CSP calls for realistic physio staffing levels to manage winter demands

On 12 August, NHS England Chief Executive, Amanda Prichard, wrote to all Integrated Care Boards (ICBs) and NHS Trusts about steps they need to take to increase capacity and operational resilience in urgent and emergency care ahead of winter.

The letter acknowledges the significant pressures urgent and emergency care is under, and the need for the response to this to include increasing capacity outside of acute trusts – including in community teams and scaling up of additional roles in primary care, which includes First Contact Physiotherapy (FCP).

• Reduce hospital occupancy, through increasing capacity by the equivalent of at least 7,000 general and acute beds, through a mix of new physical beds, virtual wards, and improvements elsewhere in the pathway.
• Ensure timely discharge, across acute, mental health, and community settings, by working with social care partners and implementing the ten best practice interventions through the ‘100 day challenge’. One of the performance metrics to be used is the percentage of beds occupied by patients who no long need to be there.
• Provide better support for people at home, including the scaling up of virtual wards and additional support for High Intensity Users with complex needs.

In addition, the report recognises the need for a sufficient workforce and workforce wellbeing, with ICBs having responsibility for developing plans based on realistic assumptions of what staff can be recruited.

What does the CSP say?

CSP members are leading and delivering Discharge to Assess, Urgent Community Response, Community Rehabilitation services and Virtual Wards, and implementing the roll out of FCPs in primary care.

These positive initiatives can only be successful with sufficient numbers of registered physios and support workers. If D2A and UCR services are provided at the expense of rehabilitation the goals of reducing admissions and readmissions will be undermined. If FCP posts are recruited to with no backfill, then it lengthens waits for community MSK services needed to help clear the backlog of elective surgery.

Physio managers and leaders need to be influencing their Trusts and ICB People Boards to ensure that physio staffing is increased to deliver these priorities. We are in a fortunate position of having steady growth in physio graduate numbers. This needs to start being reflected in physio staffing numbers in the NHS.