us in a room and asked us some really challenging questions about what we wanted to get across,’ she says.
‘We needed something visual and simple, and that is what has been produced. The content is all our own, but the communications team were a huge help in how it was presented.’
The Back to Health Back to Life leaflet has now been distributed to all local clinical commissioning groups, and to NHS foundation trusts and other providers. Ms Courtney says the providers who design the services need to be aware of AHPs’ potential contribution as much as the commissioners.
The MSK outpatients department at Addenbrooke’s Hospital in Cambridge has also produced an early example of a clear and unambiguous guide to exactly what services it can provide.
Crucially, the department’s web page includes information on how patients can access the outpatient service. It tells patients that they can ask their GP to refer them through the Choose and Book system, and it also instructs patients how to self refer.
The web page cleverly uses snippets of glowing praise from the department’s most recent patient satisfaction survey to show how happy many patients are with the treatment they received.
The CSP suggests that the volume of referrals will be the key to success for provider organisations under AQP.
It recommends that marketing opportunities should be supported by excellent patient information; developing strong relationships with commissioners, health and wellbeing boards, and patient groups.
Andrew Walton, managing director of Connect Physio Health, says physiotherapists need to rethink their relationship with marketing in a fundamental way.
‘With the greatest respect to physios, they don’t really know what marketing is,’ he says.
‘Everyone tends to focus on developing good clinical services - and there’s obviously nothing wrong with that - rather than marketing their services because they don’t understand it.
‘But osteopaths don’t shy away from it, chiropractors don’t shy away from it, and that is why they are moving into our space, as it were.’
Connect runs four physio clinics in the north of England, and provides physiotherapy as part of a tie-up with Lloyds Pharmacy in two ‘health villages’ in shopping centres in the south.
The firm has a number of corporate contracts to provide occupational health physiotherapy, and it has secured contracts with 10 primary care trusts.
Mr Walton says physios need to understand both provider marketing and demand marketing. They must meet informally with GPs and commissioners, network through the CSP, look at other health professions, and even learn from other industries on how they share information.
To market on the demand side, physios need to know what patients and commissioners want and this can involve some very hard decisions.
‘It’s all very well doing patient satisfaction surveys, but do you ask the uncomfortable questions, are you asking the people who aren’t accessing services?’ he says.
‘And when you have the data it’s no good putting in the too-difficult-to-deal-with pile.’
CSP treasurer Sue England established her private physiotherapy clinic in Stratford-upon-Avon more than 25 years ago.
In that time she has never advertised, other than as part of a national awareness-raising exercise, such as Move for Health.
‘In the private sector at least, you are only as good as your last ten patients, and that’s probably something the NHS could learn from,’ she says.
‘It is all about world of mouth and the service that you provide to your patients’, she says.
A self-confessed ‘Luddite’, Ms England accepts that social media can be harnessed to generate business, particularly as it can air patients’ own recommendations, but the key to successful ‘marketing’ is the patient’s experience, she says.
‘A lot of my patients don’t even know I’m a physio when they first arrive, despite it being plastered everywhere. All they know is that I have been recommended by a friend, and that is good enough for them.’
Developing the clinical excellence that produces such recommendations takes constant hard work, and the marketing that will be needed to spread the word will also not be easy.
Mr Walton says: ‘Physios will have to invest a lot of time and effort if they are going to market themselves successfully.
‘They could just run off a patient satisfaction survey and produce a nice leaflet and then pat themselves on the back, but that isn’t going to work.’
There is no commissioner and provider split in the Scottish NHS.
Local delivery plans are considered the performance contract between the Scottish Health Department and the 14 regional health boards and seven special boards that cover the country.
The Scottish AHP delivery plan proposes a radical shift of rehabilitation services to a primary and community setting, which will require physiotherapy to promote its role and value to new audiences.
Although there is no internal market in the NHS in Wales, in local government-funded services the commissioners and providers are separate.
Therapists working in local government already have to operate in the market model, and where health and social services are increasingly working together there will be implications for physiotherapy provision, such as in reablement services.
Five local commissioning groups take the key commissioning decisions for the country’s health service, in conjunction with the country’s health and social care boards.
Uniquely in the UK, health and social care services are jointly commissioned.
There are currently 17 primary care partnerships working as loose GP federations, with the intention that all GP practices will join one of these networks. Integrated care partnerships will also be established to help design integrated health and social care across Northern Ireland.
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