Letters: 1 October 2014

Practice Defects

With National Older People’s Day occurring this week (1 October), I would like to share what happens when professionals, including a physiotherapist, get the management of falls in the elderly wrong.

My 86-year-old mother was admitted to hospital in March 2013 following a series of falls at home. The physio assessed her and prescribed a Zimmer frame but failed to remove mum’s quad stick. The physio wrote in the notes ‘patient discharged due to dementia’. She did not provide any written guidance on the level of supervision mum required or arrange for the quad stick to be taken away. She failed to change mum’s falls care plan to reflect the use of the Zimmer. She then went on holiday.

I chose to remove mum’s quad stick and naively assumed the staff would supervise her adequately when she used the frame. They did not and mum fell and broke her neck when walking unsupervised with the frame. The neck fracture went undiagnosed from 9am until 5pm (yes, eight hours!). Mum died 16 hours after the fall. At the inquest it was made clear that no amount of treatment, including a prompt diagnosis, would have saved mum’s life. We did, however, get a heartfelt apology from the doctor who missed the neck fracture and that means a lot.

I have channelled my personal anger into talking to hospital staff as an ‘expert relative’ to help them understand what could have been done better, my work with the ‘older people’s champion’ is my personal legacy to my mother in the hope that the tragedy of her death is not repeated. Jane Stewart-Parry, CSP member See also pages 8-9

Flawed approach

I am a second-year student and have dyslexia. I was very excited as to see the dyslexia article (page 22, 3 September) as I feel the subject is overlooked in the physio world.

On flicking to the article I felt nothing but disappointment. First, people with dyslexia find it very difficult to focus and read words on a white background. Second, there were two pages with a vast amount of text. People with dyslexia find it easier to read large, widely-spaced print, and have difficulty tracking across the page – again making this article hugely difficult to read.  Aimee McGuckin

Frontline responds:
You make some very good points. Though the article wasn’t aimed specifically at people with dyslexia, perhaps, with hindsight, we could have asked for feedback on its presentation prior to publication. You probably know that all Frontline articles are available via the CSP website, which gives members an opportunity to read them in a more acceptable format. Here is a link to the dyslexia article.

Support needed

An anonymous member discussed physios and medico-legal reporting (page 7, 17 September).

The member pointed out that perception of physiotherapy among medical agencies is poor, preferring to instruct GPs ahead of our members. I am afraid that this perception is real and becoming more prevalent. Certain networks serve only to enable business owners to skim money out of the system by giving shorter appointments with less experienced physiotherapists. Fresh from university, working without supervision, some are happy to earn far less than is needed to run a private clinic professionally.

Until the CSP starts to support private practice, campaign with the government to remove the layers of intermediary companies in the chain and help set minimum standards of care in the system, therapists’ wages will continue to fall.  Mark (surname withheld at writer’s request)

The CSP responds:
We have been working with the Ministry of Justice and other stakeholders looking at medico-legal reporting following injury claims after road traffic accidents. This is part of a move to reduce fraud and excessive costs in the system.  Thus far we have succeeded in having the expertise of physios recognised in assessing these patients and continue with this work to look at possible routes for accreditation for suitable clinicians.

You’ve Added...

• Sarajacklin responded to an article on dyslexia (page 22, 3 September) At the University of Central Lancashire, we are proactive in helping our physio students with dyslexia to access all parts of their studies, from classroom learning to placement and particularly around examinations. In addition, we are alert to the fact that in any intake there will be at least one student who is undiagnosed and I would venture the Mr Rockett’s story is not unusual.  In fact, the students with undiagonsed dyslexia are often very hard working and very intelligent – almost by definition they have to be, to have got as far as acceptance onto a physio programme without a previous diagnosis. We support acceptance of the suspected dyslexia with the individual student and support them while they participate in the assessment process. Often it is a relief for the student, because it helps them to understand some of the academic challenges they may have had in the past, but helps them to put skills in place which enable them to succeed.

• And Karen Atkinson added I have supported many students with dyslexia and, generally speaking, when all parties work together, the communication is good and effective support put in place then study and placements are really successful. I would really encourage students to disclose any particular issues they may have which could affect their performance. This is fine if they know what these issues are. If diagnosis is recent, however, understandably they may not know how their dyslexia might affect them or indeed what reasonable adjustments they require.

• Commenting on the profile of researcher Leigh Boxall (page 66, 17 September),amandaham104 wrote: Great to see a viewpoint from a physio researcher. I think this is definitely an area where physios can shine. Also, it offers individuals great opportunities that you might not otherwise get – like conference travel and research skills that easily transfer outside of the UK. (I now work in Australia).

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