Your chance to influence

NHS England’s Long Term Plan includes some encouraging commitments for our profession but their success depends on your involvement, says Karen Middleton

Karen Middleton: your chance to influence

The CSP works on behalf of all its members, wherever you live or work, but I make no apologies for focusing this column on the Long Term Plan for the NHS in England. To be honest, many of the policy directions set out in the plan for England, simply serve to ‘catch up’ with those in the other three countries and being a UK body means there is the potential to learn across all geographical – and any other – boundaries.

The plan was published a few weeks ago and I was delighted to see our two big strategic objectives feature so highly: first contact physiotherapy and rehabilitation in all its forms. 

There are numerous mentions of physiotherapy and some specific physiotherapy workforce pledges too (more details on page 8). For me, so much in the plan about physiotherapy is a clear vindication of the way my teams have been working to influence at the highest levels, in partnership with many members, using robust data, case studies, evidence and influencing skills. There was also a large dollop of good timing. Such success does not come quickly and really serves to illustrate the importance of strategy and sticking with it.

The plan makes very clear, however, that it balances ‘national direction with local autonomy’ for implementation. With such a huge geography, there is clearly room for considerable variety in how the plan is implemented... this is where you come in.

If you are based in England, it is imperative you find out who is leading the local implementation and who is influencing that person. Do not wait for instruction or an invitation, get emailing and calling. Do not assume others know what is happening – they probably don’t, so it is imperative you are armed with some specifics you want to help on. Help is the key word – offer it. This work will be a local collective effort and you need to be part of that or it is unlikely implementation will happen. 

We are already seeing some local plans being developed where any mention of rehabilitation, of first contact physiotherapy and every other reference to the national direction is forgotten. I hope the AHPsintoAction work will help but I cannot stress enough how important it is for you – yes, you – to get engaged. There isn’t someone else in another room who will do it for you.

This really matters.  

We have an exciting policy platform to build on now that aligns with our priorities, so to waste it by not influencing locally would be a crime. Think of all the patients who will not benefit if we don’t get involved now. Anything not in the Long Term Plan will be deprioritised and you don’t want that to be your service. This takes courage, I know that. You won’t know what you’re engaging with or how much time it will take, even if you have the skills or expertise to make it work, but you will know more than a non-physiotherapist. Transfer those skills you apply in other situations when you are not sure. Align yourself with someone in a similar position or a fellow member and go to it together. The CSP is there to help every step of the way. We have been preparing for this situation for a while and the teams here are ready. I have written to all the Sustainability and Transformation Partnership leads to offer our support and to outline where physiotherapy will make a difference, and that support is there for you too. Just contact our engagement team at This could be a once in a lifetime chance to change the face of the NHS in England through the offer physiotherapy and physiotherapists can make. Don’t waste it.


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