Embedding a Health Promotion Strategy across MSK

physiotherapy services in SalfordGillian Rawlinson

Advanced MSK Physiotherapy PractitionerSalford Royal NHS Trust

(Senior Lecturer Physiotherapy, University of Central Lancashire )

What was the problem?

• Salford has some of the worst health in the country and large health inequalities.

• AHP’s being urged to optimise Public health interventions.

• Many MSK problems are influenced by health and lifestyle choices e.g. weight, physical activity, smoking, mental health issues e.g. OA, LBP, tendinopathies etc. (NICE 2014, Tilley et al 2015, Ranger et al 2015)

• Physiotherapy undergraduate education leading and developing public health practice yet not always modelled in practice.

• Public health practice on physio practice was sub optimal, patchy and not seen as a priority.

Management of OA (NICE 2014)

So what did I do?

• Spoke to my manager with passion and enthusiasm for change and identified key drivers.

• Suggested seeking funding to ‘do it properly’

• Spoke to innovation fund lead at Salford CCG, armed with facts and passionate about what and why we need to change.

Next steps…

• What did I want to achieve, what was the vision?

• What were the drivers behind this change? • Where were we at?• How could we measure impact and

demonstrate change?• What did I require to achieve this vision?• How could this change be sustainable and

how could we share good practice ?

Why?

(NHS England, 2014)(AHPF, 2015)

(PHE 2015)

So what happened next?

• Developed and wrote bid with guidance from commissioners, they were very supportive and friendly!

• Got £21,000 to fund myself (0.2 WTE for 6 months) and a Band 2 (0.5WTE for 1 yr) plus funding plus for equipment scales, leaflet racks etc.

• Funds rental of health data machine at one site for year as pilot .

Our Vision

1. All patients will be given the opportunity to discuss their lifestyle

factors in a supportive environment focussed on improving their

overall health and wellbeing.

2. All patients will have their basic health data collected, recorded and communicated to GP (height/ weight/ BMI) .

3. The team will take every opportunity to support and foster a

positive culture of embedding health promotion in everything we

do.

4. We will work together with our partners in the trust, community

and voluntary organisations to facilitate seamless transfer of care

and access to all health promoting services. 

What to measure?

• Record Number of healthy conversations and content

• Record BMI data for all patients• Record number of onward referrals to

health promoting services • Evaluate staff knowledge and attitudes

towards health promotion .• Case studies to identify impact

Results and evaluation.

Key Objectives1. 80% of patients who are attending for an appointment will have BMI

/ BP data recorded in their physiotherapy health record (and communicated with GP on discharge).

2. 80% of consultations will have an appropriate and meaningful healthy conversation recorded in their physiotherapy record.

3. Establish and maintain firm partnerships with trust departments, and health promoting community and voluntary organisations.

4. Increase appropriate referrals to other agencies e.g. smoking cessation/ active lifestyles team, weight management services by 100%.

5. Service staff will have an increased in positive attitudes towards embedding a health promotion strategy within MSK/ CATS services.

Baseline evaluation (n= 70) Physiotherapy and CATS records (bands 5-8b) across geographical sites from Jan 2016.

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Documented information in Physiotherapy records relating to lifestyles and health

behaviours and referrals

recorded not recorded

The story so far…

• Baseline data collected• Outline of services developed • Met with all key partners and stakeholders to identify

services, referral pathways and develop partnerships • Discussion with senior Trust executives re

development of Trust wide health promotion strategy • Alignment with Salford's National Diabetes Prevention

programme (NDPP) / identifying those with IGR pre -surgery

• Liaison with PH commissioners re ‘health check’ provision

• Plan to; Launch’ project with staff including training and support

BMI/ BP Machines

Its growing!....

Embedding a Culture of Health

promotion

Healthy cubicles/

environment

Building partnerships across trust

and third sector

Changing EPR documentation to demonstrate

impact

Staff training and leadership

Links with National Diabetes

prevention programme

Collection health data

/Health checks

Top Tips!• Your enthusiasm and passion for change is the

critical factor that will keep you going! • Don’t accept No for an answer, go to the top!• Do your research about why need change/

innovation • Pick up the phone and talk to your commissioners• Think about measurement and use your relevant

departments to support you.• Network and share what’s happening to grow and

develop ideas.

Thank you ! @GillRPhysio

References

Ranger TA, Wong AMY, Cook JL, et al. (2015) Is there an association between tendinopathy and diabetes mellitus? A systematic review with meta-analysis. Br J Sports Med.;0:1-10.

Tilley BJ, Cook JL, Docking SI, et al. (2015) Is higher serum cholesterol associated with altered tendon structure or tendon pain? A systematic review. Br J Sports Med. NICE (2014) Guidelines for Care and Management of Osteoarthritis; ;London CG177

Allied Health Professionals (AHP) Federation (2015). A strategy to develop the capacity, Impact and Profile of AHP’s in Public health 2015-2018http://www.ahpf.org.uk/files/AHP%20Public%20Health%20Strategy.pdf

NHS England, Care Quality Commission (2014) NHS Five year forward view ; London; NHS England

Public Health England (2015) Health Profile for Salford; London; PHE; http://www.apho.org.uk/resource/item.aspx?RID=171633