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Health and Social Care Committee
Inquiry into Stroke Risk Reduction
SRR 8 – Chartered Society of Physiotherapy
Committee Clerk
Health and Social Care Committee
National Assembly for Wales
Cardiff Bay
CF99 1NA
September 2011
Dear Chair and Committee Members
Enquiry into Stroke Risk Reduction
The Chartered Society of Physiotherapy (CSP) in Wales is pleased to provide a written contribution to this review.
General introduction
Physiotherapy skills are required throughout all stages of the stroke pathway and are essential as part of the acute and rehabilitation phases of treatment and management. Physiotherapists also contribute to the risk reduction services, particularly in relation to cardiac rehabilitation and health promotion as part of a holistic physiotherapeutic management of patients who may be at risk of suffering a stroke or having already survived a stroke and need to decrease the potential risk of having a further stroke. Exercise is crucial and physiotherapists use exercise as part of their treatment programmes.
Key points from the Chartered Society of Physiotherapy
The CSP makes the following points which it is hoped will be discussed as part of the review.
The CSP notes the Action Plan points (14) and (15) which relate to the National Exercise Referral Scheme. The profession fully supports this scheme but cautions that capacity could become an issue as NERS is used increasingly for a range of pathways (back pain, cardiac, COPD, falls etc). The danger may be development of waiting lists for this service.
The CSP also notes that NERS has funding agreed for the next 3 years. What will happen if the funding is not continued after this time?
The physiotherapy profession has been developing its relationship with NERS services locally and this has proved useful in terms of supporting the links between hospital based exercise progressing to lifestyle based exercise undertaken in local communities.
Training for NERS professionals is essential and regular review and update of training modules is required. This needs to be undertaken across Wales to ensure equity of provision and access for people at risk. The CSP recommends the National Organiser for NERS would be a valuable person to provide oral evidence to the Committee.
The CSP notes that the Stroke Risk Reduction Action Plan addresses a wide range of actions to prevent stoke in the first place. It does not, however, include a section on dealing with risk reduction for a person who has suffered a stroke. Including something on this will provide an opportunity to ensure stroke risk reduction is a priority for health profession in primary, community and hospital based settings. Physiotherapists would be key professionals who would play an active part in this. If included within the Action Plan and referred to by the Committee, it will mean Health Boards and Public Health Wales will need to demonstrate success as part of performance management.
The CSP considers the hardest part of any risk reduction programme is demonstrating success. The profession notes the high level evaluation measure and timeline associated with the Stroke Risk Reduction Action Plan. Many of the dates in the timescale section have already passed. The CSP suggests the Committee will want to scrutinise this area and consider ways in which improvements can be demonstrated. The Action Plan should provide a performance management tool to check that activities have been undertaken but no report on progress against the 40 action points in the plan has been seen by the profession to date.
Concluding comment
The CSP hopes the committee finds these points useful and looks forward to following the progress of the review. If further information is required from the profession please do not hesitate to contact us.
In association with:
The CSP Welsh Board
The CSP Wales Neurological Network
The All Wales Physiotherapy Managers Committee
About the CSP and Physiotherapy:
The Chartered Society of Physiotherapy is the professional, educational and trade union body for the UK’s 50,000 chartered physiotherapists, physiotherapy students and support workers. The CSP represents over 2,000 members in Wales.
Physiotherapists use manual therapy, therapeutic exercise and rehabilitative approaches to restore, maintain and improve movement and activity. Physiotherapists and their teams work with a wide range of population groups (including children, those of working age and older people); across sectors; and in hospital, community and workplace settings. Physiotherapists facilitate early intervention, support self management and promote independence, helping to prevent episodes of ill health and disability developing into chronic conditions.
Physiotherapy delivers high quality, innovative services in accessible, responsive and timely ways. It is founded on an increasingly strong evidence base, an evolving scope of practice, clinical leadership and person centred professionalism. As an adaptable, engaged workforce, physiotherapy teams have the skills to address healthcare priorities, meet individual needs and to develop and deliver services in clinically and cost-effective ways. With a focus on quality and productivity, physiotherapy puts meeting patient and population needs, optimising clinical outcomes and the patient experience at the centre of all it does.
Philippa Ford MCSP
CSP Policy Officer for Wales
07990 542436
September 2011