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A Physiotherapy Service Managers Perspective – Scrutiny & Viability Seamus Doherty Head of Physiotherapy Services WHSCT Vicki Quinn Consultant Physiotherapist.

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Presentation on theme: "A Physiotherapy Service Managers Perspective – Scrutiny & Viability Seamus Doherty Head of Physiotherapy Services WHSCT Vicki Quinn Consultant Physiotherapist."— Presentation transcript:

1 A Physiotherapy Service Managers Perspective – Scrutiny & Viability Seamus Doherty Head of Physiotherapy Services WHSCT Vicki Quinn Consultant Physiotherapist – Orthopaedic ICATS WHSCT 27/06/13

2 Scrutiny - Qualitative Non-Medical Prescribing (NMP) Should not be scrutinised in terms of a Training and Development opportunity 1. Is not well-matched to every physiotherapy service area Non-Medical Prescribing requires a high level of expertise and should be an advanced practitioner. World Congress Physiotherapy October 2012 Is not suited to every physiotherapist ; even advanced practitioners Clinical outcomes, process outcomes, cost outcomes, service outcomes

3 Quantitative - What We Know Prescriber Type Count of Registered Prescribers Count of Prescriber Activity (Feb-Mar 13) % Prescriber Activity V Registrants (Feb-Mar 13) Community Nurse (restricted list) NISP (whole BNF) PISP Total

4 Physiotherapy NMP - Current Trust Sub- specialityNumber Supplementary (S) Independent (I)State of Readiness BHSCT NHSCT Resp. Rheum.3S Waiting prescription pads. Not on Trust register - query re drug budget. On professional register. Non medical prescribing Trust policy in place. Mentor in place. SEHCT SHSCT MSK/Pain Resp. 3131S Waiting prescription pads once data base goes live for the MSK staff. Required protocols and mentor in place and letters of recommendation ed??? in acute WHSCT MSK1S Required protocols and mentor in place – registration to be completed to implement

5 Physiotherapy NMP - Prospective Clinical outcomes, process outcomes, cost outcomes, service outcomes Trust Sub- specialityNumber Supplementary (S) Independent (I) BHSCT NHSCT Resp. MSK2I (+ 3 Conversions) SEHCT SHSCT MSK Womens Health. 2222I (+ 4 Conversions) WHSCT MSK Resp. 1111I (+ 1 Conversion)

6 Challenges Service review – assessment of service need/value of NMP NMP protocols / policies within scope of practice in the respective Trusts Robust Partnership & Support - Close working liaison with medical colleagues / stakeholders Knowing your staff and medical champions of NMP - Consultant / GP mentors - Acute Vs Community Constraints of the service (Parameters) - Clinical Management Plan; generic, individual patient - Formulary as per practitioner/mentor discussion with respect to scope of practice

7 Benefit Analysis - Service Quality Outpatient Respiratory Physiotherapy Service - Altnagelvin - Robust PT to Consultant relationship within the current service - PT practitioner keen to undertake NMP training to enhance the current service - Defined scope of practice; Respiratory Framework standard – Bronchiectasis - Rationalise the patient pathway; Modernisation & Reform - Optimise patient management - LTC Case Management Approach Self-management Self-referral - Easily evaluated

8 Conclusion (Perspective) Low hanging fruit picked too early, before the need for it, can still rot. NMP is a fundamentally different Training & Development opportunity for Physiotherapists – while an extension to their pre- existing knowledge and skills it requires its own set of foundations. Proposals to implement NMP should be scrutinized in the context of holistic service development in advance of personal professional development. There is clear potential for a shift to right person management; reducing unnecessary need for GP visits or referrals to medical consultants while enhancing and integrating services from a patient- centred perspective.


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