This phrase has been buzzing around Twitter for a while now but I didn't know much about it until the RCOT (Royal College of Occupational Therapists) held a study day about it and we were subsequently all encouraged to read the document. A harrowing 136 pages later (!) and I have a reasonable handle on what its all about. I wrote notes to myself as I went along which I thought I would share with the wider AHP community to hopefully make understanding it a slightly less daunting task to others! This is not a comprehensive summary - just the scaffolding of the main points and some of the parts I found particularly interesting.
What is AHPS into Action?
‘Allied Health Professionals into Action’ is a product for NHS leaders and decision makers. It offers them current examples of innovative AHP practice, service redesign and a vision for the AHP workforce for the future. The document basically highlights what a crucial and cost effective role AHPs have, and advocates for us to be utilized to our full potential (ie in extended roles). The document outlines the strategy for AHPs over the next few years so is well worth reading and understanding.
How was it developed?
The document was developed through triangulation of data and evidence from the following sources:
Review of national policies and publications
Crowdsourcing: problem solving and generating collaborative insight via online platform with over 16,000 contributors
Involvement of senior leaders
Why was it developed?
The purpose of the document is to inform and inspire the contribution that AHPs can make directly in supporting delivery of healthcare. This is through the vehicle of the STPs (Sustainability and Transformation plans). More on STPs here: https://www.kingsfund.org.uk/topics/integrated-care/sustainability-transformation-plans-explained
What does it say?
The document is in 2 parts:
Part 1 describes four impacts AHPs play in health, care and wellbeing. It gives examples of how AHPs ‘close the gap’ in (1) health and wellbeing, (2) care and quality and (3) finance and efficiency. The document describes how AHPs have a positive impact in each of these areas.
I found this section quite inspirational to read; it showcases the outstanding work AHPs are already doing across the country. There are examples from specific services and a range of disciplines describing the innovative services they have developed. Go team AHP!
Part 2: Enabling AHPs to transform health, care and wellbeing
This section provides a framework to support local decision makers to address how they utilize the potential of AHPS as described in part 1. It describes 4 'commitments' to the way AHP services are delivered and 4 priorities for AHPS to meet the challenges of changing care needs.
I've briefly summarised both parts using excerpts from the document here:
Part 1: The impact of AHPs
IMPACT 1: AHPs will improve the health and wellbeing of people and populations
Positive impact statement:
‘My community and I will be happier, healthier and have greater control of our health, care and wellbeing’.
This section describes how AHPs help people and populations remain as close to home for as long as possible, achieved through services such as reablement, rehabilitation and self-management.
It also emphasises that AHPs have a unique role to play in health promotion, social inclusion and participation.
I thought this quote was interesting – it highlights that we as AHPs are good at reporting individual gains of patients, but not always the value for a whole population:
“AHPs have a huge impact in ensuring the health and
wellbeing at individual and population level, whilst
it may seem evident to AHPs it is less evident to the
system especially in terms of population level impact
of AHP interventions, we are often better at describing
individual patient level improvements but often find
it hard to concisely articulate population level impact
which is what is needed to establish “value”. We need to
become better at this narrative which should inform the
focus on sustainability and transformation.”
IMPACT 2 ‘AHPs will support and provide solutions to general practice and urgent and emergency services to address demand.’
Positive impact statement:
‘I will be able to see the right person, the first time, when and where I need to’.
This section describes the shift away from over-reliance on hospitals. AHPs in A&E play a role in reducing inappropriate admissions. It highlights the lack of consistency to be able to self-refer to AHP services and advocates for use of AHPs in GP services and a need for improved direct access to AHPs.
IMPACT 3 AHPs will support integration, addressing historical service boundaries to reduce duplication and fragmentation.
Positive impact statement:
‘Everyone involved in my care, including myself, family and carers, will work together to address my needs in the best way possible’.
This section promotes AHPs taking more leadership and care co-ordinator roles, especially for those with several co-morbidities. Our AHP models of service delivery move away from traditional service divides (acute/ community, mental vs physical health, health/social care) which makes us well equipped for these roles.
“As AHPs we need to work together
towards services that we aspire to
provide rather than being constrained
by organisational boundaries. We all
have common goals in improving care
and this needs to work in both acute
and community without being limited
by the structure that services are
provided in”.
Anon: July 2016. Direct quote; contributed
to phase two of AHP online workshop
IMPACT 4 ‘AHPs will deliver evidence based/informed practice to address unexplained variances in service quality and efficiency.’
Positive impact statement:
‘No matter where I receive care I will be offered the same level of service’.
This section is a challenge to AHPs to be more consistent across services, particularly in the use of outcome measures. TOMS gets a shout out here as an example of an outcome measure being used to consistently measure outcomes. There is a need for use for evidence based practice and consistently measure outcomes and this section states that there shouldn’t be so much variation in quality of services.
Part 2 – Enabling AHPS to transform health, care and wellbeing
(How to utilize the potential of AHPs mentioned in part 1)
4 commitments to the way AHP services are delivered:
Commitment to the individual
Commitment to keep care closer to home
Commitment to the health and wellbeing of populations
Commitment to care for those who care
4 priorities for AHPS to meet the challenges of changing care needs
AHPS can lead change
AHP skills can be further developed - Traditionally AHPs have been regarded primarily as experts in their clinical fields. Increasingly AHPs are developing wider skills which complement their specialisms and provide flexibility
What is our unique selling point?
What roles do others do that we could also do?
What are our shared skills and knowledge?
What skills can we share with others?
AHPS evaluate, improve and evidence the impact of their contribution
AHPS can utilise information and technology
Use of informatics in training and daily work
This section asks challenging questions to academics, STPs, health boards managers to ask them if they are fully utilizing AHPS.
The Chief Allied Health Professions Officer (CAHPO) (most senior officer in England for AHPS) sponsors AHPS into action and will provide strategic leadership and accountability, champion, ensure opportunities
Part 2 outlines the responsibilities of CAHPO, system leaders and AHPS in relation to this document.
AHPS must demonstrate the quality and cost effectiveness of services they deliver
What should we do as a result?
I think all AHPs should familiarise themselves with this document as it very much outlines the strategy for AHPs over the next few years. Discuss it with your colleagues and managers, and consider the questions listed in part 2 for your own discipline:
What is our unique selling point?
What roles do others do that we could also do?
What are our shared skills and knowledge?
What skills can we share with others?
The full document has some very nice tables and prompt questions that could be used to generate and structure discussions within teams. They also have some good summary infographic posters to display and further promote the AHP role. Link to the full document: https://www.england.nhs.uk/wp-content/uploads/2017/01/ahp-action-transform-hlth.pdf
This document raises some interesting challenges and debates in my mind regarding the call to push beyond our traditional speciality boundaries and how that affects our professional identity, and what training and support there will be for these evolving roles. Some interesting discussions to be had - comments welcome!