Frontline: Allied health professional

“I’m an allied health professional working in a teaching hospital in London. The term ‘allied health professional’ (AHP) is hard to explain because it’s quite broad: it covers physiotherapists; occupational therapists; radiographers. In one sense, though, we are just what the title says: trained health professionals who work together with doctors.

AHPs are regulated by the Health Professionals Council, so that is probably the government organisation with which I come into contact most often. It monitors our continuous professional development (CPD) work – we have to keep a folder that tracks what we’ve being doing, to show we’re keeping up with best practice and research, and the HPC can request to see that at any time.

Some colleagues do complain about having to keep that paperwork up to date, but I think the balance is about right. CPD would be the first thing to slip off the list when you are busy, but it’s a really important part of what makes us professionals; without it we’d get stuck in our ways.

In terms of national targets or regulations that have affected me, the main one is the target for A&E waiting times: patients have to be seen and out of the door within four hours. It’s just a nightmare, partly because our ability to deal with a patient in that time depends on their condition. The result is that people come to casualty with a relatively minor problem and are seen by specialists before people who’ve taken the correct route by seeing their GP, getting a referral and coming in for an appointment.

If they wanted to reduce waiting times in A&E, it would have been better to hire more staff. It’s renowned as an area where few people want to work, because the hours are long and it’s incredibly hard work. If they’d provided incentives for people to go into that field and reduced the pressure on staff, they’d have got a better result.

You could say that the target forced hospitals to put more money into A&E, and that in turn should improve staffing, but really it just meant people had to do longer shifts; staff from other clinics had to go into A&E; and we ended up distorting the ways in which patients access care.

One of the worst changes we saw under the last government was when, a few years ago, they said we couldn’t see children and adults in the same clinic. This meant everything had to be split – we had to build new facilities. It really stretched our resources, because if you have children and adults on separate sites you have to have two teams. We also have to run separate adult and child clinics at outreaches, when we see patients outside the hospital. This might mean that rather than seeing all our patients in one area during a given session, we see three adults one morning and go back later to see the children; it can be very inefficient.

The reasons behind that change weren’t well communicated. Maybe they were trying to add extra protection from child abuse; but we can’t separate adults and children in society, and all of our staff are CRB-checked. If they were trying to improve the care for children, they should simply have made sure we had the right facilities for them. I suppose this rule did make hospitals invest in facilities – but it meant that the management had to focus on the issue of creating children’s clinics, rather than investing in upgrading other areas which might have been more important for them.

I’d say that, at the moment, we do have too many managers in hospitals. We need a good mix of frontline staff and managers, particularly clinical managers – people with experience of patient care – and currently it feels as though the frontline staff are often overlooked by government.

The new government says it wants to reduce the number of managers and give more power to the frontline, and hopefully that will be a good thing – I say ‘hopefully’ because we’re waiting to see whether that will happen, and whether they’re ready to put money into management training for frontline staff. You can’t expect people who have good clinical skills to automatically be good at managing. For example, look at the plan to give more power to GPs: I haven’t been in the sector for long enough to know what it was like when GPs used to have more of a role in commissioning services, but some of my colleagues have voiced concerns about the fact that GPs’ knowledge is so general; and while GPs don’t have training on the financial side of things, they will be expected to manage big budgets.

For the last three years, I’ve had a teaching element to my role – both supervising trainees in our profession, and lecturing medical students who need to know about our specialism as part of their broader work. I was given a lot of support for that; my hospital funded a PGCE and gave me time to study, because it’s an important part of supporting the profession. In the same way, if you are giving power to people on the frontline and expecting them to take on management-style roles – which could be an important part of delivering better care for patients – then there needs to be support available so they can use that power properly."