The Scottish Government

« Previous | Contents | Next »

Listen

Building on Success - Future Directions for the Allied Health Professions in Scotland

Shaping the Future
4. Improving Health

NHSScotland has a long-term commitment to improving health. Empowering individuals and communities to achieve better health in partnership with social care, education, housing and voluntary agencies is central to the process. This chapter highlights some examples of AHPs' practice in improving the health and wellbeing of individuals and outlines actions that will enable AHPs to work more effectively in this priority area.

4. Improving Health

Allied health professionals are committed to health improvement, which is often integral to their specific clinical role. Many are involved in health screening, health promotion, public health, social inclusion and participation initiatives and in advising individual people who access their services. Their work is extensive and diverse, but may often be uni-professional in its focus.

Working strategically to improve health

The appointment of the National Food and Health Co-ordinator, a dietitian, to take the lead in this important area of health signals the determination of the Scottish Executive to work across agencies in both public and private sectors to promote healthy eating. The Scottish Diet Action Plan, Eating for Health (1996), recommended that larger Health Boards in Scotland should appoint Public Health Nutritionists/Dietitians. AHPs are now also working in the food and catering industries, occupational health and industrial research settings to contribute to health in the widest context.

>> The 'Better Health Through Better Communication' project of Speech and Language Therapists in Lothian Primary Care Trust is improving access to services for people with communication difficulties, including low literacy groups, ethnic minority communities and people with learning disabilities.<<

A number of AHPs have recently been appointed as Public Health Practitioners and are working with the Public Health Institute of Scotland (PHIS) and multiprofessional colleagues to develop the role. This is a real opportunity for AHPs to use their expertise in health improvement and to be at the forefront of public health initiatives in Scotland.

Gillian Kynoch
National Food and Health Co-ordinator

AHPs have also been actively involved in the development of public awareness of health issues and national health promotion initiatives developed by the Health Education Board for Scotland (HEBS).

>> Physiotherapists and Occupational Therapists worked as partners in a national multi-professional project called 'Working Backs Scotland 'which aimed to highlight awareness of back injuries and how to manage them. They worked with the Health Education Board for Scotland, the Health and Safety Executive, Occupational Medicine specialists, GPs, Pharmacists, Nurses, STUC representatives and many other professional colleagues to produce a highly successful national advertising campaign that included radio advertising, a website and the production of 35,000 information packs which were distributed across Scotland. <<

>> Occupational Therapists at Glasgow Caledonian University provide a work rehabilitation service to Strathclyde Police to support police officers to return to work after illness or injury. <<

Working in areas of national priority

The Cancer in Scotland report identified a range of issues that will improve the prevention of cancer and deliver more effective and integrated care throughout the patient journey. The Clinical Standards Board for Scotland (CSBS) identifies the multi-professional management of patients with cancer as a key 'standard' statement.

AHPs deliver a wide range of cancer services, such as diagnostic and screening programmes and radiotherapy. They also provide support and rehabilitation after surgery, radiotherapy and chemotherapy, and when palliative care services are accessed. They therefore need to be closely involved in local cancer networks, working to develop action plans to progress improvements in prevention and treatment in local areas.

>> Therapeutic Radiographers undertake fast-track palliative radiotherapy planning and delivery at the Western General Hospital, Edinburgh. This ensures a faster, seamless service for patients receiving radiotherapy. <<

>> The multi-professional rehabilitation team for cancer patients in North Glasgow NHS Trust works to enable patients to recover from cancer treatments such as surgery and the impact of chemotherapy and radiotherapy on everyday living. Therapists support individuals to return home from hospital and to maintain quality of life throughout the care journey. <<

>> Radiographers at the South Glasgow Hospitals NHS Trust provide a 'one stop' breast clinic with multi-professional team members, speeding up diagnosis and treatment. Most patients are seen within one week of referral and receive their results on the same day. <<

The Coronary Heart Disease/Stroke Task Force highlights areas of priority action in both primary and secondary prevention. AHPs have a key role to play in reducing ill health through encouraging better diet, increased exercise and better lifestyle management.

>> A Dietitian-led project within five rural GP practices facilitated a multi-professional approach to adult obesity for patients with coronary heart disease, hypertension and Type II diabetes in Tayside Primary Care Trust. This has successfully enhanced the knowledge and skills of primary care teams and improved the advice given to these patients. <<

Mental health

In 2000, over 30% of the population in Scotland sought help from their GP on mental health-related problems. Approximately one-fifth of the population will experience mental heath problems at some time.

AHPs have responded positively to the challenges set out in The Framework for Mental Health Services (1997) to improve the access and responsiveness of services. Many AHPs are involved, with Occupational Therapists being core members of mental health teams delivering services to children, adolescents, adults and older people. The particular expertise of Arts Therapists is also utilised extensively in this field, and Dietitians and Speech and Language Therapists are increasingly working within multi-professional teams in mental health services.

>> Direct access to brief intervention Occupational Therapy is available to patients with mild to moderate mental health problems such as anxiety and depression within Ayrshire and Arran Primary Care NHS Trust. This has resulted in a more responsive service to patients and a reduction in GP consulting time. <<

>> An Arts Therapist and Clinical Psychologist in Glasgow Primary Care Trust have worked together to provide an innovative programme of community-based group therapy for women asylum seekers. This successful programme supports individuals with mental health problems associated with displacement and trauma to develop coping skills, integrate socially, manage the impact of anxiety and depression and make use of mainstream community services. <<

>> Solution focused brief intervention Drama Therapy has been developed as part of an integrated care pathway in Tayside community mental health service as part of a multi-professional treatment programme. <<

Health and wellbeing of older people

People are likely to live longer in the 21st century. The demographic trends indicate a steady increase in the population of older people and a drop in the numbers of children over the next 30 years. Services need to be able to respond to the challenges presented by a rising population of older people, who often have complex medical and social care needs.

AHPs have a central role to play in maintaining the health and wellbeing of older people and have developed a range of initiatives to support people in living healthy, active and independent lives. This is the key objective of Adding Life to Years, the report of the expert group on health care of older people.

>> The R.O.S.E. Project in Glasgow (Review of Outreach Services for the Elderly) was a controlled trial of multi-professional home intervention which began in January 2000. The interim results show that rehabilitation at home significantly improves function and reduces the risk of falls for older adults with a history of unplanned hospital admissions. <<

>> The AHP Nursing and Residential Home Team advise, educate and provide guidance for staff in care homes throughout Glasgow. This multi-professional service has been highly valued by the Nursing and Residential Homes, in particular providing staff with a single-named contact for expert advice and in helping to maintain individuals' abilities within these settings. <<

>> Dietitians and Speech and Language Therapists in Highland Acute Trust are working with the Trust Nutrition Steering Group to implement the recommendations of Promoting the Nutrition of Older Adults in NHS Hospitals. This multi-professional group also includes representation from the Patients' Council to support a 'whole systems approach' to improving nutrition and overall patient care. <<

Working with children

Children are the key to a healthier future for Scotland and they are the second new national priority group outlined in Our National Health: a Plan for Action a Plan for Change.

AHPs are extensively involved in delivering services to children. Occupational Therapists, Physiotherapists and Speech and Language Therapists often work across health, education and social care settings, supporting children to participate in their learning and development at school. In addition, Orthoptists undertake nearly 70% of their work with children. All other AHPs provide specialist interventions for children, according to need.

>> Orthoptists in Argyll and Clyde Acute NHS Trust provide pre-school visual screening in nursery schools rather than clinics to maximise detection of pre-school visual problems. This has made the service more accessible and has reduced non-attendance. <<

>> A paediatric Music Therapy service has been developed in East Lothian for pre-school children with communication difficulties. The associated research project has demonstrated positive observable changes in the children and high levels of satisfaction with the service. <<

The case for services for children provided by the education, health and social care sectors to be better integrated is outlined in the report For Scotland's Children, and the Manual for Good Practice in Education makes specific reference to joint working by teachers and therapists. Walk the Talk (2000) stimulated a range of multi-professional initiatives aimed at making specific primary care services accessible to younger people. And the particular needs of children with disabilities in making the transition between child and adult services have been highlighted in several of the Physical Disability Reviews undertaken by the Scottish Health Advisory Service.

By working closely with young people, AHPs and health, education and social care colleagues hope to make a real difference to their general awareness and sense of personal responsibility for health and wellbeing.

>> Dietitians in Forth Valley Primary Care Trust are working closely with local schools to develop healthy eating for primary school children. The 'Food Dudes' programme encourages children to taste fruit and vegetables repeatedly to develop a liking for them and is helping to create a culture within the school that supports the consumption of fruit and vegetables. Every participating school now has a school-run fruit shop and children's consumption of fruit and vegetables at snack and mealtimes has reportedly increased at school and at home. <<

Improving health locally

A collective multi-professional approach to improving health is likely to have the biggest impact and achieve greater success. AHPs are already contributing effectively to achieving this goal, and are now aiming to work more closely together and with other professional colleagues.

Shifting the focus of existing services from being reactive to ill health to being proactive in improving health is a significant challenge for all Scotland's NHS Boards. AHP leaders and employers should therefore recognise and define specific contributions to health improvement when reviewing job descriptions, and ensure that AHPs get the opportunity to contribute to local Health Improvement Planning mechanisms.

>> Dietitians in Ayrshire and Arran Primary Care NHS Trust work with local authorities, social work department, education and community education services to develop the role of "Community food workers" which is aimed at improving the knowledge of links between food and health and promoting increased fruit and vegetable consumption in low-income communities and families. <<

Every discipline has different skills and expertise to contribute to the health improvement agenda and these examples are by no means all-encompassing or exhaustive. They do, however, serve to illustrate current achievements and the extensive capacity of AHPs to contribute effectively to improving the health of the population.

« Previous | Contents | Next »