BAPO

Executive

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Postcode Lottery

Postcode lottery for NHS orthotics patients

Specialist orthotics care for patients with mobility issues varies significantly depending on where they live, new research by Staffordshire University reveals.

The findings, published on BMJ Open, have uncovered major differences across orthotics services at various NHS trusts and health boards.

Problems within orthotic service provision in the UK have been the focus of a number of reports by the NHS and other organisations.  An NHS report from 2014 highlighted that many patients experienced long waiting times which could lead to the development of secondary health complications.

Professor Chockalingam and colleagues at Staffordshire University based their research on Freedom of Information (FOI) requests sent to all NHS trusts and Health Boards in the UK. The survey scrutinises information on Finance, Service Provision, Staffing, Complaints, and Outcome measures and key performance indicators (KPIs).

The results highlight large variances in the length of appointments, appointment waiting times, product entitlements for patients, and product lead times. Certain geographical areas were found to provide shorter waiting times and wider access to assistive devices. The findings also reflect there is more information available on the quantity of service above the quality of service.

The findings showed that:

  • average and maximum waiting times for adult appointments were 7 and 34 weeks, respectively.
  • Scotland seems to fair better in all of the reported measures. Patients in Scotland have longer appointment times and the average waiting times are lower.
  • some Trusts are not fully accommodating the needs of children

Nachiappan Chockalingam, Professor of Clinical Biomechanics at Staffordshire University, explained: “Within the NHS, the Orthotics Service is poorly understood and low in priority lists. Therefore, it is essential to evaluate the current state of provision to ensure that services are capable of meeting future demands.

“In 2011, a report estimated there were 2m orthotics users in England and assistive devices including wrist splints, custom footwear, foot and ankle support, back and neck braces are needed to alleviate pain, help patients recovering from injury and those with chronic conditions.

“In future, there will be an increased demand for orthotics services because of the projected population growth, the aging population and the rising prevalence of obesity, diabetes, cardiovascular and peripheral vascular diseases.”

Dr Aoife Healy who co-authored this study added: “Our results highlight that some of the Trusts appeared to not accommodate the needs of children fully. Waiting times of 20 weeks for routine and 8.2 weeks for urgent appointments are unacceptable”.

The researchers hope that these findings will prompt the NHS to instigate its own evaluation of services across the country.  Ms Lynne Rowley, Chair of British Association of Prosthetists and Orthotists (BAPO) said: “We welcome this study, which clearly showcases the inequalities across orthotic service provision in the UK. BAPO has been aware of this issue and has been working with NHS England. However, this study is timely and provides a push in the right direction.”

However, the combination of the number of Trusts and Health Boards who declined to reply to the FOI request and those who replied with limited information hindered the team’s ability to provide a national picture of Orthotic Service provision.

Professor Chockalingam added: “The UK NHS needs to establish appropriate processes to record the quality of service provision since this will enable improvements in clinical management and ensure good value for money.”

Read the full paper http://dx.doi.org/10.1136/bmjopen-2018-028186 here.

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National Associations for Orthotist/Prosthetists

BAPO has represented British Prosthetists and Orthotists at the inaugural meeting of National Associations for Orthotist/Prosthetists. We are proud to be working alongside some wonderful other P&O societies from across the world to improve P&O!

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Social Prescribing

RSPH have just launched a new framework for social prescribing for AHPs

Social prescribing, sometimes referred to as community referral, is a means of enabling people to be referred to a range of local, non-medical services. 

Recognising that people’s health is determined primarily by a range of social, economic and environmental factors, social prescribing seeks to address people’s needs in a holistic way. It also aims to support people to take greater control of their own health.

Social prescribing can meet a wide range of needs, with many schemes aiming to improve mental health and physical wellbeing. It can be used to support adults, young people and children as well as people with learning disabilities or mental health problems. It can take place in primary and secondary care. Social prescribing can also help to address social issues such as debt, unemployment, gambling and loneliness.

Social prescribing and community-based support is part of the NHS Long-Term Plan’s commitment to make personalised care[i] business as usual across the health and care system in England. The NHS Long Term Plan[ii] published in January 2019 has a commitment to personalised care and increasing access to social prescribing for the whole population. 

This approach to holistic care is not new to allied health professionals who frequently have conversations and provide support related to the wider factors influencing the health of the people they work with. 

To illustrate the way AHPs already support this agenda and to provide a framework to support them to do more; a new social prescribing framework for AHPs[iii] has been developed by the Royal Society for Public Health, Public Health England, NHS Improvement and NHS England along with AHP professional bodies and voluntary sector partners.

The framework is divided into 4 sections to reflect the varying intensity of AHP interventions, these include:

  • Active signposting – a light-touch approach where staff provide information and choice to signpost people to services, using local knowledge and resource directories.  This works best for clients who are confident and skilled enough to find their own way to services after a brief conversation. 
  • Referral to a link worker – In cases where a person needs more support than active signposting can provide, it may be appropriate to refer them to non-medical link workers who can provide more time to understand what matters to the individual and connect them to relevant community groups and other agencies for practical and emotional support.
  • Undertaking social prescribing – AHPs are likely to undertake social prescribing themselves when they are already providing long-term intensive support to a person as part of their job role. It will involve supporting people to work out which local groups and services would be beneficial to them and helping them to access them in a variety of ways. You may need to work through multiple options with a client and accompany them on first visits. Some AHPs are likely to do this than others because of the nature of their role.
  • Supporting the development of social prescribing – for example by providing community groups and services and providing guidance, supervision and training to link workers.

Over 2500 AHPs engaged with the development of this framework by completing a survey, joining a twitter chat, providing feedback on early drafts and submitting case studies.  This shows the enthusiasm for this agenda amongst the professions.  We hope the framework will support all AHPs to articulate their current role in social prescribing and consider how they could do more.

Click here to access the site

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[i] https://www.england.nhs.uk/personalisedcare/

[ii] https://www.england.nhs.uk/long-term-plan/

[iii] https://www.rsph.org.uk/our-work/resources/ahp-social-prescribing-frameworks/ahps-promoting-growing-and-developing-social-prescribing.html

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One Year On – The SIHED programme and I See The Difference campaign

                                      

The SIHED (Strategic Interventions in Health Education Disciplines) programme is a £3m, three-year initiative to help build the sustainability of the allied health professions (AHPs). A big part of the programme, the I See the Difference campaign, has been developed to include lots of helpful information about AHPs on the website, currently alongside social media channels such as @icthedifference Twitter, Facebook and Instagram. The digital campaign is also backed up by a large amount of outreach activities at schools and careers events across England.

More programme updates include:

  • The Challenge Fund – In year one, six higher education projects were funded which focus on supporting the recruitment and retention of existing and new students of podiatry and therapeutic radiography. Find out more about the providers and projects here. As we begin year two, we have launched a second challenge fund with a wider remit and a budget of £400,000. Successful bid winners will be announced in the coming months.
  • The British and Irish Orthoptic Society (BIOS) are working on a project to facilitate work shadowing opportunities in orthoptics.
  • A funded fixed-term role to increase capacity for prosthetics and orthotics work placements, allowing more students to study the subject.
  • Two research projects. The first report looked into the barriers to mature student engagementin healthcare, and how to address them. See report here
  • We are currently working with another research company who are completing a study of male participation in nursing and allied health (NMAH). The report will seek to understand current differences in male participation to different NMAH disciplines to help understand and overcome barriers.

Some of our achievements in Year One of the campaign and programme include:

  • More than 11,000 people visited the campaign website, 90% were new users. This equated to 19,637 page views
  • A direct email campaign to 2500 secondary schools was undertaken, with 772 emails opened, equated to an open rate of 30.9%
  • Attending more than 100 events including presentations to schools and smaller career fairs. Reaching 1700 students, families, teachers and careers advisors at large scale events and receiving 236 requests for school outreach at these events.

Also, visit the I See The Difference website for more information about the campaign.

Get in touch with the team, info@iseethedifference.co.uk, Twitter, Instagram, Facebook

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Anti-Bullying

BAPO is proud to be a part of a new anti-bullying alliance, supporting and sharing ideas and promoting resources and support systems

Bulling has no place in healthcare or the NHS, and it negatively effects staff, services and patients. BAPO are strongly committed to supporting our P&O professionals alongside the wider healthcare environment to erradicate bullying

For more information and resources see the Anti-Bulling document below

AntiBullying AllianceDownload

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A Digital Framework for Allied Health Professionals

“This year we have seen the NHS long term plan explicitly identify that digitally enabled care will go mainstream across the NHS to improve population health and support healthcare professionals. This is supported by the recently published Topol review recommendations, asking NHS staff to make the most of innovative technologies such as genomics, digital medicine, artificial intelligence and robotics to improve services. As allied health professions (AHPs) we have an individual and collective responsibility to play a role in the development of these digital and data capabilities, anticipating the challenges and realising the benefits.

Enabling AHPs to use information and technology is therefore one of 4 priorities in AHPs into Action. A Digital Framework for Allied Health Professionals – Key foundations for future clinical practice supports local services and AHPs to make that happen and works towards services that are both paper-free at the point of care and connected to other services and systems.

I would encourage you to share, discuss and use this framework with your members and networks. Together we can ensure we deliver digital and data enabled AHP services for the benefit of citizens and the wider health and care system.”

Kind regards,
Suzanne Rastrick
Chief Allied Health Professions Officer
NHS England

A Digital Framework for Allied Health ProfessionalsDownload