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Department of Health Update
60
There are other problems too: .Purchasers, providers and patients have a lack of basic information on different treatments and how these generate health gain. .There is a lack of social consensus about what comprises health gain and how it is measured. Here we face moral and possibly ethical issues, brought home to many of us with the media publicity about Laura Davies with her repeated major organ transplant interventions. W h e r e is also a lack of consensus that the objective of health interventions is to maximise health gain. .Health professionals’ personal interest in a particular field often prevents purchasing for health gain.
So how can we tackle the issues? OThe physiotherapy profession needs to have a better understanding of the relationship between intervention(s) and outcome. .We need to continue to focus on research and standard setting and promote the Clinical Interest Groups’ and the profession’s role in this field. .Where interventions are shown not to be beneficial we must stop their practice.
*Physiotherapy managers need to lead their staff and support them throughout the change process. .All physiotherapists need to participate in the wider health context to improve public education and build consensus amid the inevitably limited access to health care. 0 We must work with other health care professionals to reduce the often inappropriate influence of interest groups and politics in determining priorities. Certainly in the future purchasers will select the services they want by their contribution to health gain. This will result in changes to our current scope of practice, but this is nothing new, practice has changed phenomenally during the last decade and will continue to do so as we head into our Centenary year and another century. To safeguard the future of the profession these issues need to be tackled in earnest. We all need to look positively at what we can achieve - I think we can do this, as physiotherapists are highly motivated and always rise to a challenge.
Natalie Beswetherick MCSP Acting Head of Physiotherapy Services East Gloucestershire NHS Trust
Thisis the first of a series of columns by the physiotherapy officer at the Department of Health. Mrs Cogan will be pleased to receive feedback on any of the topics mentioned. The Department of Health is very conscious of the management reviews that are taking place and how they will impinge on the projected work plan. Everybody will be affeded by the changes made and therefore it is not surprising that feelings of hysteria occur every now and then. It is no bad thing that readers are made aware of the fact that the Department as well as people in the field is going through turmoil and change.
Current Issues 1.Granta awarded for developing services for people with a disability in the transitional stage between child and adult were agreed with great difficulty. The money was made available a t such a late stage that it was only with considerable effort that we were able to award the grants. Some money is likely to be available in 1994/95so if anyone has a project which needs pump priming and is actually about services for this specific group, ie 16- to 25-year-olds, contact me and we can discuss it.
2. The clinical audit scenario is progresing, and a meeting of the medical, nursing and therapy co-ordinators took place in January. This will be enhanced by the conference in February although it seemed that too many of the multidisciplinary audit projects would be presented by doctors as leaders of the team. This is not what we wanted and we will try to persuade others to do the presentations. Unfortunately the physiotherapy response was thin and unadventurous. I am sure that good projects are around but people never seem to be able to present them at the right moment. If you have done a good project, write it up and keep it, it is bound to be useful one day. [Orsend it for publication in the Journal.-Ed.] 3. Those of you in management should look out for ‘Pressure Sores: A Key Quality Indicator’. This guide for NHS purchasers and providers should be published soon. Clinical guide lines are being developed and the physiotherapy standards of practice documentation has
Physlotherapy, February 1994, vol80, no 2
been used when developing the paper, although it is not specifically mentioned in it. Do remember how important it is to have all our professional documentation professionally presented, pithy and precise, because I use it to raise our profile in the Department.
Conclusion These are some of the key areas that are currently active. Look out for National Continence Week on March 14-18. It will be an opportunity for virtually everyone involved in physiotherapy to have a role, whatever the age of your clients. I hope that you will not let me down by saying that it is not an area relevant to your practice. I also hope to see some of you a t the Clinical Audit Conference on February 17 as well as a t some of the Centenary events.
Nicky Cogan MCSP Physiotherapy OfFcer, Department of Health
There are other problems too: .Purchasers, providers and patients have a lack of basic information on different treatments and how these generate health gain. .There is a lack of social consensus about what comprises health gain and how it is measured. Here we face moral and possibly ethical issues, brought home to many of us with the media publicity about Laura Davies with her repeated major organ transplant interventions. W h e r e is also a lack of consensus that the objective of health interventions is to maximise health gain. .Health professionals’ personal interest in a particular field often prevents purchasing for health gain.
So how can we tackle the issues? OThe physiotherapy profession needs to have a better understanding of the relationship between intervention(s) and outcome. .We need to continue to focus on research and standard setting and promote the Clinical Interest Groups’ and the profession’s role in this field. .Where interventions are shown not to be beneficial we must stop their practice.
*Physiotherapy managers need to lead their staff and support them throughout the change process. .All physiotherapists need to participate in the wider health context to improve public education and build consensus amid the inevitably limited access to health care. 0 We must work with other health care professionals to reduce the often inappropriate influence of interest groups and politics in determining priorities. Certainly in the future purchasers will select the services they want by their contribution to health gain. This will result in changes to our current scope of practice, but this is nothing new, practice has changed phenomenally during the last decade and will continue to do so as we head into our Centenary year and another century. To safeguard the future of the profession these issues need to be tackled in earnest. We all need to look positively at what we can achieve - I think we can do this, as physiotherapists are highly motivated and always rise to a challenge.
Natalie Beswetherick MCSP Acting Head of Physiotherapy Services East Gloucestershire NHS Trust
Thisis the first of a series of columns by the physiotherapy officer at the Department of Health. Mrs Cogan will be pleased to receive feedback on any of the topics mentioned. The Department of Health is very conscious of the management reviews that are taking place and how they will impinge on the projected work plan. Everybody will be affeded by the changes made and therefore it is not surprising that feelings of hysteria occur every now and then. It is no bad thing that readers are made aware of the fact that the Department as well as people in the field is going through turmoil and change.
Current Issues 1.Granta awarded for developing services for people with a disability in the transitional stage between child and adult were agreed with great difficulty. The money was made available a t such a late stage that it was only with considerable effort that we were able to award the grants. Some money is likely to be available in 1994/95so if anyone has a project which needs pump priming and is actually about services for this specific group, ie 16- to 25-year-olds, contact me and we can discuss it.
2. The clinical audit scenario is progresing, and a meeting of the medical, nursing and therapy co-ordinators took place in January. This will be enhanced by the conference in February although it seemed that too many of the multidisciplinary audit projects would be presented by doctors as leaders of the team. This is not what we wanted and we will try to persuade others to do the presentations. Unfortunately the physiotherapy response was thin and unadventurous. I am sure that good projects are around but people never seem to be able to present them at the right moment. If you have done a good project, write it up and keep it, it is bound to be useful one day. [Orsend it for publication in the Journal.-Ed.] 3. Those of you in management should look out for ‘Pressure Sores: A Key Quality Indicator’. This guide for NHS purchasers and providers should be published soon. Clinical guide lines are being developed and the physiotherapy standards of practice documentation has
Physlotherapy, February 1994, vol80, no 2
been used when developing the paper, although it is not specifically mentioned in it. Do remember how important it is to have all our professional documentation professionally presented, pithy and precise, because I use it to raise our profile in the Department.
Conclusion These are some of the key areas that are currently active. Look out for National Continence Week on March 14-18. It will be an opportunity for virtually everyone involved in physiotherapy to have a role, whatever the age of your clients. I hope that you will not let me down by saying that it is not an area relevant to your practice. I also hope to see some of you a t the Clinical Audit Conference on February 17 as well as a t some of the Centenary events.
Nicky Cogan MCSP Physiotherapy OfFcer, Department of Health