3 minutes with Anna Lowe

Essentially it’s about organising services to deliver preventive care. There are lots of different definitions of public health but the key components are that it is informed by health analysis  and it is preventive (either prevents occurrence or recurrence). It is applied to a defined population and aims to reduce disparities in healthcare.

 

There is a misconception that public health means working with healthy populations to prevent ill-health; this type of public health work is termed primary prevention. Physiotherapists are more commonly involved in secondary prevention where the focus is on early diagnosis and management to prevent long-term health problems – such as the early management of musculoskeletal disorders.

 

We are also frequently involved in tertiary prevention, which aims to limit the impact of ongoing health conditions by preventing further complications. An example of this would be a physical activity programme after stroke. It’s important to remember that many areas of physiotherapy practice are not public health, even though they improve the health of many members of the public. Individualised, clinical care is a huge part of what we do and we shouldn’t feel pressure to try to make services fit a public health mould.

Yes. The policy drivers are clear: preventive care is a major priority and I think we all have a part to play. As a profession we need to identify areas of existing preventive practice that fit a public health approach and use them to showcase our contribution. At a team or department level, we can familiarise ourselves with local public health priorities and think about how services can contribute to improving public health and to reducing health inequalities. At an individual level, we can tweak what we do, so that, in addition to addressing a patient’s presenting complaint, we also capitalise on the opportunity to improve that person’s general health. 

 

Ultimately, public health is about using finite resources to the greatest effect. It is essential that we collect data to demonstrate that our preventive interventions (primary, secondary or tertiary) are effective. It’s a numbers game at the end of the day and we won’t get a look in unless we can show the difference that we make.

Physical inactivity is a major public health issue and physiotherapists are extremely well-placed to promote physical activity, especially to people with long-term conditions. Despite this, many physiotherapists lack confidence in their exercise prescription skills. At Sheffield Hallam University we have worked with Skills Active to embed the level 2 fitness instructor and the level 3 exercise referral award into our undergraduate programme. The process needs further development but the early feedback has been great.

 

By integrating these industry awards we aim to equip physiotherapists to work flexibly across health, social and leisure sectors. I see us leading multi-professional teams that enable patients with long-term conditions to access the right support at the right time.

A friend and I set up a social enterprise called Active Together, which offers physiotherapy-led exercise sessions for people with long-term neurological conditions. We are aware that the ongoing needs of people with long-term conditions vary and cannot always be met by the NHS. We wanted to give people a supported and safe way of maintaining their activity levels through the ups and downs of managing a long-term condition. Partners and carers are encouraged to join in too which helps adherence and makes the classes fun. We’ve had great feedback about the psychosocial impact as well as the functional benefits. It’s a good way for me to keep in touch with clinical practice and operating as a third sector organisation has been really interesting. I also write a blog and tweet as a way of sharing public health information with other allied health professionals.

I love my bikes and I spend a lot of time on and off-road around the Peak District. I’m also looking forward to a summer holiday: mountain biking in the Alps with lovely family and friends, kids, bikes, cheese, wine – 65 days to go and counting!  fl