We have heard a lot about the crisis affecting the NHS this winter. Professor Karen Middleton, the chair of the Chartered Society of Physiotherapy wrote in The Huffington Post on 13th January 2017, “ It’s clear that the NHS needs a whole-system transformation and that’s what Mr Stevens is looking to achieve with the Five Year Forward View (FYFV).
This document, published in 2015, sets out a vision of taking services out of hospital and delivering more care closer to home. Meaning more community rehabilitation and care to help get patients discharged from hospital and preventive services. This should in turn reduce the number of people admitted in the first instance.
It also places a heavy emphasis on primary care, expanding the team in GP surgeries so that patients can see a wider range of professionals – including physiotherapists – as a first point of contact.”
Having spent the best part of 20 years of my working life in the NHS, I am a staunch supporter.
But 20 years ago starting heads up! – a private stroke and neurological physiotherapy practice – I wanted to give people the individual treatment, time, personal attention and continuity of input to allow everybody to explore their full potential for recovery. This passion is still at the heart of the practice today.
NHS focus has changed from in-patient rehabilitation to early discharge and treatment at home. Self-management and time-limited treatment provision is widespread. The design of the service rather than the individual needs of each person seems to dictate what treatment is available and for how long.
As the focus in neurological physiotherapy in some services has moved from “hands on” more towards “hands off”, people have been assessed, advised and encouraged to return to as much function as possible as quickly as possible.
The vast majority of people are keen to be at home rather than in hospital but sometimes we hear that people do feel abandoned when community services do not live up to their expectations.
Understanding and recognising the value of all levels of care is essential for people to receive the best possible opportunity. We often work closely with our colleagues in the NHS and sometimes stepping in between discharge from hospital and the start of community services.
Specialist neurological physiotherapy certainly plays an important role in enabling people to be discharged from hospital as soon as possible, providing treatment at home aimed at getting people who have had strokes to be as independent as they can be. At heads up! we work very closely with relatives and carers of people with neurological disability helping them to find the best ways that they can work together to get the best recovery.
On the preventive side neurological physiotherapists have an important part to play in assessing, treating and advising people with issues surrounding balance and mobility and we see people with a very wide range of problems both in their homes and at our clinics.
Anna Hamer is a specialist neurophysio working everyday with patients who have had a stroke, Parkinson’s, MS, Cerebral Palsy, Brain Injury and many more.