Taking Stock

Seismic impacts

This time last year, healthcare faced unprecedented pressure as the national lockdown was lifted, days before frontline workers received their first vaccine doses. With a constant fear of exposure to Covid, it was a tough time to work through.

Many also saw their rehab spaces closed, with a snapshot survey of CSP members this summer showing one in five services never restarted. CSP steward Kavitha Santhanurthy, who was infected while working in community rehab, recalls, ‘It was hard, dreading we might get it, not knowing how it would affect us. But we didn’t let our fears affect the service we offered. We followed all precautions, stepped up, crossed professional barriers, and kept going together as a team.’ 

Physiotherapists redeployed to combat the crisis embraced change with grace, switching protocols and fitting in seamlessly with new colleagues. Some created virtual services offering vital treatments to shielding patients or helped mobilise the national response, including a network of nightingale hospitals.

Rachel Dalton, whose organisation Barts Health hosted the Nightingale Hospital at the Excel Centre in East London during the first wave, says,

‘Physiotherapists from all backgrounds and specialities came forward to undergo intensive training in order to care for acute Covid patients in an unknown environment. I could not have been prouder of both the Nightingale physios and those at our four acute hospitals for their commitment to patient care, creativity, versatility and outright hard work.’ Community advanced practitioner Jeremy Gee, who helped design the outcome measure Covid-19 Yorkshire Rehabilitation Scale, adds, ‘Since the emergence of Covid-19 the strength, flexibility and resilience of physiotherapists has shone through to advance practice in all areas and helped find solutions in the most difficult of times.’

The CSP and its professional networks supported with guidance, education and learning resources, ensuring that members’ voices were heard and included in key guidelines. While physiotherapists such as Darren Brown filled emerging gaps, such as creating networks for members with Long Covid.

Brown says of the 267-member strong network Long Covid Physio, ‘Physiotherapists living with Long Covid recognised early in the pandemic the need to mobilise knowledge from lived experience, generate visibility of our disability and safe rehabilitation, and the power of organising to create change.’ 

Though the pandemic is far from over, eight members who contacted Frontline to share their experiences look back at that extraordinary time, and the new knowledge they gained, which is now enhancing their everyday practice.  

Jennifer Davison, clinical coordinator, set up Leeds Long Covid community rehab pathway, which is therapy led and supported by rehab consultants, with colleague Rachel Tarrant

‘We learned about patients’ symptoms and effective interventions in more detail over the course of the pandemic, sharing our findings on the impact that Long Covid has on patients’ quality of life as well as showcasing how rehab is essential and at the heart of supporting patients with Long Covid. 

‘This new condition required an MDT approach to ensure post-Covid conditions such as Postural Orthostatic Tachycardia Syndrome are diagnosed and medical management optimised. Alongside a personalised rehabilitation approach these have been the key to our success. 

It was a great learning curve using technology to facilitate virtual multidisciplinary team meetings and apps to track and support patients’ progress, but they proved invaluable. ‘The team has worked relentlessly to establish this ever-evolving service and are a credit to the NHS. To quote a patient, “The team really do care, they are so helpful, I’d be lost without them”.

Ryan Allen, director of independent practice Primary Care Physio, whose FCP team was redeployed to Covid-19 vaccine centres

‘Our first contact physiotherapy team was supporting primary care networks and their member GP practices with vaccinating the patient population – it was great to be able to support the cause in this way. Some team members even helped as car park attendants stood outside in the January snow! I would like to thank every single one of our amazing team who went out of their way to integrate into primary care and support or GP colleagues and patients in the most challenging of circumstances. You should all be very proud of the work you have done throughout the pandemic and continue to do so today.’

Priyanka Patel, Senior Physiotherapist, Kettering General Hospital, launched an acute rehab service 

‘Being able to implement a Rehab Team within an acute setting is one thing, but being able to sustain this innovation during a pandemic and expand our services into the community has been the highlight of my career so far. Watching patients improve continuously and following their journeys home has shown how important therapy and the profession is.’

Tina Haghighi, physiotherapy student, University of Brighton, MSc graduate, carried out a research study exploring the experiences of physiotherapy students

‘Despite the many challenges faced, the students summarised their experience as positive, encouraging prospective students to approach the learning curve. The physiotherapy students’ compassion, determination, bravery, and continuous passion for the profession is something that will stay with me forever.’

Elaine McConnell, professional head of physiotherapy, Belfast Health and Social Care Trust, led the mobilisation of physiotherapists at her trust during the pandemic