https://publichealthmatters.blog.gov.uk/2014/11/06/allied-health-professionals-a-missed-opportunity-for-commissioners/

Allied health professionals - a missed opportunity for commissioners?

Allied Health Professionals (AHPs) are a large, relatively untapped public health resource with potential to impact on virtually every important issue affecting health and wellbeing.

AHPs can improve lives and save health and social care services money by preventing falls, helping people back into work, supporting people to live independently, increasing children’s educational attainment, preventing and reversing obesity, increasing physical activity and improving emotional wellbeing.

They are key to integration, early intervention and supporting independence, yet the value of this workforce is not fully realised because of their limited voice in local strategic planning.

There is now consensus that our NHS, public health and social care system is unsustainable without radical transformation. The ageing population, increase in lifestyle-related poor health and financial forecasts mean it has never been more urgent to shift our focus to prevention. We must take every opportunity to create the environment, information and support to help people and communities change their behaviour and to enjoy better health and wellbeing.  To achieve this we need everyone at every level to play their part.

I've been discussing this challenge with the 12 Allied Health Professions  recently, to encourage them to consider how they can support the public health agenda. The Allied health professionals are 12 regulated health professions:

  • speech and language therapists
  • radiographers
  • prosthetists and orthotists
  • podiatrists
  • physiotherapists
  • paramedics
  • orthoptists
  • occupational Therapists
  • dietitians
  • music therapists
  • art therapists
  • dramatherapists

The response from them to the public health challenge has been overwhelming. They are ready, willing and able to be part of the system wide response.  With over 80,000 allied health professionals in England, they have at least 2 million contacts with the public every week.  They work across the system in health, social care, education, voluntary and private sectors and across the life course.  As a result the allied health professionals have the potential to contribute to virtually every public health priority, and as recent mapping  presented at Public Health England’s Annual Conference in September shows, many of them already are.

But here is the problem!   As relatively small professions, they don't have a strong local strategic voice; they aren't invited to the planning tables and therefore their potential value is not fully utilised.

Commissioners of health and social care services don’t have the time or capacity to work with individual services, instead they understandably do their business via contracts departments in major providers. These contracts specialists equally lack the time and capacity to understand anything other than the top line of the multitude of complex services provided by their organisations.  A typical contract meeting will rightly discuss high-value or high risk services, however where does that leave services of lower value, low-risk but huge potential to support change?

Do decision makers know enough about allied health professional services and how they can contribute to the major healthcare challenges we face?

What are allied health professions and services doing about this?

And is there a failing in the system if it isn't easy for services within the health and social care system to contribute to solving the system’s problems?

You may be thinking we should all be leaders and allied health professionals need to use their leadership, networking and influencing skills to make changes themselves and influence local leaders and decision makers.  This has been taken on board by allied health professionals and many of the professional bodies are supporting their members to have focused conversations by producing costed, evidence packs for use at a local level.  A good example of this is Physiotherapy Works which aims to increase health and social care decision makers understanding of the benefits of physiotherapy as a cost effective solution to deliver their key priorities.

However I invite commissioners and planners to take a closer look at what the allied health professions can do to help address some of our major health challenges, for example.

Giving children the best start in life - Stoke Speaks Out, run by speech and language therapists, is tackling the high incidence of language delay in young children across Stoke on Trent by supporting staff in early year’s settings to improve language development.  This programme has reduced the proportion of children entering school with significantly delayed language skills from 64% to 39% children. Tackling this early has a direct impact on children’s development, educational outcomes, health and well-being.

Keeping people in work – The AHP Advisory Fitness for Work Report  has been designed to enable AHPs to provide information on the functional impact of a patient’s reported problem and to suggest options that may support the patient to remain in, or return to, work.

Occupational health services involving a range of allied health professionals achieve a substantial return on investment by reducing sickness absence; this amounted to £1.2 million per year in York Teaching Hospital NHS Foundation Trust.

Reducing hospital admissions - Community-based falls prevention programmes tackle one of the biggest health issues facing older people, and reduce costs through hospital admissions. Allied health profession led falls prevention services have contributed to reductions in admissions due to falls in the home of 32 per cent, falls in residential institutions of 27 per cent and falls in the street of nearly 40 per cent.  A tool recently launched by the Chartered Society of Physiotherapy enables local areas to calculate the costs of falls and the return on investment of different interventions.

There is clearly a need for better dialogue between allied health professionals and their local commissioners and service planners about how the allied health professions can contribute to the solutions needed to improve the sustainability of our health and social care system.  Allied health professionals are working to strengthen their arguments, make their cases more succinctly and tailor their offer to current priorities.

Colleagues in London are planning to pilot an approach to improve the systematic engagement of allied health professionals in decision making processes.  The AHP strategic advisory forum will act as a conduit to find the most suitable AHP colleagues to give independent advice on issues highlighted as important by local authority or NHS commissioners.

I ask commissioners to question whether the skills of AHPs are appropriately deployed within the services you commission and whether your current contracts with AHPs encourage services to focus on prevention as well as treatment.

I would be very pleased to hear from anyone with feedback about how allied health professionals can better engage with you?

1 comment

  1. Bren

    Hello Linda,

    A really interesting blog and it clearly shows examples of Allied Heath Professionals taking a proactive role in a number of areas. There is clearly an opportunity for areas such as the Better Care Fund, and joint commissioning to expand this much further.

    There is clearly an opportunity to unlock a huge resource for the the benefit of the patient and public, and particularly in the area of early intervention and prevention.

    Best wishes,

    Bren.

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