GP consortia: What Allied Health Professionals (AHPs) can do for you

Allied Health Professionals
The Allied Health Professions are a diverse group of highly skilled clinicians who work right across the health, social care, local government and education sectors. They are, in the main, autonomous practitioners who assess, diagnose, treat and discharge patients. They work in public health, acute care, primary and community care and many work at these interfaces so can often be the ‘integrators’ of care for your practice population. Large numbers also work in industry, the independent sector and the voluntary sector as well as in private practice. AHPs are registered with the Health Professions Council and are required to provide evidence in order to re-register every 2 years.

Who are they?
Podiatrists, Dietitians, Occupational Therapists, Orthoptists, Orthotists, Prosthetists, Paramedics, Physiotherapists, Diagnostic Radiographers, Therapeutic Radiographers, Speech and Language Therapists, Art Therapists, Dramatherapists and Music Therapists.

Why they could be the solution to your QIPP conundrum
As autonomous practitioners, this group of clinicians are extremely good value for money. Both as individual professions and as a collective, they offer innovative and creative solutions to those intractable problems that mean patients and their families do not always get the service they need when they need it.

They offer screening, diagnostics and treatments which promote health and well-being and prevent your practice-population requiring expensive investigations and interventions – take paramedics, diagnostic radiographers, dietitians and physiotherapists, for example, and their respective roles in falls management, screening for breast cancer, healthy eating and the promotion of physical exercise. Consider speech and language therapists and their work with children who have communication difficulties – did you know that 60 % of the prison population have some sort of communication difficulty?

This group of clinicians significantly, however, focus on the true outcomes of any health intervention. They focus, whether in physical or mental health (art, music and dramatherapy), on treatment and strategies that optimise a person’s function – what’s the point of the hip replacement if the person isn’t enabled to go back to work or to drive, for example (occupational therapy)? AHPs focus on rehabilitation and reablement – they promote independence and reduce dependence on the health and social care system. Did you know that for every £1 spent on orthotics, it saves the system £4? There are over 70 amputations per week in England and 70% of them are preventable – imagine the difference podiatrists can make if they treat those with diabetic foot ulcers earlier.

Some specific examples of service redesign
The national AHP Service Improvement Project finishes in March 2011. Thirty AHP services across the country have been involved in service redesign in order to resolve some intractable quality problems and attempt to release cash – many of these services are for those who are most vulnerable in society and who require care at the ‘unsexy’ end of the spectrum.

Examples include a musculoskeletal physiotherapy service that introduced self-referral by the patient, a ring and rebook system and workforce re-profiling. In one month, DNA rates reduced from 14% to 6%, saving 214 appointments or 107 clinician hours or £19, 968 if based on a band 6 physiotherapist. Through this redesign, waiting times were reduced from 9 weeks non-urgent to 4 weeks and from 4 weeks urgent to within 1 week. Measurements of quality, in particular the patient experience, improved. You can improve quality and productivity!

Another example is a children’s occupational therapy service which had waiting times of 13 months. In order to meet demand without service redesign they needed to fund an additional 9 WTE OTs – impossible within the current financial constraints! The clinicians devised a new sustainable model within their financial envelope but that would also improve the quality of service. The team developed a 3 tier model of universal, targeted and complex interventions which included involving parents and teachers in the provision of therapy and an interactive website to provide immediate advice and support. The quality of outcomes was measured using a patient reported outcome measure and waiting times have reduced to almost zero in the 4 months since the model went live.

How to get in touch with AHPs
You may well have local contacts that you are familiar with but more strategic AHPs are often hard to get hold of because they don’t necessarily sit within in a traditional hierarchy in an acute trust, PCT or local authority. Every Strategic Health Authority, however, does have an AHP lead and their contact details are below. However, if you still have problems, please do not hesitate to contact Karen Middleton, Chief Health Professions Officer at the Department of Health.

AHPs could be the solution you are looking for!

Yorkshire and the Humber - david.thompson@yorksandhumber.nhs.uk and bryony.simpson@nhs.net

East of England - sally.judges@hertspartsft.nhs.uk

South East Coast - amanda.allen@southeastcoast.nhs.uk

North East - julie.parkes@nth.nhs.uk

North West – sue.louth@salford.nhs.uk

West Midlands – emma.williams@westmidlands.nhs.uk

South East Coast - beverley.harden@southcentral.nhs.uk

South West – karen.tanner@southwest.nhs.uk

London – lesley.johnson@london.nhs.uk

East Midlands – H.marriott@nhs.net

Department of Health – Karen Middleton, Chief Health Professions Officer, England Karen.middleton@dh.gsi.gov.uk

In Pathfinder Learning Network

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