Inspired alliances: easing student placement pressure

While the creation and expansion of physiotherapy training courses across the country can only be welcome, the growth in the numbers of physiotherapy students in training means educators are struggling to offer “traditional” placements.

The constraints and pressures of the Covid pandemic, where hospitals were too stretched to welcome students, saw teaching institutions look to placements outside of “normal” clinical settings. While the pressures of Covid have receded, the pressure on the NHS to cut waiting lists is even more acute.

Jen Straker, the CSP’s professional adviser for the West Midlands, says that with these factors in mind educators are looking at new ways of providing students with the 1,000 hours of practical experience they need to qualify. She says novel alliances are helping the profession to grow, while benefiting local communities by addressing inequities in access to care.

‘Universities are offering clinics in-house, or going out into the community offering not for profit services in places where access to physiotherapy is difficult.’

She gives the example of Newman University in Birmingham – a new provider in its first year – which is looking at how it can set up clinics in local communities where access to healthcare is poor.  

‘When setting up novel placements there has to be the right levels of governance and supervision put in place,’ Jen adds.

Campus care

Last autumn the University of Cumbria, in partnership with North Cumbria Integrated Care (NCIC) NHS Trust, opened a new NHS musculoskeletal (MSK) physiotherapy outpatient clinic on the site of its Fusehill Street campus in the centre of Carlisle.

Sarah Smith, principal lecturer rehabilitation and physiotherapy rehabilitation at the university, says the clinic is the first of its kind in the UK where students are supported to treat physiotherapy out-patients referred through the NHS.

Health Education England provided £80,000 to transform former classrooms into a dedicated clinical area for physiotherapy, and patients are directly referred from NCIC’s MSK outpatient’s department. 

The clinics are run by two MSK specialists working with four students on six-week block placements. Sarah says the partnership has led to a fourfold increase in the number of students placements that can be supported. And the initiative is proving popular.

‘So far, we have had 100 per cent satisfaction from students and patients. Patients are told on referral that they will be seen by supervised students and there has not been a single refusal. 

‘It’s a huge testament to the students and staff,’ she says.

‘Students have clinical contact four days per week and the fifth day is protected for service evaluation and research – the current evaluation is looking at patient outcomes and looking into the needs of the patient community in North Cumbria, which is a remote semi-rural area, so has challenges of its own.’

The collaboration will be a pilot for the first year and longer term it is hoped to explore opportunities for similar partnership working with other NHS services in north Cumbria.

As well assessing and treating patients, students are developing learning patient management resources that can be used in all MSK services across north Cumbria.

Sarah adds that students are using digital resources to produce information pack for patients having a total knee replacement – providing information and guidance about what patients should be doing to prepare before surgery and what they should be doing post-op.

Growing the workforce and cutting waiting times

Rebecca Tiffen, the east Cumbria physiotherapy team lead at NCIC, says the collaboration looked to address the aims of the NHS Workforce Plan’s ‘train, retain and reform’ agenda which is about growing your own, supporting local talent and local jobs.

‘We provide a really great student and patient experience that is accessible, comfortable and conducive to treatment.’

As the clinic space is an extension of the service that is currently provided in Carlisle, Rebecca says the longer-term hope is that it cuts waits.

‘The collaboration also plans to give current staff further opportunities for their own development through research opportunities and projects with the university.’

When two organisations with their own separate policies embark on collaborative work Rebecca says there always bound to be red tape issues.

‘But all in all, everything has worked well as we are aligned and have the same set of values and agreement on a plan.’

Saving careers

Coventry University assistant professor of physiotherapy Kirk Holland has over 15 years of experience working in professional football at a number of high-profile clubs including Birmingham City.

But he says that grassroots clubs don’t have the cash or resources to provide the sort of medical cover that the elite clubs can offer. ‘Many young footballers at this level sustain injuries that the clubs cannot deal with, so the players are faced with the long waits for NHS physiotherapy,’ he explains.

‘The longer these injuries can remain untreated and the greater the chance of it turning into a chronic problem that could ruin a career – and add to the burden on the NHS.’

Kirk says his students are crying out for novel placements so they can see patients with acute injuries such as ankle sprains or ACL injuries rather than their usual fare of chronic conditions.

Kirk approached local side Coventry Sphinx, who play in Northern Premier League Division One, to ask if his students could set up a free of charge sports injuries clinic on site. 

‘The idea was my own as I had seen at the lower end of the football pyramid how poor the care was for their players so I thought we could give something back here.

‘The club were really happy to take up the offer, players are getting speedy care and not putting demand on the NHS, and our students are getting the experience of seeing acute sports injuries. Some of the students are even going along with a qualified physiotherapist who will offer pitch-side treatment. The students are only there as observers but it’s all valuable experience.’

Funding came to the university from the NHS England tariff and is spent on dressings and tapes and the day-to-day expendables of a physio clinic. Any leftover money goes into a pot to help invest in local deserving causes. 

Three clubs, including Coventry Sphinx, host student clinics with four students at each club. Kirk says the sessions are supervised by a physio professor although, as the students gain skills and experience, they are allowed to work alone with regular patients. 

‘Although if something comes up there is always a professor on hand to contact via Teams who can see the patient and offer advice.’

Kirk believes other educators could seek out similar collaborations. ‘There are hundreds of grassroots clubs all over the country crying out of physio support so any university that wants to give its students a novel placement could contact them. 

‘All it requires is the for qualified staff to be prepared to give over some of their time and for the club to provide some space.’