Karen Middleton: "Let"s add existence to many years, not just many years to life"

Operating on a rehabilitation consultation undertaking in Tower Hamlets was ‘a total life changer’, says Karen Middleton. Photograph: David Harrison

For some former large-ranking public servants, leaving the NHS means consultancy, a directorship, or a rewarding position at some transatlantic arriviste.

But following 28 years, Karen Middleton has left NHS England’s offices as chief allied wellness professions officer for what her colleagues contact the “other side”. Getting trained initially as a physiotherapist at St Mary’s hospital in Paddington, London, just before practising in Essex and east London, she has headed property.

In February Middleton became chief executive of the Chartered Society of Physiotherapists (CSP) – a entire body that represents 52,000 physiotherapists in the Uk. It really is not quite as outdated as its Georgian headquarters in London, but since 1894 the CSP has been the key association, and much more recently trade union as well, for physiotherapists.

Despite their crucial care for individuals with cancer, heart failure, persistent obstructive pulmonary illness, stroke and sports activities injuries, physiotherapists have a minimal profile in contrast with several other healthcare professionals. Perhaps this is why Middleton insists that her most considerable achievement at NHS England was in obtaining greater recognition for physiotherapists and the other allied health specialists (AHPs), such as podiatrists, occupational therapists, radiographers and speech and language therapists. “Even though we’re nowhere close to where I’d like to be in terms of visibility, now there’s considerably greater recognition of the role of AHPs in each and every care pathway,” she says, “and which is been as a result of some important pieces of operate.”

Amid these, she contends, are the introduction of independent prescribing for physiotherapists and podiatrists and self-referral pilots. These showed that individuals who self-refer to physiotherapy get fewer days off function and are half as probably to be off work for more than a month, compared with these referred via standard routes. This implies the NHS is ready to conduct fewer x-rays, give out fewer medication and make fewer referrals to orthopaedic experts.

Then there have been the NHS support improvement programmes. In excess of twelve months, AHP services regarded as to be carrying out poorly by the former strategic health authorities had been redesigned. Waiting occasions were cut, even though clinical outcomes and patient knowledge had been improved at no extra price.

Middleton says: “The key to all thirty of these services redesigns was that the clinicians foremost the redesign commenced with the patient view of what essential to occur.” She believes that service planners are now considerably more aware of the value of patient view, but have concerns about acquiring a genuinely representative picture – like, for example, the voices of men and women with finding out disabilities.

Almost 20 many years ago Middleton worked on a rehabilitation consultation undertaking in Tower Hamlets, east London. “It was a full lifestyle changer,” she says. “I believed that I knew and understood what men and women who necessary rehab desired, but [investing] a month just listening to people’s stories fully transformed my perception.”

There was the physically disabled lady in a ground floor flat who asked for her windows to be cleaned so she could see the planet outside – not the electric wheelchair Middleton had expected. And individuals were considerably much more concerned about improving the co-ordination and administration of solutions than the clinical interventions.

Her experiences in Tower Hamlets enthused her about the potential of digital technologies to streamline patient solutions and empower clinicians. A single of the most effective resources for Middleton has been the NHS Atlas of Variation, which compares companies and outcomes. She wants to include an NHS Atlas of Variation for rehabilitation, so physiotherapy solutions across the country can be compared.

Asked why rehabilitation is still not integral to NHS acute care, Middleton murmurs: “How extended have you received?” She goes on to say that in terms of policy, targets or outcomes measures, the NHS is too targeted on mortality costs as an alternative of on what transpires when lives have been saved.

“Even though AHPs – and specifically physios – have a huge contribution to make in terms of saving lives, by way of avoiding falls and respiratory care, the true vital additional value of AHPs is not merely in including years to life, but life to many years.” She is alarmed by statistics displaying that by 2035 46% of males and 40% of females in the Uk will be obese and needs to see physiotherapists major the march for physical exercise.

As the CSP chief, Middleton programs to devote a day each week with physiotherapists, many of whom encounter uncertainty simply because of monetary pressures and down-banding of expert posts. Then there is the fantastic privatisation of NHS solutions. Must NHS physiotherapists be anxious? “Properly I do not feel there is a ‘great’ privatisation,” she says. “The final time I saw the figures it was four% of services. But there is no doubt that the plurality of provision is there.”

For Middleton, plurality could indicate unnecessary expenses – for tendering and contract management for illustration – and she is concerned that it could compromise much-necessary integration and co-ordination of companies. She is not confident, even so, that privatisation threatens NHS physiotherapists: “If they are providing excellent high quality care that is expense effective, secure, a fantastic encounter for sufferers, why would a commissioner go elsewhere?”

Speaking on the shift to 7-day operating in the NHS, Middleton says she believes it’s what the public needs and that it really is backed up by the findings of NHS England’s national health care director Sir Bruce Keogh (published in December 2013) about improved mortality rates, and lowered length of hospital stays and readmission costs. She cites the instance of Birmingham Heartlands hospital, which has launched 7 day working within present sources.

Her departure from the NHS has been an emotional affair and Middleton realises how significantly the service has been component of her recognize. At her leaving get together she told colleagues that her work will constantly be foremost about sufferers – regardless of whether she’s with the NHS or on the “other side”.

Are you a member of our on-line community? Join the Healthcare Pros Network to obtain normal emails and unique provides.

Karen Middleton: "Let"s add existence to many years, not just many years to life"