NICE consultation on arthroplasty: CSP seeks clarity on a technicality which may affect best use of the workforce

The National Institute for Health and Care Excellence (NICE) is consulting on proposed new guidelines for care following primary joint replacement of the hip, knee and shoulder.

The CSP will be seeking clarity over the wording within recommendation 1.10. Photo: Nathan Clarke

The consultation closes on Tuesday 26 November.

The CSP is encouraging members working in these areas to consider recommendation 1.10 which relates to post-operative rehabilitation both in hospital and afterwards.

The recommendation cites ‘physiotherapists’ instead of physiotherapy teams as a key workforce providing rehabilitation, although there appears to be an assumption in the evidence that the title ‘physiotherapist’ includes support workers at NHS band 4.

Effective workforce deployment

‘Whilst subtle, the wording could significantly impact effective deployment of the in-patient physiotherapy workforce and influence a patient’s ability to access post-operative rehabilitation if changes are made to services,' said CSP professional adviser Pip White.

‘The CSP will be seeking clarity over the wording within recommendation 1.10 and its evidence. 'It must be clear that physiotherapy includes provision by both registered staff and higher level support workers.'

Inpatient care

CSP professional adviser Claire Fordham said: ‘Many patients following elective hip and knee replacement are triaged to a higher level support worker for their inpatient care, so careful use of language is required.

‘The CSP would want to ensure that there are no unintended consequences to this established, safe and successful approach to workforce deployment in this context.’

Ms White added: ‘Self–directed rehabilitation is an important part of recovery for all patients.

Community rehab

‘Community rehabilitation is a core focus of the CSP’s current work and effective rehabilitation for all enables people to achieve their potential and enable people to live lives as well as possible.

‘The CSP want to ensure that all patients can continue to access physiotherapy-led rehabilitation after hospital to ensure they meet their rehabilitation goals.’

The CSP will be submitting a corporate response to NICE.

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Contact your professional network for example ATOCP, AGILE and ATACP, who will also be responding.

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