This document provides a summary of the consultation findings and a response to the comments received.

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As a result, from 26 March 2013, this AHP Bulletin website will no longer be updated and these pages will be archived by The National Archives (TNA).

We will redirect our website addresses to make sure you can still access the archived information.

For all future updates, please refer to the NHS Commissioning Board

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The theme for this year’s campaign, which runs from 13-19 May, will be physical activity and exercise, highlighting the impact they have on mental health and wellbeing.

More information is available here

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In addition, Karen Middleton reflects on the achievements of the last five years as she prepares to move to her new Chief AHP role at the NHS Commissioning Board.

To read these stories and more, click on the links below.

AHP Bulletin – March 2013

• Voicepiece
• News
• Prescribing
• Recovery, rehabilitation, reablement
• Awards
• Clinical developments
• Consultations
• Informatics
• NICE
• Patient involvement
• Training and development
• Service redesign and improvement

Download the AHP Bulletin, March 2013 edition (PDF, 307 KB)

Gateway reference number: 18866

Disclaimer: Unless otherwise stated, guidance referred to in the bulletin has not been commissioned or endorsed by the Department of Health – it is evidence that organisations and professionals may find helpful in improving practice.  The National Institute for Health and Clinical Excellence is the Department’s provider of accredited evidence and guidance, which can be found on the Institute’s website

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Whilst I can provide some continuity from the old to the new – as will Shelagh Morris, my new deputy – the new role will be different.  While I will still be providing system-wide clinical and professional leadership and advice to the allied health professions, Shelagh and I will be focused more on supporting the delivery of the Outcomes Framework across the five domains through engaging with commissioners, both local and national, to show where AHPs can improve care and add greatest value.

I see this shift as analogous to the journey that AHPs have been on over the last few years where the focus has been on raising the profile of this group of diverse professions as a collective, in order to maximise their influence and contribution to services.

This work has had four main themes:

• leadership development:  (the Leadership Challenges, the Darzi Fellows, the Clinical Leadership Fellows and all those AHPs now in leadership roles)
• data: (from 1 April the first RTT data flows for all AHP services start, the National AHP Informatics Strategic Taskforce will continue into the Health and Social Care Information Centre and we have a significant rise in the AHP services registered with Choose and Book)
• access: (the Service Improvement Programme, the QIPP AHP Toolkits and Independent Prescribing for Podiatrists and Physiotherapists)
• a flexible workforce (AHP Competence-based Career Framework and the Clinical Academic Career Pathway)

These are just some of the achievements of the last five years and there are very many more local ones – not least, all the regional and local AHP conferences where AHPs share best practice and innovation and really come together as a group.

However, I have always been clear that increased visibility was not the end point, it is simply a vehicle to help maximise the contribution these fantastic professions can make to better quality of care and improved outcomes for our patients.

So now, as I focus on supporting commissioners to deliver against the Outcomes Framework and get down to some really detailed work and specific deliverables, every single AHP must to do the same – work with their local commissioners, be clear about your service offer and how it will improve quality, meet local need, and reduce demand and costs. You must provide them with your clinical and professional advice to ensure commissioning decisions are informed. Being more visible is one thing, – now we need to deliver!

As we lose the links via the SHA AHP Leads, who have played such an important role over the last five years, it is important we all find ways of staying connected. This will take more work on all of our parts. The following people have volunteered to ‘hold’ the networks in each of the four regions until something more sustainable can be developed:

• North – Sue Louth on sue.louth@srft.nhs.uk or Bryony Simpson on bryony.simpson@nhs.net
• South – Beverley Harden. Email: Beverley.harden@hhft.nhs.uk
• Midlands and the East – Helen Marriott. Email: h.marriott@nhs.net
• London – please contact your AHP Fora Chair:
  • Nita Madhani (Redbridge Community)
  • Patricia Hill (Kings College Hospital)
  • Sarah Vernon (Croydon Health)
  • Susanne Selvaduria (Royal National Orthopaedic Hospital)
  • Csaba Barody (Homerton University Hospital)

There are also the other networks:

• AHP Informatics network
• Local area Teams and Clinical Senates
• Rehabilitation community of practice
• Strategic Clinical networks for Cancer, Cardiovascular, Maternity and Children and  Mental health, dementia and neurological conditions.

And, of course, the many different professional networks and informal connections you have all made. I do feel that connectivity will be absolutely vital as we endeavour to share best practice and innovation.

Lastly, I want to share with you something that was said at my interview – ‘It is crucial that every part of commissioning is infected with AHPness’.

I think this says it all!

The contribution our services can make is recognised, we now need to ensure we influence commissioners to commission them in order to deliver the outcomes patients and their families want to see!

*This is the last edition of AHP Bulletin published by the Department of Health. As a recipient of AHP Bulletin, your email address will be transferred to the NHS Commissioning Board, unless you request otherwise. For more information about the NHS Commissioning Board’s planned publications, please contact seth.edwards@london.nhs.uk You can also visit www.commissioningboard.nhs.uk

If you do not want your email address shared with the NHS Commissioning Board, please email ahp-branch@dh.gsi.gov.uk no later than Thursday 28 March 2013.

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Karen said:” I am delighted to be able to provide some continuity to the national leadership of the allied health professions but this is a new role. I will be focused on supporting local and national commissioners in identifying how AHPs can best contribute to the delivery of high quality and efficient services and deliver the very best outcomes for patients.”

Prior to taking up her current DH post, Karen was Health Professions Advisor at the Department, from 2003,  and the specific lead for children and primary care. During this period, Karen completed her Masters in Consultation and the Organisation: a psychoanalytic approach as well as the European Leadership Programme at INSEAD, France.

Earlier in her career, Karen held a range of NHS management posts across the allied health professions, nursing and support services. In 1996, she managed a large user consultation project in Tower Hamlets and went on to develop the Disability Options Team, an inter-disciplinary service for people with physical disability, which gained national recognition. Karen qualified as a Chartered Physiotherapist in 1985 and went onto specialise in musculoskeletal therapy. She became a Fellow of the Society of Orthopaedic Medicine in 1994, and taught at under-graduate and post-graduate levels in both Orthopaedic Medicine and Hydrotherapy.

Shelagh trained as an occupational therapist at the Liverpool School of Occupational Therapy, now part of Liverpool University. She has held a range of general management and leadership roles in the NHS before joining the Department of Health as Allied Health Professions Officer in April 2003.

Her recent work has included:

• service improvement in a range of AHP services including occupational therapy, speech and language therapy, physiotherapy and dietetics to help reduce waiting times and improve access for patients
• independent prescribing for physiotherapists and podiatrists.

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This complements the existing Statement of Fitness for Work used by GPs to determine if patients can remain in work or need to be signed off.

The new report, developed by the Chartered Society of Physiotherapy (CSP), the College of Occupational Therapists (COT), the Society of Chiropody and Podiatrists (SCP) and the Allied Health Professions Federation, enables AHPs to play their part in getting people who are ill, injured or recovering from treatment back to work or prevent them from going off sick in the first place. The Department of Health and Department of Work and Pensions have been involved throughout its development and the DWP has already said it is keen to encourage AHPs to use the Report.

CSP professional adviser, Léonie Dawson, said: “The AHP Fitness Report aims to help people remain engaged with work and prevent the slide into reliance on benefits. It can provide evidence to employers for sick pay purposes and advice on how to help staff get back to work sooner. It is an ideal opportunity for physiotherapists and other AHPs with expertise in occupational health to support people in using work as part of their rehabilitation.”

COT director of professional operations, Julia Skelton, said: “This advisory assessment report will identify how occupational therapists can help someone overcome physical and mental difficulties to return to a productive working life. This will help reduce the costs of sickness absence, support employers and, importantly, improve the health and wellbeing of the working population.”

Sharon Gray, professional and private practice officer, who led the project for the SCP said: “The AHP Advisory Fitness for Work Report will enable podiatrists to advise, following treatment or a procedure, that either their patients should be off work or encourage patients back to work, but with amended duties.”

While people will still require a Statement of Fitness for Work from a doctor to claim ill health benefits, the new AHP Fitness Report provides an opportunity for AHPs to assist GPs, employers and patients.  The new report:

• shows employers how they can help support staff affected by illness, injury or recovery from treatment to enable them to stay in employment
• gives employees a better understanding of their condition to help them structure return to work discussions with their employer
• gives GPs a report on which to base the provision of a Statement of Fitness for Work to the employee.

Further details are available here

The AHP Advisory Fitness for Work Report is available to all AHPs who are members of their professional body and will be available on the member side of their professional bodies’ website.

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The report provides high-level thought leadership to support service and education commissioners, including local education and training boards. It gives an overview of the latest thinking about AHP interventions across care pathways, the benefits they can provide to people using AHP services and how they can help meet the QIPP Challenge.

The report complements the AHP Quality Innovation Productivity and Prevention (QIPP) Toolkit, produced by NHS London on behalf of the Strategic Allied Health Professionals Leads Group in March last year.  The QIPP toolkit demonstrates how AHP interventions can reduce costs and improve outcomes for people along each major stage of various pathways.

Drawings on published evidence, local studies and good practice, alongside a series of round-table discussions into factors such as educational changes, the effective use of skill mix and the use of advanced and extended scope of practice roles, the report is intended to start the debate and consider some of the workforce challenges and opportunities involved in delivering the QIPP transformation agenda.

The report has nine key messages:

• making better use of AHPs improves outcomes for people and makes better use of finite resources
• the skills mix of AHPs adds value and improves outcomes across care pathways
• making better use of support workers and assistant practitioners enables AHPs to do more of what they are uniquely qualified to do
• effective clinical leadership is one of the key enablers to harness the potential of the AHP workforce, as leadership is required to drive collaboration, research, evidence-based care and involvement
• incentivising practice placements and focusing on the importance of the practice educator role during commissioning can help to make sure there are enough high-quality practice placement opportunities for AHPs
• maintaining and sustaining a high-quality AHP academic workforce skilled in clinical research is essential to secure high-quality education and training
• preceptorship is a model of workforce enhancement that can help ensure the system has confident practitioners to work in new and emerging models of care delivery
• making better use of advanced practitioners could help meet the QIPP transformation challenge by leading innovation through research and development, improving productivity by leading service redesign and preventing both admissions and readmissions to hospital
• AHPs can be pivotal in supporting integrated care and have a key role to play in prevention, cure, rehabilitation and support across integrated care pathways

The report can be downloaded here

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As an added incentive they are both offering advice to any AHP applicants.

Darzi Fellows are engaged in a 12 month out of programme experience based in an acute, foundation, mental health or primary care organisation. Mentored by their medical director (or nominated deputy) Fellows lead on a variety of priority service change projects. They also take part in a bespoke (university accredited) leadership development programme to support the organisational and leadership skills needed for their future roles as clinical leaders. Due to the high status of the programme, Fellows are in high demand for a variety of clinical conferences, forums and knowledge sharing events.

Julie and Jaqualine both say they have gained much from their fellowships.

After several years as a respiratory physio, Julie wanted to get a better view of the NHS as a whole. “I wanted to see how other parts of the service were working, and I wanted a new challenge,” she said.  Julie’s Darzi project, which takes up 50 percent of her time, is working with Bromley Healthcare – a community health services provider.

“Having two part-time jobs means, of course, working more than one whole job, “Julie added. “I have had to work on my time management. It’s not easy, but has been so beneficial, not just through seeing things from other perspectives but also through networking with other Fellows.”

A secondary benefit Julie has found is that, in the social enterprise where she is working, she is seeing how AHPs are working differently and how these roles can be used in various services.

After 13 years as a paramedic, much of which was in a teaching role, Jaqualine wanted to find out more about the rest of the healthcare system.

“I knew a lot about my particular piece of the jigsaw and I wanted to find out about all the other pieces,” she said.  Jaqualine’s Darzi project is with a CCG in Croydon and is based on the healthy child programme.  Looking at children from conception to five years of age, the programme brings together health and social care to look at children in families who need extra support.

“The project brings together a multi-disciplinary team of health and social care professionals, targeting children and families who need that bit of extra care to prevent longer term problems,” said Jaqualine.  “It is really rewarding as well as being interesting and giving me a real feel for other parts of the health and social care system. I am still very much a health care professional, but in a different way.”

If you are interested in a ‘Darzi’ Fellowship, further information is available here or email leadership@londondeanery.ac.uk

Julie and Jaqualine can be contacted by e-mail at Julie.Read@hrch.nhs.uk and Jaqualine.Lindridge@lond-amb.nhs.uk

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In a video, Jeremy Hunt outlines his ambition to cut avoidable deaths from the five major causes – cancer, heart, stroke, respiratory and liver disease – and to make life expectancy in England among the best in Europe.

• More information is available here

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