Past, present and future for allied health professionals Karen Middleton – CBE Chief Health Professions Officer

The past for AHPs Not known or understood by the public Highly valued by patients Working in silos Highly skilled and specialised Community working regarded as low value Little strategic influence Poor evidence of clinical effectiveness

The last 5 years…. Data collection and use of informatics Referral to treatment (RTT) National AHP Informatics Strategic Taskforce (NAHPIST) Improving access to AHP services Self-referral Service Improvement Programme (SIP) AHP QIPP Toolkit Independent prescribing for physiotherapists and podiatrists

Leadership AHP Leadership Challenges Clinical Leadership Fellowships Chamberlain-Dunn CHPO Leadership Award NHS Leadership awards SHA AHP Leads posts Flexible workforce AHP Competence-based Career Framework Clinical Academic Careers Training Pathways Allied Health Professional Advisory Board The last 5 years………

And the present for AHPs? Getting organised Getting more political Getting more business-like Gaining a profile Professionalism being recognised A tipping point or a knife edge? Survive or thrive? Adapt of die?

The future for AHPs Dependent on demand not self-interest Shaped by the context in which we will work

Ageing population will mean doubling the number of very old people over next 20 years Number of over 85s will double by 2030 – and over 65s will make up over a fifth of the population Proportion of total population by age group Source: ONS population projections Under 19-year old people falling as a proportion of the population

….and we know that musculoskeletal conditions account for over half the overall burden of disease for people with LTCs… Source: DH analysis of HSE Circulatory conditions are common, but have smaller impact on quality of life Burden of disease – People with LTCs Mental illness has lower prevalence as LTC, but also has large impact on quality of life Based on prevalence and quality of life, musculoskeletal conditions make up over around half the burden of disease

…and the impact of rising expectations and new technologies are likely to outweigh the impacts of ageing and disease patterns Breakdown of projected long-term pressure Almost half of future pressures are rising expectations and technology change

Early 1980s Stomach ulcers – from operations to antibiotics Late 1980s - from heart bypass to stents Technological advances in medicine can rapidly change the model of care s MRI and CT scanners – reduced invasive operations Future tech advances?

The recession caused a permanent loss of economic output – not like a normal recession Percentage change Level, 2005 = 100 Source: GDP to 2010, ONS; GDP projections 2011 onwards - OBR (trend of 2.1% p.a. growth) Real and projected GDP growth GDP level (rhs) Projected GDP level, (rhs) Projected GDP level without recession (rhs) Annual GDP growth (lhs) Projected annual GDP growth (lhs)

The vision Patients and the public are central Clinically informed Outcomes focused

Implications for AHPs and the services we deliver Influencing commissioners Understand your customer Understand your business Data, information and evidence What is your offer? Prevention Rehabilitation Flexible workforce Collaboration and competition Innovation Radical change

The future for AHPs? The solution to preventing ill health, reducing demand, speeding up discharge and maximising people’s potential New and diverse roles with greater responsibility New and diverse career pathways Leading rehabilitation services across sectors Integrated into pathways of care Delivering very different services in different ways A force to be reckoned with!

It’s in your hands…… Get organised Don’t wait, act now Be courageous Do it together Remember that we cannot afford self- interest