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Allied health professionals are critical to new models of care

David Oliver considers the role allied health professionals will have in meeting the challenges facing our health and social care systems and in delivering the new care models outlines in the NHS five year forward view.

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Allied health professionals (AHPs) make up 6 per cent of the NHS workforce – the third largest professional group – and still more work in social care, housing, local government, and the voluntary and private sectors. They are highly trained and professionally autonomous practitioners, yet too often their vital contribution is marginalised in a public discourse that tends to refer only to ‘doctors and nurses’. This needs to change.

Twelve diverse professions are listed under the AHP umbrella. I want to name them all: podiatrists; occupational therapists; physiotherapists; speech and language therapists; orthoptists; dieticians; paramedics; diagnostic and therapeutic radiographers; prosthetists and orthotists; drama therapists; music therapists; and art therapists. Pharmacists also play a key role in the NHS but are not historically grouped with AHPs.

Each has its own professional body. There is also an Allied Health Professions Federation, which – it is fair to say – does not have as strong a public voice as similar bodies for doctors and nurses.

Yet at a policy-making level, this large workforce has just one chief professional officer, supported by a small team, to advocate for all the allied health professions in England. Compare this to the plethora of doctors and nurses who work within the Department of Health and NHS England. That chief professional officer is currently Suzanne Rastrick, who will be speaking at the conference that The King’s Fund is running next week on enabling AHPs to lead and shape new models of care.

The AHP workforce will be expected to play a critical role in meeting the challenges facing our health and social care systems. But how well placed are AHPs to play that role?

Despite a steady increase in AHP numbers over the past decade, a report last year by the Nuffield Trust showed that there is still major geographical variation in numbers per 1,000 population, difficulty in recruiting to some posts and inconsistency in matching provision to need.

NHS Benchmarking’s National Audit of Intermediate Care 2015 showed that access to all kinds of short-burst rehabilitation services outside hospital has worsened since last year. This is bound to impact on transfers of care and on hospitals’ ability to discharge patients, to prevent re-admissions or to help patients regain functional independence – an issue particularly for older patients. AHPs – especially physiotherapists and occupational therapists – play a key role in all these areas.

AHPs will also have a crucial role in government policy priorities for service transformation, such as those included in the consultation on the new NHS Mandate, which focuses on preventing ill health and supporting healthier lives; on a safe, high-quality, seven-day health service; on transforming out-of-hospital care and ensuring that services outside hospital are more integrated and accessible; and on supporting improvements in efficiency and productivity.

NHS England’s new models of care – especially primary and acute care systems, emergency care networks and improving health care for care home residents – all require input and leadership from skilled AHPs. At the conference next week, Samantha Jones, the national lead for the New Care Models programme, will be discussing the key role that AHPs will play in delivering the NHS five year forward view.

More widely, the push from the Royal College of General Practitioners, the British Geriatrics Society and others to focus more on care planning, care co-ordination and self-management, and on anticipatory care for older people living with frailty, relies heavily on the role of AHPs. As does the focus on transforming urgent and emergency care services, on improving patient flow and on maintaining performance on the four-hour A&E waiting times target.

There are excellent examples of how AHPs can transform care, some of which will be on show at the conference. Speakers will cover the contribution that AHPs can make to the prevention and public health agendas and to transforming primary care models.

I very much hope you can join us on the day. If you can’t, we will post some of the material online and there is always a lively Twitter following on the day (#kfahps). So one way or another, do come and join the discussion.