1. education

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, Sue.Louth1@srft.nhs.uk
Strategic Intent / Service Transformation
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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:
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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:
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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