The implementation of physiotherapy programmes in a secondary special school

Purpose

After assessment and /or review, young people in education settings are provided with physiotherapy programmes for activities, participation, and use of equipment. These activities are supervised by, or carried out by the school staff.

In the context of a special school, this information is described within the Education, Health and Care Plan (EHCP), and also classroom programmes.

The evaluation had two main aims: to assess the extent of implementation of the programmes, and to identify reasons why implementation may not have been carried out. The need for an evaluation arose from multi-agency discussions between the school management team and therapy staff.

Approach

Following discussions with the school Management Team and Care Team, it was decided to carry out a survey in which school staff would record the physiotherapy activities carried out each day.

The record sheets used corresponded to the physiotherapy therapy programmes, so a tick or cross could be used to show if an activity was done or not, with a box in which to record any reasons for it not being done. The survey was carried out over four weeks.

The returned forms were analysed, and the results summarised and fed back to the school management and care team, and therapy service staff.

Outcomes

The main findings were:

A low return rate of 50% of the forms (due to a variety of practical/operational reasons).

Useful information from those returned, including:

 

  • Good rates of carrying out certain activities, especially relating to postural management, and use of functional walking frames
  • Lower rates of use of equipment, such as standers and therapeutic walkers
  • Variation in implementation of programmes between class groups
  • High rates of pupil absence (mainly due to health reasons)
  • Other practical reasons for activities not being implemented: e.g. specially trained staff not available (particularly for rebound), or insufficient staff.

 

Useful information was gained, even though it was from a limited number of responses. Activities which had more 'success' in implementation were identified, and areas for improvement were shown.

Many reasons for non-implementation were practical: some were unpredictable, while others could be planned for and /or avoided.

Overall, it was found that many pupils were not be taking part in the recommended activities, or not doing so at the suggested frequency. This therefore means that the expected outcomes and benefits may not be achieved. The school also has a responsibility to implement the activities which are recommended within the EHCP.

Implications

Physiotherapy advice and programmes are provided but were not always implemented. The information obtained was useful in showing practical factors to be addressed to improve implementation. This is necessary, so that the pupils can benefit from taking part in the therapy activities, and also due to the legal requirement for provision.

Comparison within the same school at a later date, or with other schools would be useful in future.

Funding acknowledgements

This work was unfunded

Additional notes

This work was presented at Physiotherapy UK 2019.