AHPFS Questions to Professor Kerr for Health Committee
Involvement of AHPs in planning, provision, evaluation etc.
- Professor Kerr talks repeatedly about the need to engage with “the” Royal Colleges – e.g. in the Foreword he says “Improving the culture of leadership, collectivism and engagement … Building bridges between Royal Colleges …” Could the professor list those Royal Colleges he refers to and in particular the AHP professional bodies he has in mind?
- The report talks at length about the engagement of medical staff (sometimes with the encouragement of incentives) at National, Regional, NHS Board and CHP levels in planning, delivery and evaluation of services. Given that the report also stresses the importance of collective responsibility and interdependency of everyone involved in health and care provision – how does he envisage this interdependence being reflected in the structures and data used to plan, deliver and services? For example will the medical Consultant work in equal partnership with AHP Consultant to determine extended roles throughout the patient care pathway – using a multi-disciplinary dataset to anticipate demand and monitor impact of various service designs?
- How does Professor Kerr envisage the costs of the multi-disciplinary care pathway being factored in to tariff setting for particular procedures?
- The majority of Professor Kerr’s recommendations impact significantly on AHP service providers and users. Where in his report is this impact best reflected in his opinion?
Workforce
- How did Kerr take in to account the workforce issues, beyond WTD, which affect health and care staff beyond medical staff?
- What information is there currently on AHP adequacy in emergency and planned care? What does Professor Kerr know about the challenges the shifts from DGH to Community Hospitals and Community Based Teams will have on their workforce?
- Culture, custom and practice of medical and nursing professions and the subsequent inaccessibility of opportunities to innovate and produce change in health service can disaffect AHPs graduate professions with subsequent impact on retention of these staff. How do the workforce solutions proposed deliver for anyone other than doctors - they won’t solve the problems of culture and opportunity to lead change for AHPs?
- Professor Kerr suggests fundamental questions must be asked in respect of the recruitment and training of medical staff – would he extend the same reflection to AHPs?
- In the report it states new models of care “… will require role extension with nurses and other health professionals taking on roles that were once the sole domain of doctors”. What is going to happen to boost AHP numbers so they can do both their own unique and distinct jobs (that doctors have never done) as well as some of the tasks previously performed by doctors? Particularly given many AHP tasks can’t be passed on to support staff – because of the evidence based clinical standards set by the AHP professional bodies.
- Staff development and increased establishment are absolutely key to the success of this, how can we liberate this change process when we know that staff development and increases to establishments are held down for short term financial reasons?
Culture change / Attitude / Assumptions in paper
- The report repeatedly recommends AHPs and other staff need to be retrained to take over the current roles of doctors because of the extreme demands on them – the implication being that non-medics don’t have their own unique and distinctive contributions to make to health care and / or they are currently under utilised and not overburdened themselves and / or they aspire to do doctors tasks. Would Professor Kerr like to reflect on how the recommendation and it’s rationale contributes to developing a culture of mutual respect, recognition and support between all members of the multi-disciplinary team?
- How much listening and learning to AHPs and others does the Professor think medical staff and other key planners need to do to make the NHS fit for the future?
- What part of the report – in his opinion - best encourages and builds confidence among AHPs and other staff that the NHS in the future will be a place where interdisciplinary hierarchies (which have acted to skew attention and funds to the minority interest of the most “politically” powerful and to create a public perception that “Doctor good – other at best okay, at worst bad”) are a thing of the past?
The sell
- What does Professor Kerr believe needs to happen to challenge the public perception “Doctor is good – other health team member okay / alright or bad”?
- There is little realistic addressing of the huge shift in public behaviour and attitude that implementing Professor Kerr’s recommendations involves. Section 5 “How can we reduce Health inequalities?” Comes closest to grasping the thistle on this, but still doesn’t go far enough. There is nothing about what resources are going to be available for action on “the systematic adoption of the principles of anticipatory care and preventative medicine”. Also how is the target group going to be encouraged / educated to take up the “enhanced opportunities” assuming that these are properly resourced and available?
Combining this with the statement in section 7 that the Health Committee “identify a “fault line” that has appeared between the view of NHS Boards and the public”. Leads to the question
- Professor Kerr talks repeatedly about the need to engage with “the” Royal Colleges – e.g. in the Foreword he says “Improving the culture of leadership, collectivism and engagement … Building bridges between Royal Colleges …” Could the professor list those Royal Colleges he refers to and in particular the AHP professional bodies he has in mind?
- The report talks at length about the engagement of medical staff (sometimes with the encouragement of incentives) at National, Regional, NHS Board and CHP levels in planning, delivery and evaluation of services. Given that the report also stresses the importance of collective responsibility and interdependency of everyone involved in health and care provision – how does he envisage this interdependence being reflected in the structures and data used to plan, deliver and services? For example will the medical Consultant work in equal partnership with AHP Consultant to determine extended roles throughout the patient care pathway – using a multi-disciplinary dataset to anticipate demand and monitor impact of various service designs?
- How does Professor Kerr envisage the costs of the multi-disciplinary care pathway being factored in to tariff setting for particular procedures?
- The majority of Professor Kerr’s recommendations impact significantly on AHP service providers and users. Where in his report is this impact best reflected in his opinion?
- How did Kerr take in to account the workforce issues, beyond WTD, which affect health and care staff beyond medical staff?
- What information is there currently on AHP adequacy in emergency and planned care? What does Professor Kerr know about the challenges the shifts from DGH to Community Hospitals and Community Based Teams will have on their workforce?
- Culture, custom and practice of medical and nursing professions and the subsequent inaccessibility of opportunities to innovate and produce change in health service can disaffect AHPs graduate professions with subsequent impact on retention of these staff. How do the workforce solutions proposed deliver for anyone other than doctors - they won’t solve the problems of culture and opportunity to lead change for AHPs?
- Professor Kerr suggests fundamental questions must be asked in respect of the recruitment and training of medical staff – would he extend the same reflection to AHPs?
- In the report it states new models of care “… will require role extension with nurses and other health professionals taking on roles that were once the sole domain of doctors”. What is going to happen to boost AHP numbers so they can do both their own unique and distinct jobs (that doctors have never done) as well as some of the tasks previously performed by doctors? Particularly given many AHP tasks can’t be passed on to support staff – because of the evidence based clinical standards set by the AHP professional bodies.
- Staff development and increased establishment are absolutely key to the success of this, how can we liberate this change process when we know that staff development and increases to establishments are held down for short term financial reasons?
- The report repeatedly recommends AHPs and other staff need to be retrained to take over the current roles of doctors because of the extreme demands on them – the implication being that non-medics don’t have their own unique and distinctive contributions to make to health care and / or they are currently under utilised and not overburdened themselves and / or they aspire to do doctors tasks. Would Professor Kerr like to reflect on how the recommendation and it’s rationale contributes to developing a culture of mutual respect, recognition and support between all members of the multi-disciplinary team?
- How much listening and learning to AHPs and others does the Professor think medical staff and other key planners need to do to make the NHS fit for the future?
- What part of the report – in his opinion - best encourages and builds confidence among AHPs and other staff that the NHS in the future will be a place where interdisciplinary hierarchies (which have acted to skew attention and funds to the minority interest of the most “politically” powerful and to create a public perception that “Doctor good – other at best okay, at worst bad”) are a thing of the past?
- What does Professor Kerr believe needs to happen to challenge the public perception “Doctor is good – other health team member okay / alright or bad”?
- There is little realistic addressing of the huge shift in public behaviour and attitude that implementing Professor Kerr’s recommendations involves. Section 5 “How can we reduce Health inequalities?” Comes closest to grasping the thistle on this, but still doesn’t go far enough. There is nothing about what resources are going to be available for action on “the systematic adoption of the principles of anticipatory care and preventative medicine”. Also how is the target group going to be encouraged / educated to take up the “enhanced opportunities” assuming that these are properly resourced and available?
Does Professor Kerr envisage a high profile national campaign in order to “sell” the recommendations in his report to the public? How does he see such a campaign being funded? And will the professional bodies/ trade unions representing NHS staff be fully involved in any such campaign?
Question compiled by Kim Hartley, RCSLT Scotland Officer
In consultation with
Allied Health Professions Scotland
For further information contact:
Kathleen Henderson, AHPFS Convener
Phone: 01896 826038
Mobile: 07971 515763
Email: kathleen.henderson@borders.scot.nhs.uk