CSP cries out for realistic physio staffing levels to prevent delayed discharges

The Chartered Society of Physiotherapy (CSP) says that an increase in physiotherapy staffing numbers is required to reduce the pressures on acute and emergency care by preventing admissions and delays in discharge.

It follows the circulation of a letter on 12 August from NHS England Chief Executive Amanda Prichard. She detailed 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. This includes expanding capacity in community teams and scaling up of additional roles in primary care, which includes First Contact Physiotherapy (FCP).

“Urgent and Emergency Care is currently under significant pressure,” the letter reads. “Staff have faced one of their busiest summers ever with record numbers of A&E attendances and the most urgent ambulance call outs, all alongside another wave of COVID-19. Thanks to the professionalism and commitment of those staff, the NHS continues to provide care to over 100,000 urgent and emergency care patients each week.

“Despite their best efforts, these pressures have meant that there have been too many occasions when staff have not been able to provide timely access for our patients in the way they would have wanted.”

To help expand capacity beyond maintaining progress on NHS England 2022/23 operational priorities, the letter details some key priorities ahead of the challenging winter period.

Among these priorities are expanding capacity outside of acute trusts; reducing hospital bed occupancy with a mix of new physical beds alongside virtual wards; providing better support for patients at home; and ensuring timely discharges via a multidisciplinary approach.

In addition, Amanda details 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.

In response to the letter, CSP says its members are leading and delivering Discharge to Assess (D2A), urgent community response, community rehabilitation services and virtual wards, and implementing the roll out of FCPs in primary care.

However, CSP warns that these positive initiatives rely on sufficient staffing levels of registered physiotherapists and support workers to be successful.

“If D2A and UCR services are provided at the expense of rehabilitation the goals of reducing admissions and readmissions will be undermined,” CSP added in a statement. “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.”

CSP suggests that physiotherapy managers and leaders should influence their trusts and ICB People Boards to ensure that physiotherapy staffing is increased to deliver these priorities.

For an in-depth look at ICBs, what they are, and how they fit into wider integrated care systems (ICSs), read this helpful in-depth guidance on the BHTA website.

CSP recently joined forces with the Royal College of Occupational Therapists (RCOT) to produce a series of principles for practice-based learning. These principles provide a clear direction for creating quality, practice-based placements for both physiotherapy and occupational therapy learners (students and apprentices).