The Allied Health Professions (AHP) Strategy for England¹ was launched on June 21^st 2022 at the Chief Allied Health Professions Office’s (CAHPO) national three-day conference.  This is a five-year strategy (2022 – 2027) with the subheading ‘AHPs Deliver’.  It has been developed to provide strategic direction to the AHP community across England. To help maximise their contribution to improving health outcomes for all, providing better quality care, and improving the sustainability of health and care services. The strategy is a follow-on from the 2017 Allied Health Professions into Action strategy², which was the first AHP-centric strategy in England. Alongside the strategy, the CAHPO also launched the ‘Chief AHP handbook’³ and the ‘AHPs within integrated care systems: Guidance for system executives and senior leaders’⁴.

The strategy is made up of two key themes, a group of enhanced foundations and five ‘areas of focus’.

Key themes

1. Committing to being anti-racist

The anti-racism statement in the strategy sends a clear and consistent message that racism will not be tolerated. It requires the AHP community to commit to achieving real and lasting change for ethnic minority AHPs, communities and people, through proactive challenge, advocacy, and collaboration.

Those who sign up to it commit to being anti-racist by:

• Not tolerating racist behaviour and calling out racism including micro aggressions
• Educating people on what being anti-racist means
• Addressing racial inequality, improving opportunity plus access to services and employment
• progression for underrepresented groups in the AHP community
• Being an ally by realising privilege exists, being proactive in their education and taking action to amplify the voices of under-represented people and communities

2. Co-production

Co-production in healthcare means that patients contribute to the provision of health services as partners of professional providers.  Co-production of services is much more than consulting people; they have an equal part in service conception, design, steering and management. Capturing the voice of people and communities who access health and care in England has been at the centre of the AHP strategy from the development stage, a ground-breaking and innovative method of strategy development.

Co-production was discussed at length throughout the conference.  With one memorable statement “check who doesn’t have a seat at the table and offer them one”. Co-production should also be considered from a professional viewpoint.  Ensuring equity of representation of the smaller allied health professions in decision making and service design.

Enhanced foundations

• AHPs champion and promote diverse and inclusive leadership

The strategy states that AHPs will continue to champion diverse and inclusive leadership, improving representation from those with protected characteristics and all our different professions, by gathering the evidence and working with the system to realise the potential of the AHP workforce. It is crucial that AHPs have diverse leadership, step into these roles and are representative of their communities.

• AHPs in the right place, at the right time, with the right skills

Securing the future supply, bridging the gap between education and work, and enabling the workforce to deliver and grow through AHP development.

• AHPs commit to research, innovation, and evaluation

Research is key to ensuring safe evidence-based practice to support patients and patient pathways. It is also important to strengthen the evidence base, to inform service design, clinical reasoning and shared decision-making with the people and communities we work alongside. Research is a core pillar of clinical practice.  See the co-produced ‘Allied Health Professions Research and Innovation Strategy’⁵ for vision statements.

Despite the benefits, research is often viewed as being reserved for those who work outside of clinical roles. The proportion of AHPs currently working in clinical academic roles is approximately 0.1%⁶. However, engaging with research doesn’t necessarily mean being research active. It starts with being aware of the research pertinent to your practice, critically questioning and appraising care, carrying out audits and service or quality improvement projects. These skills are helpful starting points in becoming research confident.

• AHPs further harness digital technology and innovation through data

Over the next five years, the AHP community must advance the implementation of the AHP digital framework⁷.   AHP communities need to be supported to successfully implement digital tools that optimise workforce capacity. As we move forward with the digitalisation of health care it is imperative to consider the support people and communities who experience digital exclusion require.   Digital exclusion describes people and communities who do not have the access, skills, and confidence to use the internet and benefit fully from digital technology.

The ‘enhanced foundations’ are the key enablers to achieving the five ‘areas of focus’.

Five areas of focus

1. People first

The ‘people first’ ambitions are to:

• Improve the quality of and access to services.
• Help people and communities get the care they need when they need it.
• Ensure this care considers people’s values, family situations, social circumstances, and lifestyles; seeing the person as an individual and working with them to develop appropriate solutions through shared decision-making.
• Help people, communities, and populations to look after themselves (self-care), thus reducing some of the pressure on health and social services.

2. Optimising care

• Delivering quality care: AHPs deliver high-quality care and fully contribute their skills and experience to patient pathways.
• Supporting staff: Staff are fully engaged, well-led and retained.
• Optimising the workforce: The workforce has the right skill mix and capacity and is deployed to deliver maximum impact.
• Improving productivity: Productivity is monitored; unwarranted variation and opportunities for improvement are identified.

3. Social justice, addressing health and care inequalities

The ambitions for addressing health and care inequalities are:

• Supporting more equitable access to AHP services for lower socioeconomic groups, ethnic minority groups, people living in rural areas and other specific disadvantaged groups, and people with mental health problems.
• Providing high-quality care and patient experience in terms of avoiding bias in decision-making, having culturally appropriate services, and meeting clinical standards.
• Addressing the social determinants of health through supporting employment and housing.
• Supporting mental well-being with specific AHP services as well as incorporating mental wellbeing considerations in routine AHP services.
• Engaging and empowering communities to support the co-design and delivery of culturally relevant services.

4. Environmental sustainability: Greener AHP

The ambitions for environmental sustainability are:

• Workforce: Embedding new ways of working by building net-zero into everything we do. To achieve this, all AHPs will need a good understanding of the net-zero agenda, and it will form a crucial part of our competencies.
• Models of care: including net zero as a fundamental design principle in our models of care.
• Resource use: actively considering and reducing the environmental impact of the things we procure and prescribe as part of our practice Contributions to the Greener Allied Health Professional Hub demonstrate that AHPs embrace the net-zero agenda. Action from the entire AHP community will ensure we collectively achieve the ambitions set out in this strategy, and bring the triple win of improving health, saving money, and preserving the planet.

5. Strengthening and promoting the AHP community

The ambitions for the AHP community are:

• Raising awareness of AHPs: For care to be personalised, and for people to be able to make choices on how their needs can be best supported, people and communities need to know who the AHP community are. This includes understanding the expertise the 14 professions collectively provide, alongside the unique skills of each one
• Caring for those who care: As we emerge from the COVID-19 pandemic, ensuring the health and wellbeing of the AHP community will be critical for the months and years ahead. Learning from the pandemic, as individuals, organisations, and systems will drive improvement in staff experience. Staff wellbeing links to feeling valued and belonging and can be enhanced with flexible work options to support work/life balance. It is also important to identify AHPs who act as carers and support them accordingly
• Equality, diversity, inclusion and belonging: A sense of belonging ensures people bring their very best to work and provide the best for those they care for. There is a clear ethical, moral, and social case for equality, diversity, inclusion and belonging. Where standards are in place these will be used to monitor progress. Where standards do not exist, we will work to better understand the needs of these groups

Summary

The new AHP strategy puts people first, focuses on co-production, equality, diversity and belonging and takes an active stance against racism. Embedding public health in AHP services, challenging services to incorporate mental wellbeing considerations in routine AHP services.  It also requires us to ‘care for the carers’, ensuring our workforce gets the support they need.

It encourages AHPs to view services through a green lens. To commit to research, innovation, and evaluation, harnessing digital technology and innovation through data.

The strategy further cements the AHP identity within the NHS workforce. At the Royal Wolverhampton NHS Trust (RWT) we will apply the strategy as a framework to aspire to and guide us, enabling our AHPs to realise their potential. We will use team meetings as a means of ensuring that all AHP services are aware of the new strategy. We will update our AHP Commitments document and ensure that the next iteration of the Clinical System Framework milestones reflect the aims and objectives within the strategy to make certain that the strategy is fully embedded at RWT.

 

References

1. Chief Allied Health Professions Office. The Allied Health Professions (AHPs) Strategy for England The AHP Strategy for England?: AHPs Deliver 2022 – 2027. Published 2022. https://www.england.nhs.uk/wp-content/uploads/2022/06/allied-health-professions-strategy-for-england-ahps-deliver.pdf
2. NHS England. Allied Health Professions into Action. NHS England. Published 2017. https://www.england.nhs.uk/wp-content/uploads/2017/01/ahp-action-transform-hlth.pdf
3. Chief Allied Health Professions Office. Chief allied health professionals handbook. Published 2022. https://www.england.nhs.uk/wp-content/uploads/2022/06/Chief-AHP-Handbook-v17-FINAL-13062022.pdf
4. Publishing O. Allied health professionals within integrated care systems. Guidance for system executives and senior leaders. The National Health Service. Published 2022. https://www.england.nhs.uk/publication/allied-health-professionals-within-integrated-care-systems-guidance-for-system-executives-and-senior-leaders/
5. Health Education England. Allied Health Professions ’ Research and Innovation Strategy for England. Published 2022. https://www.hee.nhs.uk/our-work/allied-health-professions/enable-workforce/allied-health-professions’-research-innovation-strategy-england
6. Cordrey T, King E, Pilkington E, Gore K, Gustafson O. Exploring research capacity and culture of allied health professionals: a mixed methods evaluation. BMC Health Serv Res. 2022;22(1):1-10. doi:10.1186/s12913-022-07480-x
7. NHS England. A Digital Framework for Allied Health Professionals #AHPsintoAction.; 2019.