NHS England Long Term Plan - reaction and analysis

Following the launch of NHS England's Long Term Plan on 7 January 2019, the CSP will be posting updates as we take an in-depth look at what the plan means for the profession and patients.

15/01/19 | FRONTLINE

NHS Long term plan for England - reaction from the physiotherapy profession

CSP Fellow Sally Singh, professor of cardiac and pulmonary rehabilitation at University Hospitals of Leicester NHS Trust, said:

It is great news, and very exciting, to have both cardiac and pulmonary rehab services endorsed and recognised as being important and part of this ten-year plan.
The plan identifies and confirms cardiac rehabilitation as an important intervention for patients with cardiovascular disease.

In addition, it sets out a target of providing cardiac rehab to 85 per cent of those who are eligible, which is quite an ambitious target, so we are obviously going to have to work hard to achieve that as part of a broader, multidisciplinary team.

But it’s good to see that it has been recognised as a valuable intervention for those groups of patients.

Read the statement in full and more member reaction.

11/01/19 | ROBIN HINKS

Respiratory and cardio-vascular rehab - potential for nationwide expansion

The NHS England Long Term Plan contains strong commitments to improve rehab for respiratory and heart health and stroke.

The imperative of expanding rehab provision was core to the CSPs submitted evidence so that many more people who would benefit from rehab are able to access services.

The plan says that pulmonary rehab should be offered to all eligible COPD patients (currently only a minority are referred) and that eligibility should be expanded to include those with less severe symptoms.

It talks about expanding pulmonary rehabilitation services to better meet need, using a population-management approach to find eligible patients who have not previously been referred, and further developing digital tools for rehabilitation and self-management.

It has an ambition of scaling up and improving promotion of cardiac rehabilitation to be amongst the best in Europe.

It recognises the potential value of generic pulmonary and cardiac rehabilitation progammes being combined (using evidence submitted by the CSP) and commits to ‘test and learn’ demonstrators of this to establish the evidence base. 

It commits to more integrated and high intensity rehab outside of hospitals for the first 6 months and beyond – looking for improvements by 2020 and full roll out over the next 10 years.

Over the coming days the CSP will be talking to leading members in these fields, charities and other professional bodies to plan how to make the most of this exciting opportunity for the profession.

Robin Hinks – Research and Policy Officer at the CSP.


A big step in the right direction for digital and data

Although not offering detailed solutions to some of the digital challenges identified, the NHS England Long Term Plan contains many encouraging promises for all those CSP members keen to embrace technology, improve their data and explore different ways of providing digitally-enabled services.

The plan acknowledges how far behind healthcare has fallen in terms of tech, but demonstrates a real ambition to catch up.

It recognises the need to get rid of the burden of ‘bad tech’, and a commitment to provide those working in the community with digital devices over the next 3 years.

It promises everyone will have a digital personal health record in the life of the plan, giving people access and control of their health record. Pelvic health physios are promoted as part of maternity MDTs, and will be contributing to electronic maternity notes.

There are commitments to improve patient access to services – from 2019, NHS 111 will start direct booking into GP practices, for example.

There is investment in the digital leadership of the NHS – through expansion of NHS Digital Academy, informatics leadership representation on board of every NHS organisation, and increased workforce training in digital capabilities.

There are commitments of support for innovative clinicians to develop tools to support people to self-care and to enhance services and to help these to be adopted at scale – speeding up the path from innovation to business as usual.

Poor data and poor technology have been holding back many areas of physiotherapy from delivering their potential – particularly services in the community. 

The NHS England Long Term Plan offers ‘permission’ for all of us to do something about this, and is a call to action for CSP members and staff. 

Euan McComiskie is Health Informatics Lead at the CSP.


FCP Case Study: The Deepings Practice, Lincolnshire

Watch NHS England's video featuring Dr Majid Akram and physiotherapist Phil Richards discussing how the successful implementation of FCP has resulted in better outcomes for patients and helped to reduce GP workload.

8/1/2019 | CSP POLICY TEAM

First Contact Physiotherapy: centre stage

For the last three years, the CSP has been campaigning across the UK for the development of First Contact Physiotherapy roles in primary care – where people with an MSK problem can opt for a consultation with an advanced practice physio rather than their GP, through contacting their practice.

In England, this has resulted in large scale FCP pilots being established – one in every STP area. The Long Term Plan for the NHS in England put this programme centre stage and committed to its continuation as part of its new vision for integrated primary and community services.

The plan says:

We will build on work already undertaken to ensure patients will have direct access to MSK First Contact Practitioners (FCP). 98% of STPs have confirmed pilot sites for FCP and 55% of pilots are already underway. We will expand the number of physiotherapists working in primary care networks, enabling people to see the right professional first time, without needing a GP referral.

Most importantly, the plan prioritises an increase in physiotherapist posts as part of the primary care workforce, necessary to establish first contact physiotherapy roles as part of mainstream services.

The workforce implementation plan will continue recent provision for a range of other roles – including pharmacists, counsellors, physiotherapists, nurse practitioners – building on the success in expanding these numbers by nearly 5,000 over the past three years – and hence building the skill mix to relieve pressure on GPs... Initially, this will focus on clinical pharmacists, link workers, first contact physiotherapists and physician associates.

The next steps for the CSP will be to continue to support FCP implementation, and using the commitments in the Long Term Plan to push for these to be properly resourced in terms of funding and staffing numbers.

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