Allied Health Professionals Workforce: a Network Summary Introduction A narrative network summary provided by the North West Allied Health Professionals Network. The chapter is structured in line with the original narrative headings of the return that networks were asked to complete. Contact name and email: Sue Louth, [email protected] Strategic Intent / Service Transformation Development of hub and spoke models of care for some pathways – major trauma, vascular – and redesign of other pathways of care e.g. stroke - impact on numbers and skill mix of workforce Drive to discharge patients from hospital care in a more timely manner – increased demand for OT and other AHP services Drive to develop alternative urgent care pathways – opportunities for AHPs especially physio, OT and paramedics Transfer of some services into the community and development of integrated services and teams, plus changes in social care Safe staffing levels for nursing may impact on AHP numbers (less resources for AHPs?). Currently no national benchmarks for AHP staffing but will this follow? Healthier Together (GM) plus other transformation programmes in Cumbria and Lancashire & Liverpool - workforce needs to work differently. Development of standards for access Increased focus on physical agenda in mental health settings Drive to improve standards of care for patients with dementia Focus on public health and prevention agenda and recognition of AHPs being an integral part of public health workforce. 7 day / extended hours services AQP provision and impact on workforce planning and education requirements. PDR changes Unbundling of tariffs for rehabilitation Francis report – focus on values and behaviours Cavendish report – currently focuses on training and development of HCAs but possible roll out to all support staff Roll out of 6 C’s to non-nursing professions Requirement for more generalist skill set at bands 5 and 6 and highly specialised workforce at band 7 and above Financial pressures /cost improvement programmes provide risks and opportunities for AHP workforce – biggest impact on small professions. Workforce: Assurance and Patient Safety Most of the processes and systems for workforce assurance are undertaken at a local level e.g. HCPC registration checks, preceptorship programmes, appraisal, CPD, promotion of evidenced based practice and allocation of resources to ensure appropriate staffing levels. 81% of the AHP workforce (2012) are under 50 years of age, so CPD for the current workforce is critical to ensure a competent and motivated workforce of the future. The AHP network has identified some risks around CPD due to long standing issues around equity of provision for CPD and lack of awareness of local processes e.g. to identify training needs and support access to CPD. Through the CPWD, the AHP Network is developing an action plan to work in partnership with the sub-regional CPD groups and higher education providers to address these. Workforce Transformation The AHP Board is currently undertaking a project (to March 2015) to explore new roles and new ways of working for AHPs to support service transformation. The project is using services for older people as a framework but the learning will be transferable across other AHP professions. The project will provide evidence on what new roles / new ways of working have already been developed A small number of advanced practitioner roles (i.e. individuals who have completed the recognised MSc programme) and consultant roles exist within AHP services across the NW. These roles exist in dietetics, physiotherapy, podiatry, speech and language therapy, podiatry, paramedics and radiography. In addition to this, many extended scope practitioner roles have emerged across the AHP professions. Many of these roles include the development of skills previously outside of the professional scope of practice to enable AHPs to undertake activities traditionally undertaken by other professions (medical, nursing). This supports the development of a workforce to deliver a particular pathway of care, based around the needs of the patient rather than one which is defined by the professions themselves. These extended roles also enable shortages in other professions to be filled by AHPs e.g. advanced/extended scope AHPs working in A+E where there is a shortage of emergency physicians. The development of new urgent care pathways is being supported through the development of advanced practice and consultant paramedics. This will support a reduction of patients being taken to hospital with referral and signposting to locality integrated teams. In 2013, legislation was introduced to enable physiotherapists and podiatrists to become independent prescribers. A number of AHPs from across the NW are undertaking the conversion programme to become independent prescribers. In addition to this, work at a national level (through NHS England and professional bodies) is on-going to extend the prescribing rights for AHPs, specifically: independent prescribing for paramedics, independent prescribing for radiographers, supplementary prescribing for dieticians and an exemption list for orthoptists. This national work is being supported through the NW AHP NMP network. Assistant practitioners make up 11% of the AHP support workforce, so this role has been under developed in AHPs compared to in nursing. Financial drivers provide opportunities to develop the skills of the support workforce through the development of additional assistant practitioner posts, but also through upskilling the wider support workforce and introducing apprenticeships and cadets into AHP services. Workforce, Education and Learning As mentioned in section 2, the Network has recently undertaken some work (at a network event in March 2013) to scope out issues across the network with regards to CPD. A limited Network wide training needs analysis was also undertaken. There are plans to repeat this, in conjunction with the other professional networks within CPWD, to identify shared training needs. A report from the Network event is attached below which contains a summary of identified training needs. Report - AHP Network Training Needs April 14.docx The North West AHP Workforce Board is working in partnership with the NW Placement Development Network to identify strategies to increase capacity within AHP preregistration placements whilst driving up quality of placements. This includes the rollout to other AHP groups of the placement equitable allocation process, which has been implemented in physiotherapy and occupational therapy. We will also be exploring how to extend the breadth of placements for AHPs, including more community placements and placements within the non NHS sector. Additional Information There is a variation in levels of engagement with local AHP managers/leads and individuals who are completing Trust workforce plans. The Network is working to improve this engagement by encouraging all AHP leads to contribute to local planning processes. Work is on-going at a national level to develop a career pathway for clinical academic careers for AHPs. A small number of AHPs have completed NIHR MRes programmes but there are few bridging programmes for individuals who have completed these to continue along a clinical academic career pathway. Workforce Risks/Issues/Shortages and Actions The key risk/shortage areas for AHPs are: A shortage of sonographers. This is a national issue complicated by the fact that several professions can undertake training to become a sonographer. The shortage is exacerbated by the private sector who offer pay rates at 3 times the AfC rates. Difficulties in recruiting paediatric dieticians in non specialist centres. Development of dysphagia competencies in newly qualified speech and language therapists. In acute sectors, 50% of a caseload may have dysphagia. Mental health physiotherapy – shortage of posts and people with appropriate knowledge and experience to undertake those posts Growing need in forensics in SLT Workforce solutions and actions for your network Network actions to address these risks/shortage areas: Discussions across NW and Y+H LETB with education providers to explore alternative education pathways for sonography. The debate around primary registration for sonography continues at a national level Project commissioned from MMU to identify strategies to support the development of dysphagia competencies in newly qualified SLTs Workforce transformation project (as identified in 1) to explore new roles and new ways of working AHP Workforce Board work stream focuses on workforce supply, including hard to recruit to areas and the provision of a flexible workforce through a NW temporary staffing contract. Action plan to address identified issues around CPD AHP non-medical prescribing network
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