We can help tackle inequalities

Physiotherapist turned public health director Edward Kunonga says physios could do much more to bridge widening health and life expectancy gaps

Healthcare systems across the globe are struggling to deliver the Triple Aim: improve health outcomes and patient experience; maximise  health gains with limited finances; and improve quality of services. 

In the UK, the approach has been articulated in the NHS Five Year Forward View and subsequent NHS Sustainability and Transformation Plans. As physiotherapists we have a lot to contribute to this agenda, but we need to become more engaged.  

The biggest challenge in area of Middlesbrough and Redcar & Cleveland is improving the length and quality of life of residents – especially in the most deprived areas. Improvements in life expectancy at birth, and healthy life expectancy, have stalled and the latest data show a downward trend. 

Alarmingly the life expectancy gap between local people and the national average is widening. Approximately one third of all deaths in our area are in people under 75, most from deprived wards. The major causes of these deaths are cancer, heart and respiratory diseases, suicide and drug misuse. 

Physiotherapists have a role to play in the prevention and management of these conditions. We are working closely with physiotherapy colleagues on initiatives such as ‘prehabilitation’ for pre-surgical conditioning and optimisation, and rehab programmes for cardiac, pulmonary, stroke and diabetes patients. We are also working with Sport England’s local delivery pilot programme to improve physical activity across our area. 

As part of the cancer survivorship agenda, we are working with the oncology team to develop support programmes.

The growing interest in the prevention, reversal and effective management of long-term conditions is an area in which physios have worked for a very long time. Physiotherapists must engage with their local health and social care systems and public health departments. The  clinical work they do needs to be made more  visible and recognised. This may mean expanding our knowledge and skills to build on our solid clinical background. 

Recently, I sat the British Society for Lifestyle Medicine’s diploma in lifestyle medicine, one of the first cohort to be certified in the UK. 

I was delighted that other physios passed too. Much of the learning material covered familiar territory and allowed me to build on my experience. I would encourage colleagues to consider becoming part of this movement, which  is gathering momentum.

There are other opportunities to be involved in leadership, system redesign and transforming healthcare, and we need to grasp these and play our part. Physios have a lot to offer to meet the challenges the NHS faces. Will you step up to the plate?

  • Edward Kunonga is director of public health at Public Health South Tees, a joint service between Middlesbrough and Redcar & Cleveland

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