Rehab must continue

As the Covid-19 pandemic took hold in the UK, physiotherapists in all sectors rose to the challenge with expert professionalism. Services were paused as staff responded to the anticipated patient need, many being redeployed to support colleagues in acute care. Our efforts did not go unnoticed. The crucial role of respiratory physiotherapy and early rehabilitation of the acutely unwell patient was rightly recognised in the media and consequently by the public.    

This provided a clear opportunity to the physiotherapy profession: to put the importance of rehab firmly on the agenda. To show that saving a life was not enough, that surviving the virus may just be the beginning and, crucially, that it is rehabilitation that will give people’s lives quality. As we enter a second wave, the physiotherapy workforce has a critical role to play in ensuring that rehabilitation continues as a priority service. 

During the early phase of adjusting to work in the pandemic there was a clear spirit that ‘we are all in this together’ and this seemed acceptable. Several months down the line when this rehab space has not been returned, it simply is not.

Lockdown, the stopping of services and redeployment of staff happened extremely quickly. However, the pace  of reopening these services has been quite the opposite. We now better understand the catastrophic impact  of stopping services in the first wave, and have knowledge about existing inequalities in healthcare as well as the multifaceted effects of lockdown on an individual’s physical and mental health. We have clearly demonstrated to all that rehabilitation is imperative, and it must not stop. 

During this time, physiotherapists and support workers have hugely innovated in their methods of rehab delivery. The workforce has navigated the new and ever-changing landscape in which they are working and has shown resilience, determination and creativity in doing so. Many physiotherapy workers are offering remote rehab solutions in a variety of formats including one-to-one, group rehab with peer support and the use of mobile device applications, widening access to their services. Remote delivery will not replace face-to-face rehab but it will have a firm place in our rehab offer going forwards.  

Where face-to-face group classes have restarted, we have supported physiotherapists to return to work safely and effectively. Considering PPE, social distancing guidelines, infection prevention control, government guidance and patient flow through the workplace among many other factors.  

The CSP’s professional advice service has received numerous examples of members thinking creatively about where rehab may take place, including outdoor settings, community halls and within large leisure facilities. These have been great to see and are testament to the profession being so agile and responsive to changing population needs.   

However, we are also hearing increasing examples of rehab space being requisitioned for new wards, PPE donning and doffing zones, storage, administration space, overspill areas and the like. These examples are continuing to be brought to our attention. During the early phase of adjusting to work in the pandemic there was a clear spirit that ‘we are all in this together’ and this seemed acceptable. Several months down the line when this rehab space has not been returned, it simply is not.  

How the pandemic evolves over the coming months is difficult to predict. What is less difficult to predict is the growing numbers of patients who will require our services to give them a quality of life and maximise their independence. This includes those recovering from Covid-19, those who have deconditioned during lockdown as well as those who have continued to experience other illnesses and injuries.  

Continuing and building on rehab services for our patients at this time is vital. Working together with patient organisations and other parts of the rehab workforce on a common agenda on rehab will strengthen our voice in making the case for rehab to continue, including innovative delivery solutions. 

Restoring physio and rehab services – CSP policy statement 

• Tamsin Baird and Sara Conroy are CSP professional advisers 

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The CSP’s Professional Advice Service gives advice and support to members on complex and specialist enquiries about physiotherapy practice, including professional practice issues, standards, values and behaviours, international working, service design and commissioning, and policy in practice.