CSP Wales Office

1 Cathedral Road

Cardiff CF11 9SD

029 2038 2429

www.csp.org.uk

 

Date 25/05/23

 

Dear Colleague

 

Re:  Health and Social Care, written Evidence for Supporting people with chronic conditions

 

 

The CSP welcomes this opportunity to respond in writing to Health and Social Care committee request for written Evidence for Supporting people with chronic conditions.

Our written briefing compliments the principles in ‘A Healthier Wales’ and, the stated aim of the Welsh Government, to “whole system approach to health and social care , which is focussed on health and wellbeing, and on preventing illness.”  In this light, we offer our comments and suggested areas of exploration for the committee.

 

 

1)    Integration of Health and Social Care

Patients This will draw on the innovation being developed at local level and accelerate the transformation process by ensuring it leads to fundamental and sustainable changes in the workforce. This will include private and voluntary provider services, volunteers and carers.”  This statement

Regional partnership boards (RPBs) and GP clusters are relatively new arrangements in the NHS.  We understand that RPBs are the future of social care and health integration based on current policy, and their role in transforming services is still developing.  The committee should look into the function of the RPBs and how chronic conditions can be managed through the integrated model.

The primary care pan cluster developments are the Welsh Government’s strategic vision for primary care development. This will result in more Allied Health Professionals (AHPs) being deployed in primary care roles across Wales, and in turn help manage chronic conditions in the population.

 

2)    First Contact Practice (FCP)

First Contact Practice is a CSP priority, and we are encouraged by the developments in this area over the last few years.  We have seen a modest increase in the number of first contact practitioners in Wales which needs to be used as a springboard for transformation in primary care. 

The HEIW workforce strategy makes reference to Person-centred care as a “driver for extended skills and advanced practice, ensuring that, where appropriate, health and social care professionals can work at the ‘top of their license/competence.”

FCP is a great example of where physiotherapy can meet the needs of patients with chronic conditions, by providing advanced skills in the primary care setting directly to the patient at the point of contact with the health service. FCPs can deliver chronic condition management services, however there aren’t enough across Wales at this current time.

In England the FCP Roadmap is in place, providing clarity for prospective FCPs on education and the role of FCPs in England. HEIW’s plans to deliver a similar “roadmap” would be an area for the committee to explore in more depth.

The education commissioning to support FCP development is key. In England there are FCP masters modules and E-learning modules available. Some of this education is under development in Wales

Our recommendations for a workforce to manage chronic conditions:

FCP funding for education and posts should be arranged on a more sustainable and consistent basis.

A co-designed national FCP roadmap should be implemented by HEIW.

 

3)    Advanced practice and chronic conditions

In our view this is a key priority area for developing the workforce to meet the challenges of chronic conditions in the future.   

We believe that a well skilled workforce is needed to meet these challenges, ad to do so the Government must commission more AHPs and provide advanced practice opportunities.

To meet the demand of future chronic condition patient needs, the Government should create an advance practice community rehab role for AHPs and deliver increased non-medical prescribing.

 

4)    Rehab space

We support the Government’s move to provide services closer to come, in the community, and and in primary care.  There is also a need to retain space and facilities in the hospital setting to ensure patients are discharged in a condition that promotes their recovery and avoids long term chronic issues.  A lack of rehab can result in a minor issue becoming a chronic one in the long term.

 

 

5)    Support Workers

A key component of providing a workforce that can meet the needs of patients is developing support workers in skill and numbers.  The support workers level 4 apprentice is currently under development. We support this workstream and hope it can be built on further. Support workers are key in meeting the workforce challenges.

6)    Funding

We welcome the specific AHP funding of £5 million that was allocated this year to primary care and community rehab roles. To deliver chronic condition management for the public more funding will be needed long term to deliver more AHPs, key to chronic condition management and rehab after other intervention.

Conclusion

Physiotherapists are key to helping patients manage their chronic conditions, particularly in prehab and rehab pathways which maximise the patient’s outcomes in intervention. During this time of increased waiting lists its vital that the Government continue to develop the key themes described above, and invest in the wider workforce to meet the ever increasing needs of an aging population.

 

The Chartered Society of Physiotherapy is the professional, educational and trade union body for the UK’s 58,000 chartered physiotherapists, physiotherapy students and support workers.  The CSP represents 2,400 members in Wales.

 

Physiotherapists use manual therapy, therapeutic exercise and rehabilitative approaches to restore, maintain and improve movement and activity.  Physiotherapists and their teams work with a wide range of population groups (including children, those of working age and older people); across sectors; and in hospital, community and workplace settings.  Physiotherapists facilitate early intervention, support self management and promote independence, helping to prevent episodes of ill health and disability developing into chronic conditions.

 

Physiotherapy delivers high quality, innovative services in accessible, responsive and timely ways.  It is founded on an increasingly strong evidence base, an evolving scope of practice, clinical leadership and person centred professionalism.  As an adaptable, engaged workforce, physiotherapy teams have the skills to address healthcare priorities, meet individual needs and to develop and deliver services in clinically and cost effective ways.  With a focus on quality and productivity, physiotherapy puts meeting patient and population needs, optimising clinical outcomes and the patient experience at the centre of all it does.