Future Proofing Physiotherapy: Equipping the future workforce to meet the needs of a changing

population

Anna Lowe

Future Proofing Physiotherapy

• Drivers for change

• 3 Key areas of development

• Making it happen

Please tweet #physio15 @annalowephysio

What has shaped my views?

• Clinical experience

• Educator

• Researcher-interest in preventative care

• Recent projects– PHE national AHP board for MECC

– Local council MECC

– PhD Physiotherapy & physical activity

– Move More Sheffield

Liverpool as an example

Source: Liverpool CCG – Primary Care Extract, September 2014

Liverpool

JSNA for Liverpool 2014

• 98,000 adults smoke (25%).

• Over half of adults are overweight or obese (55%).

• 11,500 are considered “high risk” for alcohol.

• 2 in 3 adults are physically inactive.

The health of the UK

Average annual health cost of someone with;

o 1x LTC £1000

o 2x LTCs £3000

o 3+ LTCs £8000

£7 out of every £10 of health & social care budget goes on long-term conditions.

Liverpool population changes

Source: Office for National Statistics, 2012 SNPP

Hence....

• Realisation that current health & social care is not sustainable.

• Huge focus on prevention in policy.

• National priorities outlined by PHE last year;

1. Obesity

2. Smoking

3. Alcohol

• Focus on wider PH workforce.

The parable of the river Mersey

Finding a balance

Future proofing #1

Education.....getting our heads around public health

Education

1. Types of preventiona. Primary-prevention of disease in well population

b. Secondary-early identification and early management

c. Tertiary-limit negative impact of ongoing disease

2. Understanding populations- epidemiology

3. Basic premise of PH interventions

Future proofing #2

Understanding local populations

Local Populations

• Have to align our physio public health focus with both national and local PH priorities.

• It's easier than ever before to access information on the health of populations.

Sources of Information

Community Connectors

Small part of something much bigger, connect with community assets:

• private

• local government

• volunteer-led

• charity

Move towards an asset based approach.

physical activity

alcohol support

weight services

smoking cessation

community support

mental health

services

Future proofing #3

Changing Health Behaviours

Everybody stand up..........

• Sit down if you have done less than 150 mins moderate exercise in last week.

• Sit down if on any day in the last week you have had less than 5 portions of fruit/veg.

• Sit down if you have smoked in the last week.• Sit down if you have consumed more alcohol than recommended in

last week– men >21 units– women >14 units

• Sit down if you have done less than 2 specific strength sessions • Sit down if you have not had 2 alcohol-free days • Sit down if you have consumed 3 or more units of alcohol in a single

session...including last night!

Overall Health

McGinnis 2002

Physios spend time communicating with at-risk populations....we have a unique opportunity to contribute to overall health as well as to address the presenting complaint.

Physical Therapists

• Physical Activity is so clearly aligned with our knowledge, skills and history.

• Backwards about coming forwards.

• Confused about where we fit in.

Physical Activity Interventions

Universal PA interventions

Open access e.g. walking, leisure, utility-based.

Targeted PA interventions

Address specific at-risk population.

MSK, older people, LBP, Learning Disabilities, TBI.

Specialist PA Interventions

MDT, part of integrated programme e.g. falls, obesity, cardiac rehab.

Adapted from Justin Varney 2015

PA Leadership

• Every single patient gets the opportunity to discuss PA.

• Research priority, particularly brief interventions that works for Physiotherapy.

• Physiotherapy PA strategy.

• National lead for PA.

• Examples of good practice across the PA spectrum.

To conclude...

• Basic PH education for future and current workforce.

• Understand local populations and work withcommunities

• Physical activity leadership

"A prevention-focussed profession"Karen Middleton 2015

Useful Resources

• The Upstream Doctors (2013) R. Manchanda.• Clustering of unhealthy behaviours over time (2012)The Kings Fund.• Musculoskeletal Health: A public health approach. Arthritis

Research UK• Mapping the contribution of AHPs to Public Health (2012) PHE• Healthy Conversations and the AHPs (2014) PHE/RSPH• JSNA (2014) Liverpool City Council• The case for more active policy attention to health promotion

(2002) JM. McGinnis et al.• From evidence into action: opportunities to protect and improve

the nation’s health (2014) PHE • Five Year Forward View (2014) NSHE

Any Questions?

@annalowephysio

http://physioforward.blogspot.co.uk