Orthotics provision: Survey of healthcare professionals launched

We have now opened our survey of healthcare professionals (HCPs) who are involved in providing orthotic devices for knee instability in people with neuromuscular disease or central nervous system conditions. The link to the online survey is being sent out through three professional organisations:

• Association of Chartered Physiotherapists Interested in Neurology (ACPIN)
• British Association of Prosthetists and Orthotists (BAPO)
• British Society for Rehabilitation Medicine (BSRM)

If you are a health professional working in this area and have not received an invitiation to take part, or you have any other queries please get in touch with us at kneeorthotics@gmail.com

Blogger: Catriona McDaid

Orthotics services: who is delivering what?

One of the aims of our research is to identify the types of orthotic devices currently being used by the NHS in the management of instability of the knee related to neuromuscular and CNS conditions. We also want to find the answers to other questions such as what are the pathways that patients have to follow once they are referred for an orthotic device. By finding out what resources are required to assess and fit patients with a device, we should then be able to estimate the costs for providing services. We are also interested in what healthcare professionals think are important outcomes for patients and how those outcomes should be measured. This will complement the information we are gathering from patients.

To collect the information we need, we are carrying out a survey of orthotists, physiotherapists and rehabilitation medicine clinicians who are involved in the provision of orthotic devices for patients with knee instability. The content of the questionnaire has been informed by discussions with healthcare professionals in a focus group, one-to-one interviews and discussions with our project Steering Group, which includes members of the different professional groups involved in provision of orthotic devices.

Our problem is that there is so little research available on this topic that we need to ask for a lot of information to address these really important questions. We expect that the survey will take 20-30 minutes to complete which is longer than we would like, but we know that many health professionals working in this area are as keen as we are to address this knowledge gap.

The findings from the survey will be made widely available through healthcare professional networks, patient groups and research journals, as well as forming part of the formal report to our funders, the NIHR HTA programme.

Blogger: Catriona McDaid

AHPs: essential but under valued?

There are over 64,000 allied health professionals (AHPs) in the NHS from a range of different disciplines. AHPs play vital roles within a range of care teams, in hospitals and the community: often working with older people with more complex conditions. They are increasingly expanding their skills to include prescribing and consultant practitioner status, with patients able to self-refer.

QualityWatch, an independent scruitineer of quality in health and social care, has stated that, “despite the size and importance of the AHP workforce, AHPs are rarely the subject of major policy debates and there is a concern that their contribution to care is often hidden, overlooked or potentially undervalued.”  In their report Focus on: Allied Health professionals. Can we measure quality of care?, the authors say this is primarily because of a lack of consistent data nationally on the work undertaken by AHPs.

The report highlights the need to have systems in place that can capture information on all aspects of the quality of AHP care in all settings. The authors also identify the need for continued development of AHP research. The OKIS team are pleased to be helping progress this agenda for physiotherapists, prosthetists and orthotists involved with prescribing and fitting orthotic devices for knee instability. By identifying current pathways of care and finding/understanding where and why variation exists it should be possible to ensure the best use is made of AHP skills for the benefit of patients.

Involving patients and the public in research

Over the last few years there has been a sea change in both attitudes and processes related to the inclusion of patients and members of the public in health research. For a start there’s been a radical over haul of the way people are approached to take part in research studies. Legislation and regulations have improved protection for those taking part in research through ethical requirements to safe guard and inform potential participants. Current efforts are being made to continue the streamlining of processes for researchers while still providing ‘protection’ for participants.

Perhaps the biggest step was recognising that research participants are just that – participants in research and not ‘subjects’. They could have valuable input not just by taking part but by feeding back on what was important to them, not always what clinicians had anticipated or researchers used as outcome measures. So why not involve patients and the public in the design and even the allocation of funding for research projects? Well that is exactly what is now happening.

The National Institute for Health Research (NIHR) funds an organisation called INVOLVE to support public involvement in NHS, public health and social care research. The work of INVOLVE aims to promote the empowerment of the public to become more involved in all aspects of research. Their website provides information about how to get involved without being a participant in a study. They make linkages between the public, researchers, NIHR and other funders and sponsors; and encourage evaluation of the impact of public involvement in all stages of the research process.

The NIHR encourages participation in research through their “OK to ask about clinical research” campaign. This has had the combined effect of making both patients and busy clinicians think about whether there may be a trial going on that could help make a difference. Amongst INVOLVE’s many resources is a searchable database of research projects in the field of health, public health and social care that have or plan to actively involve members of the public as partners in the research process. NHS Choices also provide information about clinical trials and medical research along with a clinical trial search facility.

By getting patients, carers and the general public involved in all aspects of research, there has to be a better understanding of the issues from all persectives and greater relevance for the research undertaken and end results.
  

How can we know what works?

The news is full of stories the amount of health information available on the internet. The availability of this wealth of information has led to an increase in informed patients being able to have detailed discussions with their doctors. The emphasis has to be on discussions because: not all information on the internet is accurate or based on sound scientific proof; not all patients can distinguish the good from the harmful; and neither can all involved in providing health care. We are all human and therefore fallible.

If you want to know how we mislead ourselves, and how we can be misled by the internet, researchers, and doctors try reading Testing Treatments. The book and interactive site, “urges everyone to get involved in improving current research and future treatment, and outlines practical steps that patients and health professionals can take together to do this.”