Solent NHS Trust Allied Health Professionals (AHPs) Strategic Framework 2016-2019
Introduction from Chief Nurse, Mandy Rayani As the executive responsible for providing professional leadership for the AHPs and nurses working in Solent I am pleased to be able to introduce this strategic framework. The framework is intended to provide clarity about the roles and contributions made by the diverse and highly skilled professionals collectively known as AHPs, whilst recognising that multi-disciplinary team working is central to the way in which all healthcare professionals come together to deliver care. Solent NHS Trust recognises that our workforce is our most valuable resource. As we move into different models of health and social care provision, as outlined in the Five Year Forward View, our teams will be working in different ways within integrated service models. In so doing it is essential that we maintain and take with us the culture and support necessary to deliver high quality health care. This strategy will act as a framework that brings together the values, beliefs and vision of Solent NHS Trust, alongside the various professional standards and code of conduct and ethics of the regulatory body, the Health and Care Professionals Council (HCPC). multi-disciplinary team working is central to the way in which all healthcare professionals come together to deliver care Mandy Rayani Chief Nurse
Our Strategic Framework The aim of this strategic framework is to position AHPs within the organisation, ensuring the contribution of AHPs is understood and fully recognised. This strategy has been developed by a task and finish group with representatives from each of the AHPs represented in our organisation. It is a consensus document detailing the commitments made by our AHPs, what they will do and how they will achieve each commitment. It describes the values underpinning each commitment and the enablers needed for the goals to be achieved. We have identified our four priority commitments to deliver in the next three years, these are linked to the national drivers set out in the Five Year Forward View, Solent s quality promise and the fundamental standards set out in Compassion in Practice. These commitments are: Person and patient centred care Promoting health and wellbeing A valued and supported workforce Quality evidence based care This strategic framework sets out the priorities and direction for the next three years for the professions traditionally described as AHPs and those who are employed by the Trust and regulated by the Health and Care Professions Council (HCPC): Art Therapy, Occupational Therapy, Physiotherapy, Speech and Language Therapy, Podiatry, Social Work, Clinical Psychologists. This strategy is aligned to Solent NHS Trust s Nursing Strategic Framework and recognises the importance of all staff, including registered and support staff, in service delivery. It provides an opportunity to create a vision for 2016-2019, which progresses the development of current practice and ensures quality is embedded in all patient related interventions. 1
Commitment Person and patient centred care We will listen to the people we work with and respect their views, whilst offering the best evidence based quality care we can provide. Where difficulties arise we will have the courage to respond appropriately and address the issues, changing practice where needed. This means we will work as equal partners with individuals and their families. We will consider their needs, concerns and preferences to inform their care programmes. 2
We will: Enable people to actively participate in their care. We will achieve this by: Showing respect and promoting independence, listening to concerns and facilitating individuals and their carers in decision making about their care. We will: Support improved patient care by working with health and social care colleagues to enable continuity of care and smooth transition between services. We will achieve this by: Ensuring a holistic approach with effective communication across all professions and sign posting to specialist input when required. We will: Promote self-management of social, emotional and physical wellbeing. We will achieve this by: Supporting individuals in developing their understanding of their needs using effective and accessible communication. We will: Provide continuity of care and relationships through effective care planning, record keeping and through listening to people who use our services. We will achieve this by: Aiming for individuals to see the same healthcare professional throughout a single episode of care. This will ensure a clear and timely exchange of information between the healthcare professional and other agencies. Enablers to support us in our commitment: Appropriate and adequate settings and equipment. Safe staffing levels, with appropriately defined competencies across all settings. Joined-up cross organisational models of working. Provision of and participation in clinical supervision. Profession specific Continuing Professional Development (CPD) opportunities. 1 2 3 4 3
Commitment Promoting health and wellbeing We recognise and are committed to promoting our contribution to preventative healthcare as an integral part of the public health workforce. This means we will work with individuals to enable them to make lifestyle choices to achieve optimal independence and self management. 4
We will: Empower clients, their families and carers to make choices which are right for them, through all phases of life. We will achieve this by: Using evidence based practice, clinical reasoning, clinical expertise and experience. We will: Identify how functional difficulties can be minimised and empower individuals and families in self-management. We will achieve this by: Evaluating all components of a persons functional difficulties, including contributory factors (physical, social, emotional and psychological) and appropriate specialist intervention and sign-posting. We will: Work with others to provide the best service (multi-disciplinary and inter-disciplinary). We will achieve this by: Communicating with other agencies including the voluntary sector. We will: Contribute to improving the wellbeing of individuals and their families within the national public health agenda. We will achieve this by: Taking responsibility for having healthy conversations and making every contact count in line with the twelve AHPs collective ambition priority areas: giving children the best start in life, making every contact count, emotional health and wellbeing and health and wellbeing of older adults. Enablers to support us in our commitment: Recognition that AHPs are an instrumental part of the wider public health workforce contributing to the national prevention agenda. Improvements in signposting and ability for AHPs to directly refer patients to services. AHPs included in training related to the prevention agenda. Timely access to necessary equipment. 1 2 3 4 5
Commitment A valued and supported workforce Courage enables us to do the right thing for the people we care for, be bold when we have good ideas, and to speak up when things go wrong. This means we will be recognised and valued for our potential in leading and shaping the future models of care in line with national drivers and professional standards and have a voice at the most senior levels of decision making within the organisation with access to the right professional leadership. We will have the right numbers of AHP staff with the right skills and levels of expertise to ensure we are delivering expert clinical care and we will have the reputation as an employer of choice for AHPs. 6
We will: Articulate the unique skills that each AHP profession brings to individuals experience, care and clinical outcomes. We will achieve this by: Striving to ensure everyone understands the unique contribution AHPs make, ensuring we have representation and a voice in Trust service developments for the benefit of the individuals we serve. We will: Encourage AHPs to take on and support new models of care and to be part of a wider career framework. We will achieve this by: Promoting training and leadership whilst celebrating and being inspired by examples of AHPs working in non-traditional roles across integrated care models. We will: Increase the flexibility of AHPs allowing them to expand into the roles needed and supported by early generic training whilst continuing to evidence the value added from highly specialist roles. We will achieve this by: Using defined competencies across each profession to ensure we have an appropriately well trained and competent registered and unregistered AHP workforce. We will: Be forward thinking in our future workforce planning. We will achieve this by: Supporting service managers offering a range of opportunities such as rotational posts, secondments, emerging placements and succession planning. Enablers to support us in our commitment: Acknowledgement and valuing of the unique skills of each profession with an understanding of how they influence care. Access to clinical supervision and specialist training appropriate to role. 1 2 3 4 7
Commitment Quality evidence based care As HCPC registered professionals we are committed to striving for clinical excellence and continuing professional development. This includes creating a professional culture that is open, honest and which uses all learning opportunities to support continuous improvement. We commit as individual practitioners and as a collective workforce to remain up to date and comply with HCPC standards and those of each professional body. We also commit as individual practitioners to keeping in touch with wider professional networks. This means we will encourage all AHPs to contribute to research in practice and remain up to date with the current evidence base. We will follow national guidelines and standards, adapt practice as appropriate, and use the current evidence base and best practice guidelines and standards to maintain and develop services. 8
We will: Use a range of outcome measures that are appropriate to the specific profession and client. We will achieve this by: Evaluating the results of the outcome measures used for the benefit of individuals and future service provision. We will: Encourage a culture of research in practice to ensure best practice and excellence in clinical care provision. We will achieve this by: Supporting opportunities for further development, training and research in practice which is open to using new innovations and technology. We will: Monitor service provision for quality, equality and clinical excellence. We will achieve this by: Reporting incidents, listening to feedback and triangulating all measures to identify actions where required. We will: Strive to actively contribute at a local, regional and national level within speciality groups. We will achieve this by: Supporting individuals to be part of profession specific groups and networks Enablers to support us in our commitment: An organisational culture that is open and honest, with a professional culture and structure that recognises, values and promotes the learning and development of expert clinicians. Effective systems for measuring, recording, reporting and evaluating clinical outcome measures. Commissioning models that recognise the unique value added by the AHPs and the opportunities for extended scope practitioner roles using the AHP workforce and non traditional care models of working. 1 2 3 4 9
Measures of success As we move forward as a workforce we will measure our success with a number of indicators. These will include: Senior leadership posts that require a clinical background will be open to all registered professions, including AHPs, with an increase in AHPs leading new innovative models of care. Professional issues associated with AHPs are appropriately represented at board. Equality of representation of AHPs at corporate committees and senior leadership forums. A memorandum of understanding will be in place for all AHPs who report to and are managed by a staff member of a different profession. A specific communication channel will be in place for AHPs to network, share and disseminate knowledge and best practice. AHPs from each profession will be given the opportunity to be involved in research activity. AHPs ensure celebration of success of the value added by the professions to patient experience, quality of care and clinical outcomes. A library of patient stories demonstrating the unique contribution of the professions to patient safety, clinical effectiveness, patient experience and AHPs as leaders and innovators will be available. Equality of access to Learning Beyond Registration Funding. 10
Strategy launch, implementation and governance The AHP Strategic Framework will be launched jointly with the Nursing Strategic Framework in late 2016. The delivery of this framework is underpinned by a work plan. It will be the responsibility of the AHP Leadership Forum to deliver the objectives of the strategy, reporting to the Quality Improvement and Risk Group. 11
The future Solent NHS Trust recognises its workforce is its most valuable resource and as it moves into different models of health and social care provision as outlined in the Five Year Forward View, teams will be working in different ways within integrated service models. In doing so, it is essential that we maintain and take with us the culture and support necessary to deliver high quality healthcare. This document will act as a framework that brings together the values, beliefs and vision of Solent NHS Trust alongside the various professional standards and Code of Conduct and Ethics as outlined by the AHP regulatory body, the HCPC. The national vision for AHPs states they will: Contribute their wide ranging knowledge and skills to improve the health and well-being of the population, particularly in disadvantaged communities, demonstrate not only their unique clinical contribution but their overall contribution to effective integrated multi-disciplinary working, work in partnership with service users and carers, deliver person centred planning and care, enable individuals to self-manage and live independently where possible, thereby avoiding repeated admission and dependence on care services, meet the needs of people with multiple long term conditions and disabilities, often with complex social care needs, support individuals to return to employment. In order to deliver this vision there will be a need for strong and effective clinical leadership and a workforce that is responsive, adaptable, collaborative, skilled and up to date (Department of Health, 2008b). 12
Art therapy Art therapy is a form of psychotherapy that uses art media as its primary mode of expression and communication. Within this context, art is not used as a diagnostic tool but as a medium to address emotional issues which may be confusing and distressing. Art therapists work with children, young people, adults and the elderly. Clients may have a wide range of difficulties, disabilities or diagnoses. These include emotional, behavioural or mental health problems, learning or physical disabilities, life-limiting conditions, neurological conditions and physical illnesses. Art therapy is provided in groups or individually, depending on clients needs. Although influenced by psychoanalysis, art therapists have been inspired by theories such as attachment-based psychotherapy and have developed a broad range of client-centred approaches. 13
Clinical Psychologists Clinical Psychologists are trained to devise, conduct and supervise doctoral level research. They employ specialist skills to reduce psychological distress and enhance psychological wellbeing in service users presenting with complex and acute levels of distress. Clinical psychology services aim to enable individual service users to have the necessary skills and abilities to function in an emotionally healthy way, to cope with their emotional needs and daily lives in order to maximise psychological and physical wellbeing, to develop and use their capacity to make informed choices in order to enhance and maximise independence and autonomy. To have a sense of self-understanding, self-respect and self-worth, and to be able to enjoy good social and personal relationships. Clinical Psychologists work with individuals of all ages, couples, families, groups, and healthcare teams in a variety of settings. They work with people who have mental health problems, learning disabilities, physical and sensory disabilities, brain injury; and people who have alcohol and other drug problems and people with a range of physical health problems. 14
Occupational therapy The role of an Occupational Therapist is to work with individuals of any age who are experiencing disruptions in physical health, mental health and/or wellbeing. Through joint goal setting interventions occupational therapists help clients to achieve a fulfilled and satisfied state in life. By using activity analysis Occupational Therapists enable the client to use purposeful activity or interventions designed to achieve functional outcomes. These outcomes promote health and self-management, prevent injury or disability and develop, improve, sustain or restore the highest possible level of independence. 15
Physiotherapy Physiotherapy is a healthcare profession that works with people to identify and maximise their ability to move and function. Functional movement is a key part of what it means to be healthy. This means that physiotherapy plays an important role in enabling people to improve their health, wellbeing and quality of life. Physiotherapists use their professional knowledge and practical skills, together with thinking skills and skills for interaction in their day-to-day practice. Physiotherapists recognise that physical, psychological, social and environmental factors can limit movement and function. They use their knowledge and skills to identify what is limiting an individual s movement and function, and to help individuals decide how to address their needs. Physiotherapy s values means that practice is person-centred, ethical and effective, CSP (2011) Physiotherapy Framework: putting physiotherapy behaviours, values, knowledge and skills into practice [updated Sept 2013] 16
Podiatry Podiatry is recognised by the public, by fellow healthcare professionals, by policy makers and commissioners of healthcare as being synonymous with foot health. Podiatrists will be at the forefront of innovative practice and high quality, cost effective care in the UK, meeting a clear and continuing need in the population. The podiatry service exists to improve the prevention and management of disease and dysfunction of the foot and its related structures through assessment, diagnosis and treatment. 17
Social work Social work is a profession that is centred around people - from babies through to older people. Social Workers form relationships with people and assist them to live more successfully within their local communities by helping them find solutions to their problems. Social Workers work with individuals and families to help improve outcomes in their lives. This may be helping to protect vulnerable people from harm or abuse or supporting people to live independently. Social workers support people, act as advocates and direct people to the services they may require. Social Workers often work in multi-disciplinary teams alongside other healthcare professionals as well as working closely with other organisations including the police, local authority departments, schools and the probation service. 18
Speech and language therapy (SLT) Speech and Language Therapists (SLTs) provide life-improving treatment, support and care for children and adults who have difficulties with communication, eating, drinking or swallowing. SLTs assess and treat speech, language and communication problems in people of all ages to help them communicate better. They also assess, treat and develop personalised plans to support people who have eating and swallowing problems. Using specialist skills, SLTs work directly with clients and their carers and provide them with tailored support. They also work closely with teachers and other healthcare professionals, such as doctors, nurses, other allied health professionals and psychologists to develop individual treatment programmes. 19
References Chartered Society of Physiotherapists (2011) Physiotherapy Framework: putting physiotherapy behaviours, values, knowledge and skills into practice [updated Sept 2013] Five year Forward View, NHS England 2014 Health and Care Professions Council (HCPC) http://www.hcpc-uk.org/ Health Conversations and the Allied Health Professionals, Royal Society for Public Health, 2015 Modernising Allied Health Professions Careers: A Competence Based Career Framework, DH Archives 2008 Royal College of Speech & Language Therapists Giving Voice Campaign The role of Allied Health Professionals in public health- examples of interventions delivered by allied health professionals that improve the public s health, Public Health England, 2015 www.solent.nhs.uk Copyright reserved Solent NHS Trust September 2016