Are you going to be the solution or the problem?

This blog has taken me a while to write because there has been so many fantastic accounts by Physiotherapy Students and Physiotherapists alike. Here are a few links below apologies if I have forgotten any.

https://aphysiostudent.wordpress.com/2015/02/10/student-rep-development-weekend-2015/

https://cuspblogs.wordpress.com/2015/02/10/having-a-voice-and-making-a-difference/

http://liamdoylestudentphysio.blogspot.co.uk/

http://www.csp.org.uk/blog/2015/02/12/physiotherapy-students-are-already-leaders-innovators

Lucy Cocker

It was at the back end of the year when I was asked to give a presentation, from a graduates perspective as part of the Physio works programme. The theme of the event stemmed from making a case for change. The event challenged the status quo and asked students to step outside the box and ask the question where will the future of Physiotherapy go? And where do we fit?

My talk gave a personal account of my journey and hopefully planted a seed to enable students to push the boundaries of their personal development. I really wanted students to think about doing things differently and not just going through the motions of student life.

“If you always do what you’ve always done, you’ll always get what you’ve always got.“

– Henry Ford (1863-1947), American founder of the Ford Motor Company

Lessons I have learnt along the way

  • Network, Network, Network! -Many of my previous experiences have come about through networking  and have got me where I am today so keep in contact with people you meet.
  • Karen Middleton: “Learn to live with a bit of mess”-Prioritisation is a key skill to develop sometimes some of the things you do don’t need to be perfect to get the job done but it is important to prioritise the things that really do need to be perfect.
  • Learn to say no-You are only one person and you can’t do it all without sending yourself into melt down so learn to delegate.
  • Interviews are a skill- Don’t worry if you struggle in your first few interviews they are a skill to develop which you may read through my blog.
  • Don’t forget about your degree- This links back to prioritisation your degree should be a priority and then work in opportunities around it.
  • Look at challenges as opportunities-There are many things i have done which I have thought I’m not sure about this but at the end of the day you don’t know until you try and if it doesn’t work what have you lost?
  • Take a positive attitude everywhere you go-You will sometimes hit problems along the way with university, placements, jobs. Take a backwards step and look at the problem holistically what can you influence and break the problem down into small chunks.

Thinking outside the right box.

  • When you are faced with barriers you need to find a route around them.
  • What are you trying to achieve? Is the thing you are doing going to provide a solution?
  • Don’t do something because it will look good on your CV.
  • “Take a chance don’t make a plan” Emma Stokes.

The event was fantastic as always and I learnt a lot from the student reps as well as the key speakers. The main thing I took away was during Karen’s and Ieuan’s talk on influencing. If you want to influence someone you need to work out what makes them tick but not only that you need to go with solutions not problems. I want to take this opportunity to thank the CSP students for inviting me to the event and I look forward to see where your journeys take you!

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Physiotherapy Works-providing evidence for solutions to problems.


So on a different note I am also going to share with you the report from the Industrial Relations Committee. I sit on this committee as a newly qualified physiotherapist and it has really been an eye opener to the campaigns and background work done by the CSP and ERUS. Below is my interpretation adapted from the key messages provided by Claire Sullivan.

Committee membership: The committee co-opted two new members; Stephanie Heasley for Northern Ireland and Chris Manning for Higher Education

TTIP: Owen Tudor, Head of European Union and international relations at the TUC, joined the meeting to give a presentation on TTIP (the transatlantic trade and investment partnership) and in particular its implications for the healthcare sector. Owen identified 3 things that CSP members could do on this issue:

  • Lobby your local MP and MEP on the issue and specifically on the need for the health sector to be excluded
  • Ensure that the CSP does the same with the relevant Secretaries of State and Shadow Secretaries
  • Raise awareness of the proposals with friends and family

TTIP is a very complex concept but in basic terms on how TTIP could affect us:

  • Investor state dispute settlement could allow for individual companies to take state/government to independent tribunal where they can sue for compensation. This is only open to foreign investors (which is an unreasonable power grab on global organisations). For example if there was a breach of expected profits from a future contract eg a private foreign company could take Government to a tribunal if an NHS contract breached the expected profit.
  • Public Service-Public services are normally protected from Free Trade Agreements, However, because the NHS is now, in part, provided by commercial companies, it will only be protected from TTIP if it is explicitly excluded from the treaty (which currently it is not).
  • Health and Safety at work under this agreement would be affected. ISDS will give any US company operating in the UK health market the right to sue the government if it introduces new public health regulation, or health protection and health promotion policy measures that might affect these companies’ future investment or profit opportunities. So evidence for safer or more effective treatments, or advances in clinical knowledge, could not be put into practice (at least without the risk of being sued) if this affected the anticipated profits of existing providers. At the same time, harmonisation of health and safety regulations is likely to mean the downgrading of UK public health measures governing the use of food labeling, pesticides, chemicals, the presence of hormones in meat production and so on.
  • We still don’t know what is in TTIP yet and there is a presumption of secrecy (we won’t like what they are offering).
  • More info can be found here: http://www.patients4nhs.org.uk/eu-us-free-trade-agreement-or-ttip/
  • https://secure.38degrees.org.uk/pages/ttip_home

Vision for UK Physiotherapy: the committee received a presentation and video on the draft ‘Vision for UK Physiotherapy’ which had been developed and seen by Council members in December. The agreed overall statement is ‘Transforming Lives, Maximising Independence, Empowering Populations.

NHS Pay in England: the revised pay offer for 2015-16 was considered by the committee. It was agreed that members would be consulted on the offer through stewards, with a recommendation to accept on the basis that the offer is the best that can achieved through negotiation (as there was no commitment to industrial action from members). Committee members acknowledged that the new offer is worse for a proportion of higher paid CSP members but noted that nonetheless it is significantly better for the large majority.

Workforce planning: members and managers are reporting significant difficulties in recruiting at both Band 5 and Band 6. Further examples of this should be fed in to Kate Moran at the CSP. I can forward this on if needs be.

Reports from the Countries: the committee considered updates from Northern Ireland, Scotland, Wales and England. In particular it was noted the substantial difficulties still being faced my members working in, or trying to obtain work in, Northern Ireland.

‘Freedom to Speak Up’ Review: the report into Robert Francis review into whistleblowing in the NHS will be published in 11 Feb and can be accessed athttps://freedomtospeakup.org.uk/

Members working outside the NHS: CSP SNO Neil Lark updated the committee on a range of issues affecting members working outside the NHS, including in higher education, the Ministry of Defence, in companies including Nuffield Healthcare and Spire and in social enterprises.

TUC Women’s Conference: this year’s delegation of members attending Womens’ TUC was ratified by the committee. The members are Kim Gainsborough, regional steward in the east of England, Gwawr Jonas, a steward in Wales and Louise Wright, regional steward in Wales.

October 18 ‘Britain needs a pay rise’ demonstration: the committee reviewed the attendance at the events in London, Glasgow and Belfast and thanked everyone who came along. The committee agreed that for any future similar events, encouragement to attend would start with CSP core activists and others who had previously expressed an interest in the relevant area.

ERUS workplan: the committee considered the progress that had been made in 2014 towards key objectives and also reviewed the draft workplan for 2015. The committee was supportive of a more streamlined version focussing on the two key priorities of ‘organising’ and ‘negotiating’.

Future meetings: priorities for the next meeting were identified and included:

  • Recruitment difficulties
  • Feedback from the workforce data modelling and safe and effective staffing levels projects
  • Post General Election wash-up
  • Inviting an outside speaker to talk about fair taxation

Thank you for taking an interest in my blog, I have been overwhelmed with positive comments which continues to drive me to write more. As always if you have any questions or comments leave a post on here or tweet me @LCphysio

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Physiotherapy Works!

Last Friday I was fortunate to be able to attend the Physiotherapy Works Locally event as part of the East Midlands Regional Network. I have been asked by the network to be a core part of the committee. This will hopefully allow me to build some momentum with social media and help get students and newly qualified members involved. This will aid the discussion regarding key decisions about the region and society which can be fed back to council. The Physio Works locally event was a joint event between East Midlands and Yorkshire/ Humber  Regions. The event was a fantastic success with a lot of social buzz and pledges being made.

Photos from Anne Jackson CSP

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The event kicked off with Karen Middleton CEO of the Chartered Society of Physiotherapy giving a talk on: “The Case for Change”

Whenever I listen to a speech by Karen I feel so empowered, I want to run outside and tell everyone how fantastic we are as Physiotherapists and that we can really make a difference to peoples lives. Her talk was powerful and to the point. She said that we as Physiotherapists need to start talking about the benefits of Physio before we miss out on our golden opportunity. The health climate in 2014 is creating an environment where people are living longer. This creates a society with patients with more long term conditions and people needing to be fit for work for longer.

 

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Physiotherapy can influence all of these groups!!

So what are you going to do about it?

The quality of a service is essential to achieve positive outcomes. We need to be effective, collect outcomes, safe and develop positive patient experiences.  However, how are we going to do this? We have less money available and a dependent medicalised society. So what innovative ideas can we take forward? The profession of physiotherapists is far too modest regarding what we can bring to the table in terms of healthcare. Overcoming this apprehension will enable us to take our ideas forward and make them reality before it is too late.

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So here are few of the things Karen suggested we should be doing:

  • See opportunities and take them.
  • Realise our potential as leaders.
  • Come of age as autonomous practitioners.
  • Use CSP support, materials and tools.
  • Make a lasting difference to patients.
  • Nobody will do this for us.

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So some tips:

  • Be flexible.
  • Connect, build, link and network!!!!
  • Think ahead and talk solutions.
  • Know how local decision makers think.
  • Use the evidence.
  • Show our impact through data collection.
  • Talk about money as well as outcomes.

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Action Point:

Think about becoming a pioneer for Physiotherapy Works –  for more information:

Web: www.csp.org.uk/physioworks

Twitter: #physioworks

Email: physioworks@csp.org.uk 

  • So what?  Now what? What difference does it make? Be Brave, Physiotherapy Works.

 

Change is the Only Constant- Alison Hughes NHS ENGLAND

Alison Hughes was another fantastic speaker of the day. She is currently Director of West and South Yorkshire and Bassetlaw Commissioning Support Unit.  She was initially a physiotherapist and an advocate for clinicians leading the NHS. As physiotherapists we are ideally placed to lead. We are able to diagnose, listen, work as an individual and as a team.

However the change you want to see starts with you!

And you need to be clear on what success looks like.

To me success looks like : Everyone in the general public knows what a Physiotherapist is and what they can do.

What are your barriers to change?

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I thought this image summed up a lot of clinicians anxiety to change. Mostly due to hidden barriers created by a Top down  organisational structure created by management. To overcome this we need  to be brave and inform management of the challenges faced by front-line staff and the solutions to overcome these difficulties (this may be where physiotherapy comes in)

Alison referred everyone to a book by Robert Kegan- Immunity to change. Which links to the image above. http://www.amazon.co.uk/Immunity-Change-Potential-Organization-Leadership/dp/1422117367 n

When planning a strategy for change, below is a great diagram to help you organise your contacts so that you target certain individuals to help promote specific campaigns.

Importance of Stakeholders

Influence of Stakeholder

Unknown

Little/ No importance

Moderate

Significant

Unknown
Little/ No importance
Moderate
Significant

So in summary:

  • In creating change we need to clarify what success looks like.
  • Set realistic goals
  • Grow and use the support you have.
  • Understand stakeholders
  • Understand hidden competing commitments for yourself and others.

 

Physiotherapy Works- Make Every Contact Count. Knowing Your Service.

The principles of this focused on:

  • The context of change
  • Knowing your Service
  • Knowing your Population
  • Knowing your Evidence.

Know where you fit in our healthcare system.

Knowing your service

Quality is based on:

  • Effectiveness
  • Patient Experience
  • Patient Safety

+COST

Quality +COST= Value.

The CSP is developing tools to give bite size pieces of evidence to show the value of Physiotherapy. This will be based on for every £ spent on Physiotherapy will save the NHS…. compared to without. The cost of Falls Tool will be launched alongside Older Peoples Day on the 1st October 2014 (and more to follow).

Knowing your Population

A population is made up of – current users of the service and future users of your service.

Accessing Health Profiles can give you  information regarding the demographics and problems in your region.

http://www.apho.org.uk/default.aspx?QN=P_HEALTH_PROFILES

Knowing the Evidence

  • Published research
  • National guidance
  • Local data- audit, patient experience, satisfaction, outcome, KPI’s
  • Other
  • This can be used to challenge the status quo!

There was a great emphasis on developing your service and having your elevator pitch in mind, so if you were stood next to a commissioner in a lift you could quite happily deliver your message.

My service is…

Delivers to this population…

Based on this Evidence…

At this price!!

So you might be thinking where do you go from this… So the next steps might be..

  • Why do you need to change?
  • What will you do differently?
  • When?
  • How can you improve?
  • Who will you influence?

This will give you a starting point for change !


In the afternoon the Physio Works team did a great job in setting up mini workshops to get us thinking about innovative ideas which could form part of our future NHS!  We looked at regional health profiles, developed  ideas and then presented them to the group. There were some great ideas being thrown around the room and it was an effective way which made everybody feel ready to go and talk about how versatile the profession of Physiotherapy really is.

The East Midlands (@CSPEastMidlands) and Yorkshire and Humber (@CSPYorksHumber) Regional Networks did a great job in organising the event and are always looking for more members to attend regional meetings, I would actively encourage you to attend. More information can be found here:

http://www.csp.org.uk/nations-regions/east-midlands

http://www.csp.org.uk/nations-regions/east-midlands-regional-priorities

http://www.csp.org.uk/nations-regions/yorkshire-humber

http://www.csp.org.uk/nations-regions/yorkshire-humber-regional-priorities

http://www.csp.org.uk/your-health/physiotherapy-works

 

Thank you again for taking an interest in my blog. As always please feel free to leave a comment below or tweet me @LCphysio.

Finally the first part of my campaign was to get my Mr to make a pledge!

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Grab Opportunities With Both Hands!

I just wanted to start this post by saying a massive thank you to everyone who has taken an interest in my blog. So far, I have had over 4000 views which is amazing and totally appreciated.

So this week I went to the CSP West Midlands Regional Network Study day in Worcester (Keep looking on the CSP website for the presentations under West Midlands Regional Network). I am going to discuss what I took from the event. See a few pictures below.

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When I was a student I was the student representative on the West Midlands Regional Network, which I have now passed onto Daniel Jackson (3rd Year Keele who kindly provided the photos). The West Midlands is a very active network and I have continued to have some involvement since qualifying which will be easier now I am staying in Birmingham. At the moment my role on the network is part of communications team which involves engaging members (mainly new grads with what goes on). The network are very welcoming and always like to know what is going on in your work place, so any issues can be fed back to the CSP through our chair Janet Davies or Rep to Council Philip Hulse. The study day kicked off similarly to a normal network meeting, so work place reports were discussed and key points in the CSP council papers and key messages were highlighted (For more information and minutes please go the West Midlands Regional Network http://www.csp.org.uk/nations-regions/west-midlands. The network meetings are great to find out what is happening in the real world of physio (for students)  and it is great way to share good practice or discuss work place issues for (qualified). For me the network meetings are a great opportunity to network and to find out first hand what issues are facing our profession.

I have highlighted presentations in bold so you can pick and choose which sections you read as there is quite a lot to talk about.

Presentation 1-“Professionalism in Today’s Regulatory Climate” Sue England who is the CSP Treasurer and Council Representative (@SueEngland10)

I believe slides will be put on the CSP website. I am not going to discuss everything in the presentation but this is what stuck with me: Firstly discussion of what defines your Scope of practice. Sue suggested it was a good thing to actually write down your scope each year. So what are you trained and competent to carry out? This changes with experience so it is good to know what the limits of your practice are. For me personally by writing down my scope this will highlight areas I need to focus my CPD to aid my career progression.

Secondly was the fact that as a physiotherapist you are an autonomous practitioner, this means any clinical decision you make you must be able to justify whether during assessment, clinical reasoning, treatment plan or record you are involved in. The first line of defense you have if you are pulled up by the HCPC are your notes, this mean they must be accurate, comprehensive and comprehensible ! As a full CSP member you have comprehensive public liability insurance (if you are working within your scope of practice). CSP membership is a bit like RAC/AA cover you don’t want to have to use it but that time you do the costs that would be covered would be equal to a lifetime cover so personally I think it is a small price to pay (fingers crossed I never have to face this!!)

Finally I found a good link to read  is :  http://webarchive.nationalarchives.gov.uk/20130402150350/http://ahp.dh.gov.uk/2012/02/27/voicepiece-karen-middleton-chief-health-professions-officer/ . Karen Middleton, Chief Health Professions Offcier, wants AHP’s  to be transparent following recent findings from the Francis report (although most of the findings were centred around nurses, physios need to ensure we don’t miss out on funding for leadership programs or CPD opportunities) . As physio’s we generally are not very good at challenging each others practice, so Karen’s aim is to encourage AHPs to talk about the issue of professional behaviour in a more open and constructive way, which I believe was the main message behind Sue’s presentation.

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2nd Presentation: A Personal Experience of Completing the HCPC CPD Audit- Jane Toms- Communication Lead WMRN and lecturer Coventry University.

I think one of the scariest things to think about as a qualified physiotherapist is being called up by the HCPC for CPD Audit. Each year the HCPC select 2.5 % of the profession to have their portfolio reviewed. Now lets face it physiotherapists are very good at doing CPD, however, if someone was to come and raid you’re house one evening, would it be in an organised manner? If you’re like me I have 3 folders which store everything but I wouldn’t necessarily think it was appropriate to hand into the HCPC. Jane Tom’s presentation gave a great insight into the process and revealed some relieving points.

How she completed it:

  1. Read carefully what was required: Guides,videos and examples from HCPC.
  2. Look at online resources from CSP, HCPC.
  3. Read carefully what is required again
  4. Look at the assessment criteria!!!
  5. Look at portfolio and select most appropriate CPD
  6. Keep cycling through 1-5.

Jane brought in a copy of her submission and it was quite a relief to see a very thin A4 folder!!!  So what was needed in the submission.

  • 500 words about current roles and responsibilities
  • 1500 Words on how she addressed standards 1-4 with evidence to support it.
  • Standard 5 submit it!! You do not need to use all 2000 words!

So a lot less work than you thought? However, do you write the dates of any CPD activities you do?

Standard 1: Maintain a continuous up to date, accurate record of CPD: Basically write a timetable for the last 2 years of things you have done and the nature of the activity, for example formal course, discussion, peer review.

Standard 2: Demonstrate that CPD activities are varied and relevant: so link to nature of the activities you have recorded and then link to why the activities are relevant to your current role (so link this to summary of role).

Standard 3: CPD has contributed to quality of practice and service delivery: Link evidence to a form of evaluation you can do this yourself or by external feedback you may have documented. How has CPD helped your practice.

Standard 4: Seek to ensure CPD benefits the service user. Who are your service users? Basically it could be anyone you come in to contact with so patients, students, staff etc. Try to link to service user feedback eg. cards, emails, patient feedback etc… This is probably the most difficult standard.

So what would Jane do differently next time?

  • don’t feel guilty if portfolio is chaotic
  • endeavor to be less chaotic as this would save time e.g write down CPD in diary.
  • Ask people who give positive feedback to email her- emails provide dated evidence.
  • email colleagues appreciation
  • even more collecting of positive emails, cards and feedback.

Presentation should again be uploaded onto the WMRN page.

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Presentation 3 Achieving CPD Excellence- Sophie Wickens CSP Fieldwork Officer for CPD

So following the previous presentation I think the importance of CPD has been highlighted. CPD is an ongoing process. My CPD has very much focused on how my CPD activity has affected me but I haven’t integrated it into how it has affected my service users, I have said it will but I haven’t evidenced it. A way I could demonstrate my CPD in this way could be what I learnt from working with England Cricket, followed up by documenting an email from Steve McCaig who gave me positive feedback for the work I did and how the players and coaches responded to me.

What are the benefits of demonstrating excellence in your CPD?

  • encourages further learning.
  • HCPC requirement
  • Role model to others.
  • Job satisfaction
  • Become critical about own practice.
  • Make the case to employers of the benefits of attending courses. i.e. applying for funding.
  • a way of influencing commissioners.

What resources are available to you from the CSP?

  • Pebblepad/ eportfolio proformas
  • Frontline
  • ICSP- Case discussions
  • Twitter
  • Championing CPD Scheme
  • CSP Colleagues
  • CPD Champions- reflective cards
  • QA Audit Tool
  • Physiotherapy Framework
  • CPD Syd
  • Specialist physio through professional advice service.
  • Links to specialist library
  • Network meetings
  • Annual Reps Conference
  • Clinical interest groups
  • Physiotherapy UK
  • Physio Journal
  • CSP Briefing papers
  • Website.

So there are a few things to be going on with.

Presentation 4 Top Ten Things you didn’t know about NICE Naomi McVey.

I am mainly going to bullet point some of the things I learnt from this presentation as I don’t have the slides in front of me.

  1. Maybe its just me but did you know the codes on NICE guidelines symbolise the type of paper you are looking at, for example CG- Clinical Guideline QS- Quality Standards PH- Public Health.
  2. The full NICE Guideline provides an in depth report of all the evidence and a summary whereas the web format provides recommendations. Naomi advised to go to the web format first and then follow up with the full guideline if you require more detail.
  3. NICE Quality Standards provide markers of high quality care from the best available evidence, so good to use when looking to implement a quality service.

CPD Opportunities and Resources available from NICE.

Presentation 5 Moving into the driving seat- how physiotherapy can benefit from this current climate Sue Browning CSP Dep Chief Exec.

Change in the NHS is here to stay as we cannot afford to keep doing what we are doing. There is increased competition to provide services, there is a shift to primary and integrated care to promote self-management and there is an increasing demand for quality to be monitored.

Change does bring opportunity: Commissioners are looking for more efficient and better ways of working and there is strong evidence that physio is the answer to many of the major current changes. However, we cannot assume that people know the key role of physio in preventing unnecessary admissions, providing alternative pathways and keeping people independent. Therefore it is our job to go out and take control of this agenda. Everyone has a role we need to understand and look to improve our role, sell ourselves, look for opportunities round local joint strategic needs assessments (JSNA), build support with patient groups (they will be your allies), learn from others and look to the CSP website. Tell the CSP what you need to do this? As a profession we are a team and need to work together.

Finally moving into the driving seat.

  • Physiotherapy has a strong future.
  • We all have a role in creating that future from student to qualified member.
  • Services will change.
  • Seize opportunities
  • Network, network, network and access the support.
  • Regional Networks have important roles.

So as you can see I have taken a lot from one study day I hope you may find some of it useful.

Finally what is happening with me, I recently went to help out at an extra session with West Brom using Functional movement screening to assess players. This worked in my favor as I am now going to be doing some paid work for West Brom, as one of the physios was unable to cover a day so I stepped in (It shows sometimes grasping any hint of opportunity can lead to others). I will do a follow up post for all of this as I feel I have I overloaded this post with information.

Thank you again for taking the time to read my post. Again any comments please leave on the page or tweet me @LCphsyio