Expanding the role of the physiotherapist

Buckinghamshire Primary Care Trust (PCT) has expanded the role of physiotherapists to include health promotion and diabetes education. These changes in practice have resulted in patients benefitting from a more holistic model of care.

• The organisation
• SHA region
• Project dates
• Project background
• What we were trying to achieve and how
• What was the result
• Tips for other trusts

The organisation

Buckinghamshire Primary Care Trust was formed on 1 October 2006 and builds on the foundations of its three predecessor PCTs - Vale of Aylesbury, Chiltern and South Bucks, and Wycombe. The PCT employs over 2,500 staff, and is responsible for a population of around 500,000 with a budget of over £500 million.

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SHA region

NHS South Central

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Project dates

January 2005 - ongoing

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Project background

In December 2006 Buckinghamshire Primary Care Trust (PCT) produced a report highlighting the burden of preventable diseases, which accounts for 60 per cent of all deaths in Buckinghamshire.

A key risk factor highlighted in the report was the low level of physical activity undertaken by the local population. The PCT decided to focus on this area as physical activity can decrease the risk of some conditions and can help in managing other conditions, such as diabetes.

The PCT put in place a programme which aimed:

• to encourage health care professionals to promote the use of physical activity to patients;
• to increase the profile of physiotherapists within the area of public health and demonstrate how the skills of physiotherapists can help deliver the PCTs targets;
• to integrate physiotherapy into a wider programme of raising the profile of health and lifestyle choices to those with long term conditions;
• to educate patients with type II diabetes on the benefits of physical activity in helping to manage their condition; and
• to educate other staff groups involved in delivering care to patients with the condition.

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What we were trying to achieve and how

As part of the programme the PCT has set up a series of four sessions for patients managing type II diabetes. These are held in various locations and are offered to patients after their initial appointment when diagnosis is made.

The sessions cover:

• an introduction to life and health with diabetes
• healthy eating
• physical activity
• medicines and podiatry.

After the sessions have been completed, the individuals receive further information on activities available in the local community so that they can make informed choices about managing their condition.

The team has widened the educational sessions to other staff groups who are involved in delivering information to patients managing the condition. This has enabled them to better inform their patients and create a more holistic approach to delivering care.

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What was the result

Physiotherapists have become involved in health promotion and diabetes education. They have also developed links with other NHS professionals as well as with the local leisure industry who are responsible for delivering exercise prescription programmes. One of the physiotherapy departments that needed to be re-located was moved to one of the leisure centres, this has proved to be a highly successful model.

The physiotherapy staff:

• learn motivational interviewing techniques on a rolling programme, this is delivered by the occupational health team
• meet with the smoking cessation so that they are aware of the services that the team offers and can confidently introduce these to patients
• use general health questionnaires as part of their assessment tool kit, this provides an opportunity to discuss issues such as smoking and alcohol consumption.

These changes in practice have been reflected in the physiotherapists KSF outlines.

The changes to practice for physiotherapists mean that patients are benefitting from a more holistic model of care - all of their needs are addressed rather than only the problem for which they may originally have been referred.

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Tips for other trusts

In order for the project to be a success, early discussions with the whole multi-disciplinary team are essential to allocate roles, objectives and intended outcomes of the service.

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Further information

• Julia Copping, Physiotherapist juliacopping@nhs.net
• Liz Paddock, County Lead for Musculoskeletal Physiotherapy and Women's Health epaddock@nhs.net