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AHPsGetting into shape to grasp emerging opportunities

Shelagh Morris

Deputy Chief Allied Health Professions Officer

3 June 2015

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Context:

Five Year Forward View

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• Currently ranked top healthcare system in the world• Cancer survival is at its highest• Operation waiting lists are down • Early deaths from heart disease down over 40%• Compared with 2009

• 4,000 more people seen in A&E each day• 3,000 more people admitted to hospital each day• 22,000 more people have outpatient appointments

each day

NHS has achieved a lot……..

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• Demand is rapidly growing• Rising burden of avoidable illness from unhealthy

lifestyles• 1 in 5 adults still smoke• Third of people drink too much alcohol• 6 in ten men and 5 in 10 women are overweight/obese

• 70% of NHS budget is now spent on LTC• People’s expectations are changing

But……

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• New technologies and treatments• Improving our ability to predict, diagnose and treat• Keeping people alive longer• Resulting in more people living with LTC

• New ways to deliver care• Dissolving traditional boundaries in how care is delivered• Improving the co-ordination of care around patients• Improving outcomes and quality

• ….but the financial challenge remains - £30bn gap projected in 2020/21

There are also new opportunities

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• Three ‘gaps’ identified:1. Health & wellbeing gap

• Radical upgrade in prevention• Back national action on major health risks• Harnessing the ‘renewable energy’ of communities

2. Care & quality gap• New models of care

• A menu of care models for local areas to consider• Greater Manchester• Vanguard sites

3. Funding gap• Efficiency & investment

• Efficiency gains & additional funding• Need for upfront pump-priming investment

The future NHS

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• Getting serious about prevention• Focusing on prevention• Empowering patients• Engaging communities

• Developing new care models• Not ‘one size fits all’, nor ‘a thousand flowers bloom

• New deal for primary care• Funding, commissioning, workforce, public engagement

How?

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• Population health• A renewed focus on prevention, not just treatment• Integral to everyday practice

• Personalised care• Personal Health Budgets• Integrated Personal Commissioning (IPC)• Individual’s goals• Remaining in or return to work

• AHP Advisory Report on Fitness for Work https://www.cot.co.uk/ahp-advisory-fitness-work-report

Through…..

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• Partnerships• Integrated care• Patients and Carers• Cross professional and organisational boundaries

• New models of care• Multispecialty Community Providers• Primary and Acute Care Systems

And…….

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Workforce

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NHSCIC (Feb 2015)

NHS 97,356

NHSCIC(Feb 2015)

Social Services 2,500

HCPC (June 2015)

Registrants 179,600

Allied Health Professionals (Headcount)

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Opportunities and challenges

- Building the evidence base- Outcomes- Informatics- Leadership- Innovation

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‘Research is everyone’s business’ – it is important for everyone• For our patients/service users

• For service transformation, improving outcomes, service redesign, participation in research 

• For AHPs and nurses• integrated within their training & practice, as users of research, as managers – supporting

research activity – students, newly qualified, expert practitioners, continually driving improvement 

• For AHP services• To improve/streamline services, aligning research topics/questions/priorities with research

activity

• For policy development• To influence and support policy development, ensuring evaluation of policy implementation

• For the system• To develop solutions to the challenges facing health and care services,to ensure alignment

across the system, improve NHS ability to undertake research and apply innovation,

commissioning through evaluation, partnerships

Building the evidence base

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Outcomes – High quality care for all

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Data and information

“……AHPs are ideally placed to address

some of the key challenges facing the health

and care sectors. As we see in the report,

their publicly funded employment already

spans the NHS, local government (social care

and education, housing, third sector and

independent practice. There is now a real

opportunity to develop and build measures

across sectors that reflect both the pattern of

actual service delivery for patients and the

outcomes AHPs achieve for them.”

Suzanne Rastrick

December 2014

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InformaticsSNOMED Clinical Terms

Technology

AHP Referral To Treatment

NAHPIST

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• Edward Jenner ProgrammeOpen access, online, designed for newly qualified clinicians but open to all, leads to

NHS Leadership Academy award in leadership Foundations.

• Mary Seacole ProgrammeFor those looking to move in to first recognised leadership role, leads to award in

Healthcare leadership and accredited Postgraduate Certificate.

• Elizabeth Garrett Anderson ProgrammeReady for more leadership challenges, leads to award in Senior Healthcare Leadership and an MSc in Healthcare Leadership.

• Nye Bevan ProgrammeFor senior leaders, those influencing beyond traditional boundaries/across the

healthcare system, leads to award in Executive Healthcare Leadership.

• Top Leaders ProgrammeFor executive or board level members.

+ more…..

http://www.leadershipacademy.nhs.uk/

Leadership Programmes

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9 Dimensions of Leadership BehaviourInspiring shared purpose

Leading with care

Evaluating information

Connecting our service

Sharing the vision

Engaging the team

Holding to account

Developing capability

Influencing for results

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‘An idea, service or product, new to the NHS

or applied in a way

that is new to the NHS,

which significantly improves the quality of

health and care

wherever it is applied.’

Innovation

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Rehabilitation Innovation Challenge Prizes• “Open Mind Partnership”

Leicestershire Partnership NHS Trust

Leicester Open Mind in partnership with Fit for Work

- GP referral or Open Mind therapists

- Long-term MSK pain

- Cognitive Therapy and Mindfulness techniques

- Addressing physical, social and mental barriers such as depression and anxiety

• “Fitness for Work Service”

Derbyshire Community Health Services NHS FT

- Self referral or by managers

- Assessment – physical activity, design of the workplace

- Phased return to work and duties where appropriate

- Service also offers MSK pain education and management, advice on equipment and educational resources

- ROI - £5 for every £1spent

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Innovation Connect is a free assessment and signposting service for innovations presented to NHS England. Innovators can submit their ideas and receive rapid advice and referrals to appropriate support. High Impact Innovations are quickly recognised, and have their implementation supported with NHS organisations

Innovation Exchange is an online collaborative web portal designed to support and develop a growing innovation community. The portal is designed for anyone who wants to develop, implement and spread innovations in health and care

 

http://www.england.nhs.uk/ourwork/innovation/innovation-connect/

Support for Innovation

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NHS EnglandAHP TeamWorkstreams

- AHP Medicines Project- Improving Rehabilitation Services

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AHP Medicines Project

• 2013• Independent prescribing by physiotherapists and

podiatrists

• Current work• Independent prescribing by paramedics and

radiographers• Supplementary prescribing by dietitians• Use of exemptions by orthoptists

24

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What this means for patients

• Greater choice and accessibility to services – reducing risks and costs associated with delays in care

• Patient-focused services that are evidence based and continually improving – best care, first time, in the right place

• Greater flexibility to design services around patient’s needs

• Redesign services that put patients at the heart of what AHPs do – reducing onward referral and hospital admissions

• Contributing to medicines optimisation

d their associated risk

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Working definition……..

Rehabilitation is the development, to the maximum degree possible, of an

individual’s function and/or role, both mentally and physically, within their family

and social networks and within education/training and the workplace where appropriate.

Improving Rehabilitation Services

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Rehabilitation will be key to every episode of care.

*It will maximise mental and physical health,

independence and occupation.

*Rehabilitation is everyone’s business.

Vision

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Focuses on good outcomes - driven by the goals set by the people we treat

Gives hope

Is centred on people’s needs – not their diagnosis

Aims high and includes vocational outcomes

Is an active and enabling process – not passive care

Relies on interdisciplinary team working

Is not impaired by organisational boundaries

Responds to change in people’s needs

Integrates specialist and generalist services

Requires leadership for transformational change

What is good rehabilitation?

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www.networks.nhs.uk

Community of Practice

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“Stand in the prow of the canoeLet the spray of the future be on your face”

Maori Proverb

A thought to end……..

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Thank you

shelagh.morris@nhs.net

@shelaghDCAHPO