Your comments: 16 March 2016

Here are your comments on topics covered in the last two weeks. We look forward to hearing from you.

Rugby injuries

I was disappointed to read the recent open letter in the media asking the government to ban tackling in school rugby. It garnered a lot of attention, but has been widely condemned by the rugby community and is unlikely to improve player welfare. 
Instead it has diverted attention away from the important issues. As a part-time referee and vestibular physio I keep a foot in both camps. In a Frontline article in 2014 I expressed reservations with the in-match protocols for concussion.  
In a recent Six Nations game against Wales, France’s Antoine Burban was allowed back on the pitch following concussion and displaying a worrying fencing response. If there is enough doubt to perform a head injury assessment, this should always result in a permanent replacement.
As a referee, I frequently need to insist on players not returning to the game. Who can blame players and coaches when they are responding to what they see on television?  The current protocol creates a means by which players can return and sets a dangerous precedent. In practice, it does more harm than good and this is why it must now be reconsidered. 
The annual conference of the Association of Chartered Physiotherapists in Vestibular Rehabilitation (ACPIVR) takes place on 23 April with international experts on concussion. I encourage as many people as possible to attend. 

Guide launched

The article ‘A foot in both camps: clinical and academic careers’ highlighted the Health Education England and National Institute for Health Research (NIHR) Integrated Clinical Academic (ICA) programme for non-medics. 
It mentioned that the NIHR was planning to publish a guide for managers on the value of clinical academic careers. This has now been published.
It can be challenging for physiotherapists in the NHS to develop clinical academic careers (combining clinical practice with research) with the support of their managers. This NIHR guide has been designed to help with that. It will help to inform the questions both should ask when considering such a career and an application to one of the opportunities the NIHR offer. These opportunities are laid out here
  • Caroline Alexander NIHR senior clinical lecturer and NIHR physiotherapy advocate, Imperial College Healthcare NHS Trust, London

A better way

I read ‘A foot in both camps’ about combining roles in research and practice. Rather than settling for the current inadequate NIHR clinical academic pathway, physiotherapists should be pushing to have the same pathways and privileges as medical staff. 
Currently, the NIHR clinical academic pathways are only on offer to physios with a wealth of experience and individuals have to apply for specific NIHR funding in their spare time, as there is no clinical academic pathway set up for physiotherapists as part of regular career pathways in the NHS. 
Physiotherapists still have the traditional banded career pathways, which limit their ability to do anything other than clinical work. Those who are interested in academic work, such as research, often have to leave the NHS to work for a university, which means the NHS loses high-quality members of staff. 
Medical staff have opportunities to undertake a clinical academic career straight from qualification, being able to work in universities on research as part of their foundation rotations. They then enter a clinical academic pathway which allows them to work in areas of research rotationally and to have time to apply for funding to do their own PhD or MD. 
After completing their PhD they can then return to their clinical academic pathway training and have further time to apply for post-doctoral fellowships, and eventually professorships (or consultancy). 
It seems that career pathways for other health care staff (such as allied health professional and nurses) are a long way from having the same flexible approach and that medical staff have more opportunities to progress both clinically and academically. 
  • Sam Stuart, clinical ageing research unit, Institute of Neuroscience, Institute for Ageing, Newcastle University

Let’s connect

I recently became a regional CSP steward, and started attending national meetings. As well as addressing topical issues such as national recruitment problems, we also discussed motions for the Annual Representative Conference and met Catherine Pope, the new chair of Council.
This opened my eyes to the workings of the CSP, most importantly ensuring that all members influence CSP actions. I have met many resourceful individuals, devoting chunks of their own time, in addition to full-time clinical roles, to represent members in their region. 
This has shown me a high level of member engagement. Members have so much potential to influence, but only if they choose to use it. Contacting your local steward is a great way to start.
  • Phil Gordon, CSP North West regional steward
Frontline and various

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