CSP Yorkshire and Humber

Regional Network Development Day

Physiotherapy: Fit for the future

#Physiofit4thefuture

Welcome and introductions

Chair of the CSP Yorkshire and

Humber Regional Network

Follow us

@CSPYorksHumber

Tweet us

#Physiofit4thefuture

Morning Programme:

• 10.20 – 10:30 Welcome & Introduction. Claire Arditto – CSP Y&H Regional Network Chair

• 10.30 – 11.15 Role of the Advanced Clinical Practitioner. Sarah Henry – Advance Clinical Practitioner. Harrogate & District NHS Foundation Trust

• 11.15 - 12.45 Physical Activity Clinical Champion. Anna Lowe -Ph.D Researcher, Health & Wellbeing Institute - Sheffield Hallam University Physical Activity Clinical Champion – Public Health England

• 12.45 – 13.30 Lunch

Afternoon Programme:

• 13.30 - 14.15 Digital Technology – using technology to enhance Physiotherapy Practice. Simon Ball Senior Physiotherapist and Product Manager Health ADI Health

• 14.15 – 14.45 CSP Strategy – Transform, Empower, Influence. CSP Y&H Regional Network Core Team

• 14.45 – 15.00 Q/A session

There are many ways to get involved

in the Network:

• Follow us on Twitter @CSPYorksHumber

• Log onto the Yorks and Humber iCSP pages and keep up to date with local news and events www.csp.org.uk/nations-regions/yorkshire-humber

• Share interesting case studies and examples of physio transforming lives in the region

• Play an active role by attending events and getting involved in a campaign in 2017 and beyond

The Role of the Advanced Clinical Practitioner

Sarah HenryAdvanced Clinical Practitioner

Acute Medicine, HDFTSeptember 2017

Overview

• About Me

• What is an Advanced Clinical Practitioner (ACP)?

• Implementation of ACP Role

• What does an ACP do?

• Trainee ACP to Qualified ACP

About Me….

Introduction

• What is an Advanced Clinical Practitioner (ACP)?

• “An ACP is a professional who has acquired the expert knowledge base, complex decision making skills and clinical competencies for expanded practice, the characteristics of which are shaped by the context and/or country in which s/he is credentialed to practice. A Masters degree is essential for entry level.”

Why do we need ACP’s?

• Service drivers for change:

• Five Year Forward View

• New Care Models

• 7 Day Working

• Urgent & Emergency Care Service Development

• Sustainability and Transformation Plans

:

What does an ACP do?

• Complementary to the traditional medical workforce • Impact on patient experience: Holistic assessment, continuity of

care patients feel that they receive a more personalised service• Bridges the gap between nursing (!!), therapies and medicine • Impact on outcomes and patient safety: recognising omissions or

shortfalls in care, increased recognition and management of deteriorating patients, organisational knowledge and skills

• Impact on staff: improved communication and team working, nurses and junior Drs see them as a source of knowledge and approachable.

• Impact on length of stay and discharge: implementing care early, understanding organisational barriers and how to work round them, completing discharge paperwork timely.

Interview

• Math's Test

• Written Paper

• OSCE

• Panel Interview

Education

• MSc in Advanced Practice

• Independent non medical prescribing

• Work based Training:

• 2 Years of work based training within AMU/CAT/CATT

• Designated Medical Consultant supervisor

• Robust standardised assessment FY1/FY2 portfolio of competencies

Pillars of Advanced Practice

• Clinical Skills

• Education

• Research

• Leadership and collaborative working

Skills

• Clinical Examination

• ALS

• Venapuncture

• Cannulation

• Male Catheterisation

• Verification of Death

• CPAP

• Independent non- medical prescribing

• Requesting diagnostics

• Formulating clinical management plans

• Advanced radiology requesting

• Diagnostic interpretation

• Teaching

• Lumbar puncture

• ++++++++++

• NOT on Junior doctors rota

• Medical Registrar ‘in hours’

• Patient assessment

• Patient Triage

• Sick patient assessment

• Core clinical Skills

• Facilitate education and learning

• Research

Challenges

• Crossing boundaries• Learning curve• Training/studying/working/living• Cost to NHS• Lack of a consistent understanding of Advanced

Practice roles, and how standardised are educational requirements, competencies and job descriptions?

• Governance of such roles right to ensure safe and effective patient care

Highlights

For Debate

• What is Advanced Practice and what isn’t

• Advanced roles vs. extended roles

• Extended scope practitioners / ACCP’s

• Need standardisation of titles, roles and training

• CSP / NHS England currently working on this

• NMC have specialist group why doesn’t CSP?

Any Questions?

Contact

• Email: sarah.henry@hdft.nhs.uk

• Twitter: @sclhenry

Lunch#Physiofit4thefuture

Digital Technology – using technology to

enhance Physiotherapy Practice

Simon Ball

www.adi-uk.com

About Me!

10 Years in Leeds Community Healthcare/PCT in MSK and Pain

Management Services

Worked privately across orthopaedics, MSK and OH

Product Manager for Advanced Digital Innovation (UK)

Currently Clinical Specialist in a community pain service in Leeds

ESP work in Sheffield

www.adi-uk.com

My digital journey!

• Local go-to IT guy!

• S1 lead and website content manager

• Clinical Field Testing

• Product development and design with the Pain Toolkit and Pain

Management Plan applications

• Commercial aspects

www.adi-uk.com

Digital Higher or Lower!!

• What % of the adult population have a smartphone in the UK? a) 68% b) 71% c) 78% d) 81%

• What % of adults use the internet?

• % of 19-24 that check their phone in the middle of the night?

• % of Smartphone users who look at their phone within 15minutes of waking?

• % of smartphone users make NO traditional voice calls in a week

• % of people who have monitored their own health with technology

• % of people have had digital access with the NHS?

Average number of app downloads per month?

What % of GP’s have digital health records?

% of people with digital access to their health records?

Imison C, Castle-Clarke S, Watson R and Edwards N (2016) Delivering the benefits of digital health care.

Nuffield Trust

There's no place like phone | Global Mobile Consumer Survey 2016: UK Cut – Deloitte

2017 Future Health Index Report

www.adi-uk.com

Why is digital here?

• Accessibility

• Knowledge

• Time

• Convenience

• Automated Procedures/Processes

• Feedback

www.adi-uk.com

Digital in our daily lives

• Television

• Music

• Banking

• Shopping/food

• Communicating with Friends and Family

• Sports/Activity

• Knowledge!

www.adi-uk.com

NHS Digital

NHS Digital Vision

Our vision for 2020 for data and information is for:

… a health and care system that has all the data and information that it needs, provided in an

accessible and timely way, to enable it to provide the best possible services and to achieve world

class health outcomes.

www.adi-uk.com

What is the value of digital to our patients?

• Communication

• Knowledge and Skills

• Monitoring

• Self-Efficacy

• Holistic intervention

• Shared decision making

• Better connected care

• Ownership of their own care/health

www.adi-uk.com

What is the value of digital to clinicians?

• Communication

• Automation of procedures

• Data capture/collection

• Time Saving

• Reducing DNA’s/cancellations

• Cost saving

• Remote monitoring

• Shared decision making

• Record keeping

• MDT working/information

www.adi-uk.com

The Pain Toolkit and Pain Mangement Plan

www.adi-uk.com

www.adi-uk.com

Learning/Challenges

• GP’s did not have enough time/inclination to discuss self-management (better

with more recent graduates)

• Clinicians wanted the ability to send patient specific resources/information

• Patients liked the app and found it easy to use and intuitive

• Clinicians liked the integration into their current clinical system

• Patients liked being able to see their progress on a chart (Dolo)

• Outcome capture an important part for the services and AQP

www.adi-uk.com

Patients

CliniciansCCG’s and

Management

www.adi-uk.com

MyPathway

MyPathway Patient View Resources Clinical portal

Personal Health Record Platform

www.adi-uk.com

Early Data

Costs:

80% cost reduction in printing & postage

Efficiencies

80% reduction in time to process patient

45% reduction in SPoA staff

PROMs

<2% PROMs completion before MyPathway introduced, around 40% completed digitally for those

registered on MyPathway

www.adi-uk.com

Development Principles

Transformation first – changed pathways – clinical and administrative

Changed culture – training programmes, learning from the innovators

User led design – patients, clinicians and administrators

Analytics enabled – built in reporting of activity and outcomes

Prototyping – innovation led design processes

Interoperability – EMIS, SYSTMOne integration with a platform to enable wider

integration

Strong IG – N3, approved provider of SCR

Taken from Nuffield Trust/KPMG Digital Health Research 17th February 2016

www.adi-uk.com

Barriers to Adoption/Innovation

• Attitudes

• Interoperability

• Funding/Costs

• Digital literacy

• Lack of trust/worries about security

• Corporate strategy does not align with the service vision

• Time

www.adi-uk.com

Digital Tech and Physiotherapy

Examples –

FizzYo - It puts a wireless sensor into the mouthpiece of a conventional airway clearance device. As the user

exhales, the sensor sends electronic signals that control computer games.

Cheshire Care Record – decreased number of orthopaedic appointments from 6-5 – increasing capacity

Virtual Clinics – Brighton and Hove #clinic £250,000 per year,

The CAREN (Computer Assisted Rehabilitation Environment) - puts people at the helm of a life-

size video game and forces them to use atrophied muscles and teaches the basic skills necessary to recover

quicker from a brain and spinal injuries.

DorsaVi – Movement sensors objectively measure movement

Online CBT Courses – wide ranging, multi-platform

Decision Support Tools – Paediatric app for meds administration/calculator

Predictive Analytical Systems – Flag deterioration/changes in symptoms – only as good as the data

www.adi-uk.com

1 - Innovation in specialist care – expensive integrated tech solutions

2 - Solutions to enhance standard practice and improve outcomes –

communication, education and holistic care

www.adi-uk.com

Where to start?

• Identify the pain point/problem/service need

• Break the problem/need down - collect evidence/data to back up your

problem

• Research what is out there already and what problem does your solution

solve?

• Who can fund it? Business/University/Charity/ Government/Private

investors

• What is the business model – sales, income generation etc.

www.adi-uk.com

Implementing technology is an ongoing programme of transformational

change.

Several cycles of development are required to get to a point where the solution

starts to show benefit – patience is needed

Digital technologies will not deliver improvements in productivity, outcomes,

patient care on their own.

www.adi-uk.com

Digital Transformation aims to

enable and enhance care and not

replace face to face care!

CSP Governance Review

CSP English Regional Networks

August 2017

Previous key Council Decisions

– Purpose of Council – “The purpose of Council is to provide leadership of the physiotherapy profession and governance of the CSP”; and

– Leadership representation – Council members are representatives of the CSP membership, elected to lead the profession. They will consider all members’ needs and work in the best interests of the profession as whole.

Key Decisions made at December and March meetings

including Council’s preferred governance model

Small Council (c. 12 members)

The purpose of Council is to provide leadership of the physiotherapy profession and governance of the CSP

• Short-life working groups to deal with time-limited issue as required.

• Drawing expertise to inform decision-making as required (ERNs,

Country Boards, professional networks & TU groups)

Finance, Risk &

Audit

Employment Professional

What will Council do?

• Seek advice

• Invite members to contribute

• Delegate work

• Tailor engagement

• Support members & networks & groups

• Listen and explain

• Be held to account

What does all this mean for ERNs?Council –

• All Council members will be representatives of the CSP membership, elected to lead the profession.

• They will consider all members’ needs and work in the best interests of the profession as whole.

English Regional Networks –

• Draw your membership from a wide range of members in your region.

• Key contacts between Council, its committees and the membership for your area.

What can we do?

• Get elected

• Encourage others to stand

• Vote for preferred candidate(s)

• Get involved through established routes:

− Project, programme or working groups e.g. Hip Fracture Steering Group

− Workshops and roundtable events e.g. practice-based learning webinars

− Peer review and research activity e.g. abstract reviewing activity (for Physiotherapy UK and ER-WCPT congress)

− Networks and representative structures e.g. National Group of Regional Stewards

Agreed Council transitional

arrangements (subject to AGM)

• Council elections postponed until after the

AGM

• Interim Council to serve from the AGM

until spring 2018

• Elections in early 2018

• New Council take office in spring 2018

AGM - VOTE on the Governance Review changes

When: 12.30pm 11 November

Where: PUK, BIC Birmingham

or

by Proxy www.csp.org.uk/agm/proxy(closes 12.30pm 6 Nov 2017)

More details & information

Can be found on the Governance Review

webpages

http://www.csp.org.uk/governance-review

Q&A#Physiofit4thefuture