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Physios and OTs crucial to 7-day NHS

Tagged In:  NHS, Physiotherapy

Many physiotherapists and occupational therapists already provide weekend emergency cover. However, drawing further on their expertise, both in hospital and community settings, could help deliver David Cameron's vision for a true 7-day NHS. 

The recent establishment by Belfast Health and Social Care Trust of an Acute Care at Home team has highlighted the vital role that allied health professionals such as physiotherapists and occupational therapists can play in realising the Government's vision for 7-day NHS services. The 40-strong team, which includes three full-time physiotherapists, works in the community to help older people manage a range of conditions, with the aim of reducing the number of A&E visits and hospital admissions.

Belfast Trust's Assistant Physiotherapy Manager, Barbara Walker, commented, "It's a really exciting development with physiotherapy and nursing working over 7 days alongside the consultant and GPs to manage the full requirements of acutely ill patients in the community."

7-day working for physiotherapists was being discussed long before David Cameron announced his plans for a 7-day NHS in May last year. In 2009, Cardiff and Vale University Health Board recruited 6 extra physiotherapists to trial a weekend and evening service for acute medical patients, resulting in improved response times and a reduction of 1.5 bed days per patient.

It was in Everyone Counts: Planning for Patients 2013/14 that the aspiration for a 7-day NHS was formalised by NHS England. This led to the creation of the Seven Days a Week Forum, led by Professor Sir Bruce Keogh, with a remit to give all NHS commissioners the 'evidence, insight and tools they need to move the NHS towards routine services being available 7 days a week'. 

In its evidence base report, the Forum emphasised the importance of multidisciplinary working in the care of patients with complex clinical presentations: "Where early medical or surgical assessment is supported with input from care professions including nursing, physiotherapy, occupational therapy, speech and language therapy, pharmacy and social care, a management plan can be implemented that addresses all of the patient’s care needs up to and including preparation for their discharge."

Following the Prime Minister's speech, the Chartered Society of Physiotherapy (CSP) issued a detailed briefing note to encourage discussion and highlight the positive role that physiotherapists can play in 7-day services. "We support the view that physios can provide value to patients 7 days a week," said Steve Tolan, the CPS's Head of Practice. "But it's important to understand and manage how this is operated."

The briefing note includes a number of case studies which show how trusts have benefited from 7-day working by physiotherapists. For example, Newton Abbot extended its stroke rehabilitation services from 5 to 7 days, resulting in the average length of stay being reduced by 2 days. In South Tees, physiotherapy teams provide an equitable 7-day service across all surgical specialities, also resulting in an average 2-day reduction for in-patient length of stay. 

At the Heart of England Trust, the Therapy Directorate (physiotherapy, occupational therapy and speech therapy) has provided 7-day services across three hospitals since April 2011. The weekend service, delivered by 45-50 therapists, speeds up discharges and has also been judged to improve clinical safety by ensuring senior staff are available at all times.

'Physiotherapy should not be seen in isolation, but as part of an integrated 7-day service pathway," concludes the CSP. It's a view which echoes Mr Cameron's. "Here's our vision," he said, "Prevention, not just treatment. Tackling causes, not just symptoms. Treating the whole person, not just an individual ailment."

Nobody is better placed to help achieve this vision than our highly skilled workforce of allied health professionals.

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