Council Responses to Motions at the Annual Representatives' Conference

Council Responses to Motions at the Annual Representatives' Conference

Council Responses to Motions at the Annual Representatives’ Conference These resolutionsfrom the Annual Representatives’ Conference in Glasgow in Octo...

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Council Responses to Motions at the Annual Representatives’ Conference These resolutionsfrom the Annual Representatives’ Conference in Glasgow in October 1992 were either passed or (in one case) remitted directly to Council. At its meeting on December 16, 1992, Council considered responses on the basis of comments from committees and Individuals, and adopted them as published here. The motions are in bold and the responses are in medium type.

Professional Practice 1. The CSP should actively support Its members who are asked to partlclpate In skill mix exercises, In order to maintain professional standlng and prevent the professlon from becoming obsolete.

Council appreciates the importance of actively supporting members in this way. A series of seminars has been organised, for managers, heads of schools and stewards, to provide them with briefing and information on the key issues. The Society will monitor development of strategic importance, and officers stand ready to assist members where particular local issues arise. 2. With Increasing numbers of SGTs more emphasis Is being placed on clinical audit. The Soclety should strongly urge the members to seek tralnlng and funding from the trusts and that we, the profession, retain control of the evaluatlon of our own service.

Council agrees with the importance of clinical audit, and of the active involvement of every member of the profession. Although there has been some central funding, this has not been adequate to support properly the scale of clinical audit that members would like to engage in, and trusts and directly managed units should provide the necessary resources. 6. The CSP should encourage managers to recognlse the role of Cllnlcal Interest Group officers.

Council is only too aware of the importanceof the Clinical Interest Groups (CIGs) for the health of the profession and for development of services to patients. They have a particular role in developing quality assurance and postgraduate education. The CSP will encourage managersto understand that the work of CIG officers is in the interestsof their local physiotherapyservice and not just of the CIG itself. The Society will also be asking CIG officers to identify the sort of support they are looking for, and will discuss the outcome with representatives of managers. 7. The CSP should strongly campaign against GP fundholders speclfylng physlotherapy treatment modalltles, and thus threatenlng professional autonomy. The Society believesthat it is the responsibility of each individual physiotherapist to maintain the autonomy of their professional practice. Health Circular HC(7333, which is official confirmation of this, remains in force. Members should aim to educate or inform referring doctors of the assessment, diagnostic and treatment skills at their disposal and, in discussion with them, resist any attempt to limit or pre-ordaintheir professionaldevelopment. The Society will be happy to repeat and reinforce this message to GPs collectively. GP fundholders may also be tempted to specify modalities or lengths of physiotherapy treatment because of the charging arrangements adopted. The Society advises strongly that the charge made to a GP fundholder should relate to the episode of care following a referral and not to the number of treatments given during an episode. (Briefing papers are available from the CSP.) 8. This conference believes that direct employment of

physiotherapists by GPs Is likely to cause severe fragmentation of the services currently provided by the local hospital or community units. Therefore the CSP should actively campaign agalnst such dlrect employment of lndlvldual physiotherapists. The Society has recently adopted a policy arguing against direct employment of individual physiotherapistsby GPs, and it will press

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this policy at national level to government departments and to health authorities. It will encourage GPs to ensure that they engage chartered and state registered physiotherapistsand will urge them to purchase services from NHS provider units. 9. In the light of the Increasing number of GP practices seeking physiotherapy servlces, the CSP should actlvely recommend that all provider units contracting services to GPs should offer specialist physlotherapycare, hence dlscouraglng a move towards more generic care, ensurlng that patients receive the care of appropriately skilled physlotheraplsts. Council recognises that it is very important that the wide range of patients which GPs should be referring to physiotherapists should receive specialist care. It is the responsibilityof individual physiotherapists tcj remain within their professional scope of practice and to draw to doctors’ attention the need to make appropriate referrals to specialist physiotherapists in particular cases. Centrally, the CSP will aim to reinforce this message, to authorities and to general practitioners. 12. The CSP must set clear standards for physiotherapy support workers, with respect to thelr tralnlng and dutles, In order to protect patient care and the professlonal role of the Chartered physlotheraplst. While it would be inappropriatefor the CSP to develop standards for staff which it does not represent, Council will consider developing standards to assist physiotherapistswho train such helpers. 42. (Remitted) The CSP should carry out a national audit of the role of the o n t a l l physlotheraplst, to Include mglonalflocal anomalles, funding and agreed definitions for ‘emergency’ referrals so as to campaign for appropriate resources.

The Society welcomes the audit to be undertaken by the Association of Chartered Physiotherapists in Respiratory Care on the work of on-call physiotherapists. It hopes however that the group will consult widely on the implications of the survey and its findings, to ensure that all aspects are taken into account. It must be clearly understood that any changes to the oncall system would have to be negotiated, through the PTA Whitley Council, by the Industrial Relations function.

Service Management 13. The CSP should strlve to ensure that physiotherapy services are organlsed by physlotheraplsts, and not devolved to consultants or non-physiotherapist buslness managers. Council’s views are set out in the joint statement by the CSP and the College of Occupational Therapists in the August 1992 edition of Physiotherapy (page 595). However, there is a valuable and clear role for business managers in organising services in support of clinical managers. 15. The CSP should devise a national scale for the recordlng of physlotherapy Input to patient care In order to enable managers to cost the service and purchasersto make accurate comparisons. Recording of input is a responsibilityof NHS management rather than of the CSP, and will have to reflect local circumstancesand policies. A number of physiotherapy managers have devised appropriate scales and the CSP will be happy to disseminate examples of good practice.

41 17. The CSP is urged to issue guide lines on the dangers and problems of accepting charitable donations for the purchase of basic essential equipment, which should be provided by health authority funding.

The CSP will continue to campaign for a properly funded health service, and recognises that members’ best interests are not served by using their own spare time - or indeed clinical time -to raise funds for their own department. But, that said, donations are often of considerable value in development of physiotherapy services. Council will prepare general guide lines on the acceptance of charitable donations. 36. The CSP should produce guide lines on minimum levels for physlotheraplsts in the Health Service In view of the cost saving pressures being imposed by management.

See 37, 37. As physiotherapists we find ourselves more and more compromised by additional responsibilities. We want the CSP to support the withdrawal of physiotherapists when staffing levels fall below those necessary to give an adequate service.

If in the judgement of managers and clinicians, it is not possible to give a service which meets appropriate professional standards, then it will be necessary to set appropriate priorities for selection of patients. This may involve either selecting clinical areas to which a service can not be given, or by refusing to accept further referrals. Since medical and legal responsibilitiesare substantial if treatment is started, an assessment of a patient should not be undertaken if it is likely that effectivetreatment cannot be offered. It should be made clear to general management that these are clinical restrictions and staff should continue to work in accordance with their contract of employment. Alternatively, action may be taken on industrial relations grounds where the withdrawal of service is proposed as a response in a dispute over cutbacks or other reductions in service provision. Any such action must comply fully with current legislation and thus must have the prior official support of the CSP. Details of these legal requirements are about to be made available to members. The advice and support of the CSP will readily be made available to staff who find themselves in any circumstances where withdrawal of service - whether on professional or industrial relations grounds - is indicated.

Education 20. Since clinical education of physiotherapy students Is vital to patient care and professional standards, and could be at risk if professional structures are fragmented, Conference believes there is a need for: (a) stringent nationwide standards for clinical supervisors and for the monitoring of clinical placements; and (b) specific funding for placements.

The CSP has recently published standards for clinical education of physiotherapystudents, and these can provide the basis for local monitoring for clinical placements. This is the responsibility of schools of physiotherapy; the Joint Validation and Recognition Panel ensures that they have machinery with which to do this. The EducationCommittee has recently established a group to look into more detail at the maintenance of standards in clinical education, which will report in the summer. Council agrees that specific funding would be of benefit if it ensures the viability and continued availability of high quality placements. 21. The CSP should promote a policy of shared appointments of ‘senior lecturer/cllnlcal physiotherapist’ between larger departments and units of physiotherapyeducation, to facilitate greater academic development at the workplace while allowing academic staff to retain specialist skills.

work, and has published guide lines which set out some options. Courses offer one such method, but in view of the fact that many such physiotherapistscannot travel great distances, and the limited uptake of previous courses, more personaiised arrangements may be more appropriate. It also hopes that employers will take up the opportunity set out in the recent GWC agreement on retainer schemes to avoid physiotherapists losing touch with professional practice.

Ethical and Regulatory 29. The CSP and CPSM should use their powers to ensure that EC and other overseas qualified physiotherapists have clinical experience and trainlng, and academic knowledge, which fully meet UK standards before full membership and State registration are granted, using ‘top-up’ placements if necessary.

The CSP and the Physiotherapists Board work closely together to ensure that this objective is achieved. A two-day workshop was held recently to review the procedures adopted. It should be noted that State registration indicates competence only at a level equivalent to a newly qualified physiotherapist.it is for employers to assess whether any physiotherapist meets the requirements of the post concerned. 30. The CSP should provide physiotherapy managers with guide lines to ensure the positive integration of overseas physiotherapists which does not result in additional stress on other physiotherapy staff.

Council recognisesthat overseas qualified physiotherapistsbring different and valuable cultural and professional perspectives to their work, and it is important that physiotherapy managers and their colleagues should recognise these. It will arrange to provide guidance to managers on the background of physiotherapy in countries from which significant numbers of staff are recruited, and some general guide lines on how to integrate such staff. 31. Due to the possible future State registration of osteopaths we feel that the CSP should have an open debate on the implicatlons to our profession of thls move.

Council agrees. This issue of the Journal includes an article on the implications of the Osteopaths Bill on page 6, and it is hoped that this will stimulate such a debate.

Industrial Relations 33. This Conference abhors any attempt to dismantle the current national physiotherapy grading structure. It Is Imperative that, in the light of accelerating NHS change, the CSP rapidly produces a policy to promote strongly the maintenance of the current Whitiey grading levels and definitions.

Council agrees that there is a very severe risk that locally negotiated grading arrangements could be very disadvantageous to physiotherapists. it will therefore continue to promote the importance of a national grading system, though it will be prepared to engage in negotiations if satisfactory regrading proposals appear to be in prospect. 34. Performance related pay contravenes the present clinical and professional standards of Chartered physiotherapists working in the NHS. We ask the CSP Council to adopt a policy of opposition to performance related pay, and to campaign against any attempted imposition of such a scheme.

Council agrees that such appointments are desirable, and would welcome their extension. But this is a matter for autonomous higher education institutions and provider units to agree.

The CSP will continue to participate in the discussions that are currently in progress in the PTA Whitley Council, but will make sure that the Management Side is fully aware of the potential problems of any form of performance related pay. The Society will not accept any imposed scheme.

25. The CSP should encourage centres of higher education and training hospitals to run refresher courses for physiotherapists wishing to return to work, particularly for those who wish to return part-time.

38. The CSP together with other professions and unions should press the Government for a national agreement to recognise continuity of employment within units which have gained trust status.

Council believes that it is important that there should be a wide range of opportunities for physiotherapists wishing to return to

Council understands this motion to be referring to continuity for the purpose of GWC and PTA terms and conditions of service

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42 when staff move from one trust or directly managed unit to another. It fully recognises the importance of this, and will refer the matter to the General Whitiey Council. 39. The CSP should be at the forefront of groups lobbying the Government and ail employers to provide more child care facilities and to reduce the cost by implementing full tax concessions. Council shares the view of conference that child care facilities are of vital importance to members. it will aim to be more active in lobbying on this front. 40. This Conference calls upon Council to do more to implement its guide lines on the advertising of job vacancies. Existing guide lines will be revised to bring them into line with the changes in the NHS, and will be circulatedto senior managers and others. it is important for the future of the profession that there should be national advertising of senior posts. 41. The Society should actively campaign to discourage members from working unpaid overtime since this masks the effect of poor staffing on patient care. Any unavoidable overtime must be strktly monitored and recorded. Council agrees with the importance of this in principle and the industrial Relations Committee will consider how to take the issue forward. 44. This conference demands adherence to the nationally agreed student training allowances so that the money reaches the staff who are actually involved in the training of students. The Society therefore should be active in ensuring that this happens and abuse of the allowance does not occur. Council agrees with this in principle; but see 46. 45. This conference calls on Council to adopt a policy to campaign for the financial reimbursement of individuals or departments involved In the training or supervision of health care assistants. it should also be policy to support any clinical physiotherapist who refuses to take part in such training should reimbursement be withheld. See 46.

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46. The CSP should ensure that physiotherapists who supervise EEC qualified physiotherapists who are undertaking an adaptation period should be financially recompensed and their cllnlcal duties should be reduced appropriately. Motions45 and 46 are an extension of the principle of allowances for supervisors. it is therefore likely that opening up this issue would also involve negotiations on the current arrangements for allowancesfor supervisors of physiotherapystudents. Before referring the matter to the PTA Council, Council will therefore undertake a review of supervisory allowances generally. 47. Foilowing the abolition of GWC section 32 by the then Secretary of Health Mr William Waldegrave in December 1992, without prior consultation, the CSP should be seeking assurances from the present Secretary of State that other sections will not be abolished in a similar underhand manner. Council agrees that it would be right to seek such an assurance and will try to do so through the GWC.

CSP Organisation 51. Each department of the Chartered Society should establish quality assurance standards for the delivery of their services to the membership. These standards should be developed now within the current resources and published and implemented for the benefit of the membership. Council has tasked the officers with beginning work on such standards, with a view to their early adoption.

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52. The CSP Council should Initiate a review of the services the CSP provides in support of student members, to meet the changing needs of students and the Society, for mutual long-term benefits. As announced at the conference, a review has been established

of student services. It will comprise two members of the Education Committee together with two members of the Student Executive Committee and will be asked to present its report by the summer of this year. 54. in view of the possibility of local pay bargaining the CSP must assist the Industrial Relations Department in ensuring that there is a steward in every unit with the skllls to undertake these negotiations and support from the physiotherapy manager. In this motion, the ‘CSP’ clearly means the membership. Council agrees that it is vital that members should continue to volunteer to act as stewards, and will support them by providingappropriate training and back-up. 56. This Conference calls on the CSP to supply every practising physiotherapist with a copy of the document ‘Standards of Physiotherapy Practice’ either In the Physiotherapy Journal or as an additional supplement to the Journal. The CSP’s ‘Standards for Physiotherapy Practice’, which set out general standards which then need to be elaborated by standards in particular areas, are currently being revised. it is accepted that it is appropriate for the text of the revised version to be published in the Journal. They will continue to be available for sale in booklet form, together with the other standards, many of which are produced by Clinical Interest Groups and which it is not intended to publish in the Journal. 62. At a time when the health service and the profession itself are going through a period of change, Council members of the CSP should communicate more effectively what they are doing for the profession they serve. Council members appreciate the importance of effective communication and are committed to it. But communication needs to be a two-way process. Members both as individuals and in their various groups (such as Branches or Specific interest Groups or departments), should seek to use Council members as a primary point of contact with the Society. To help them do this, a list of elected Council members is printed in this edition of the Journal.

Conference 65. The working of the Agenda Committee (for the Representatives Conference) appears ‘shrouded In mystery’. The committee should be more accountable when selecting motions in order that if a motlon is rejected or composlted some’ explanation Is provided to the Branch regarding the reasoning. The Agenda Committee will take this into account in developing its procedures for the 1993 conference.

Emergency Motion 1 In 1993, the Annual Representatives’ Conference should take place over two whole days to enable the proper debate of all motions. The 1993 Conference Agenda Committeewill be asked to consider the number of motions in relation to the time available so that controversial topics can be fully debated.