Equity of care in practice

When I first started my journey as a student, I assumed that being a physiotherapist was purely a clinical role. I knew about health inequities and social determinants, but I always thought only managers and NHS policies had influence. But now, I realise our scope of practice extends beyond rehabilitation and disease prevention. 

Physiotherapists, like all healthcare professionals, have a responsibility to reduce inequities. If a patient-centred approach means tailoring our assessment and treatment methods accordingly, surely that means adapting our practice to ensure every patient gets the same quality care? 

As physios we can build better therapeutic bonds with our patients

Patients get better quality care and reduced risks of developing other pathologies, reducing pressures on NHS resources. 

I understood this properly on my first placement, seeing the effect of fixed-time restraints for patients requiring a translator.

Appointments were 45 minutes for new patients and 30 minutes for follow ups, which included assessment, treatment, and note taking. Yet for patients who required translators, the time for this process, the difficulty of translating certain words and differences in meanings led to things being ‘lost in translation’. 

However, spending a little extra time with these patients could reduce this health inequity by enabling patients to gain a better understanding of their condition and treatment protocols. This could improve health outcomes and adherence to treatment.

This shows the difference between equality and equity: patients may receive equal time slots, but no adjustments are made to account for translators – so the delivery quality differs.

As a student physio, it’s easy to feel as if we have no influence over health inequities: but as those delivering services, we need to ensure social determinants do not affect patient care. Change can be initiated by anyone with patient contact.

Sometimes it can be as simple as a little extra time. Policies only work if professionals implement them into practice – including students. How do you plan on doing this while on placement?