Specialist, generalist or versatilists?

  • Natalie Beswetherick considers what might be required of the physiotherapy workforce in the future
Natalie Beswetherick
Natalie Beswetherick CSP’s director of practice and development

For decades the physiotherapy workforce has to a large extent comprised specialists and generalists. Like many health professions ours has followed the medical model of hospital-based specialists and general practitioners in primary care. But does this model fit with the population, living longer but with more years in poorer health, and with multi-morbidities? 

The adult population is 20 per cent

less active than in the 1960's

The Office for National Statistics population predictions show that there is a growing number of older people in the UK. In 2018 there were 1.6 million aged 85+, by mid-2043 it’s predicted to be three million. The number of people of pensionable age is also projected to increase the most over the next 20 years. The years spent in poorer health by the ageing population continued to increase in both men and women between 2011 and 2018. Important to remember that these projections pre-date Covid-19. 

The emerging picture of the impact of Covid is that the virus affects multiple systems. Not just the cardio-respiratory system but also the neuro-musculoskeletal, vascular, and endocrine, with fatigue, extensive de-conditioning, breathlessness, muscle pain, and cognitive impairment all being significant symptoms. 

This means we need a workforce that comprises versatilists who have breadth and depth of knowledge and experience of managing the complexity of multiple long term conditions. 

This does not mean we won’t need specialists and generalists, we will, but we do need more versatilists. Physiotherapists working in the community with older people, children, adults with learning disabilities and mental health problems are the versatilists in the workforce. 

You have the breadth and depth of knowledge and skills to deal with the complexity of conditions that affects multiple body systems. 

We need you to showcase to the whole profession the value that your versatility brings to meeting current and future population needs. 

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