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 /06/13
2 Scrutiny - Qualitative Non-Medical Prescribing (NMP)Should not be scrutinised in terms of a Training and Development opportunityIs not well-matched to every physiotherapy service areaNon-Medical Prescribing ‘requires a high level of expertise andshould be an advanced practitioner’.World Congress Physiotherapy October 2012Is not suited to every physiotherapist ; even advanced practitionersClinical outcomes, process outcomes, cost outcomes, service outcomes
3 Quantitative - What We Know Prescriber TypeCount of Registered PrescribersCount of Prescriber Activity(Feb-Mar 13)% Prescriber ActivityVRegistrantsCommunity Nurse(restricted list)63224238NISP(whole BNF)18811461PISP332471Total85338045CaveatsNurse and Pharmacist prescribers in primary/community care only2 registration systems are transitioning therefore numbers may not be 100% accurateRestricted List – Nurse Prescribers Formulary for Community Practitioners
4 Physiotherapy NMP - Current TrustSub-specialityNumberSupplementary (S)Independent (I)State of ReadinessBHSCTNHSCTResp.Rheum.3SWaiting prescription pads. Not on Trust register - query re drug budget. On professional register. Non medical prescribing Trust policy in place. Mentor in place.SEHCTSHSCTMSK/Pain1Waiting prescription pads once data base goes live for the MSK staff. Required protocols and mentor in place and letters of recommendation ed??? in acuteWHSCTMSKRequired protocols and mentor in place – registration to be completed to implement
6 Challenges Service review – assessment of service need/value of NMP NMP protocols / policies within ‘scope of practice’ in the respective TrustsRobust Partnership & Support- Close working liaison with medical colleagues / stakeholdersKnowing your staff and medical champions of NMP- Consultant / GP mentors- Acute V’s CommunityConstraints of the service (Parameters)- Clinical Management Plan; generic, individual patient- Formulary as per practitioner/mentor discussion with respect to ‘scope of practice’MSK Consultant Physiotherapist Therapeutic RadiographerAnalgesics Whole BNF; close liaison with Medical Consultants at Cancer CentreAnti-inflammatoriesNeuropathic meds.Muscle relaxantsPPI; Ant-emetics, Laxatives
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 ApproachSelf-managementSelf-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.