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	TX: 12.07.07 - Physiotherapist shortage PRESENTER: WINIFRED ROBINSON

	THE ATTACHED TRANSCRIPT WAS TYPED FROM A RECORDING AND NOT COPIED FROM AN ORIGINAL SCRIPT. BECAUSE OF THE RISK OF MISHEARING AND THE DIFFICULTY IN SOME CASES OF IDENTIFYING INDIVIDUAL SPEAKERS, THE 麻豆约拍 CANNOT VOUCH FOR ITS COMPLETE ACCURACY. ROBINSON Hundreds of physiotherapy students across the UK are graduating this week but most do not have a job to go to. Their search will be made that much harder by the fact that almost 1500 newly qualified junior physios from last year still don't have permanent posts. And meanwhile it's claimed that the demand from patients for physiotherapy is going unmet. Carolyn Atkinson has been looking at what's gone wrong. Carolyn: ATKINSON Well back in 2000 the government published a 10 year NHS plan, so zoom in on the physio section and you see that the pledge there was to expand the physio workforce by 59%, between the year 2000 and 2010. So so far so good. The strategic health authorities, who commissioned the university places for physio degrees, did their bit - the numbers of places started to go up - and everyone agreed more physios were needed asap. ROBINSON Why would more physiotherapists be needed then? ATKINSON Well the NHS realised that physios can help with all sorts of areas, they work in lots and lots of different departments - neurology, cardiac, respiratory - in fact 1 in 10 hospital admissions will involve a physio. Physios help all sorts of things - they get people home quicker; they're crucial in rehab; they, for example, help people go straight home rather than via a nursing home for example. And physios are also seen as part of the answer to so many of those government famous targets, the key one being to hit those 18 week waiting list targets or even the A&E four hour target. They can intervene early, they can take some patients out of the system altogether for treatment early on, thereby reducing consultant waiting lists and all sorts of new roles like promoting healthy living, going into schools talking about exercise, talking about obesity, etc. etc., the list goes on. Basically miracle workers. ROBINSON But you need workers to work miracles don't you? ATKINSON Indeed you do and that's where things have actually gone wrong. So cut to the year 2006, the NHS financial crisis, the Health Secretary's instruction to balance the NHS books within a year. Now that meant that quick action was needed, so the NHS trusts started freezing existing posts, they were generally junior posts, and they didn't create any new posts. So the net result was lots of the physios were coming off the courses, the numbers of physios coming off the courses was increasing but they had no jobs to go to and that is continuing this year. Thirty-three-year-old Caroline Birch gave up a 10 year career in academia to start her three year physio degree at Manchester and she's just found out she's got a first, which is great, but she says that makes absolutely no difference when it comes to getting a job. BIRCH The position's pretty dire really. Just to give you an example of applying for physiotherapy roles - most of the jobs now advertised are on an NHS website and it's common now to see a job advertised, to start to apply for the post and as I have in fact myself find that the post has been withdrawn when you're halfway through applying for that particular job. Certainly I'm aware of permanent jobs that have been advertised and go within three hours because the trusts are just overwhelmed with the number of applicants. ATKINSON And that's because they've got enough in that three hour period? BIRCH That's right, yes. I know a post yesterday, they had to close the number of applications after 50 because otherwise they'd be interviewing for three days, it's clinicians that are interviewing, so that's perhaps three days taken out of their caseload - seeing patients. ATKINSON What is your experience so far for doing applications, how many have you done? BIRCH I've applied for about 30 over the past couple of months. Of those I've had a couple of interviews and I know for one of those interviews about 400 people will have applied and four posts were available. The other post that I was interviewed for was actually an assistant role, which isn't what I'm qualified to do but would enable me to maintain my patient handling skills. ATKINSON Do you feel let down by the government or the system or the NHS because you went into this in good faith didn't you? BIRCH I think it's very easy to join the blame culture and perhaps within the past two years I've gone through that cycle of feeling very angry and very frustrated, blaming government and NHS bosses. I think there's no sense really in reducing the number of people that are going through the courses because there is a need for physiotherapists, it's just that with the freezes and with the bottlenecks and so on it means that people can't enter, never mind work their way up through the ranks. And ultimately I think now is the time to actually do something more positive and rather than looking to blame is identify what really has happened, what can now salvaged from this, before we lose a large number of very skilled potential junior physiotherapists. ATKINSON And as if it couldn't get any worse, since I spoke to Caroline Birch she's now come across a new problem - the disclaimer. Because yesterday one PCT added a disclaimer to its job advert which warns: We anticipate a positive response to this advertisement so applicants should expect a robust short-listing process, which may include random selection. As Caroline puts it that doesn't give you much hope. Well courses across the country are reporting similar problems for their graduates. I've been speaking to Phil Gray, the chief executive of the Chartered Society of Physiotherapy and Linda Hollingworth, director of physiotherapy at Salford University where 50 students have just graduated. HOLLINGWORTH I think our perception is that things are worse for this year's graduates in that the backlog of last year's graduates and some of the year before's graduates, who are picking up any jobs that come through, is having a knock on effect on the ability of this year's graduates to find any sort of employment. ATKINSON How have things changed from two or three years ago in terms of how the students go about getting a job and actually securing a job? HOLLINGWORTH The traditional experience of students would be that they would apply during the sort of spring period and they would have employment lined up for graduation. As far as I'm aware we have two of our 50 graduates from this year who have found work within the NHS and as far as I'm aware those are both temporary contracts. ATKINSON So Phil what's your take on this? GRAY The picture that we've got is that the early indications for 2007 are very grim indeed. These are bright, intelligent young people who want to come into physiotherapy, many of whom say it's their lifetime ambition to come into physiotherapy and it's a complete scandal that we've now got to a position where it looks as if a sizeable number of 2007 graduates won't be able to get in. These graduates haven't gone into university just because they wanted to, they were actually invited to. These places are all paid for by the National Health Services, the numbers are commissioned by the National Health Service. And the National Health Service therefore has a responsibility we would suggest. And the really crucial thing is that there's an enormous amount of unmet patient need out there - people in pain, people in distress, people not getting the rehabilitation that they should. Without them there the waiting lists, as we know, in outpatient physiotherapy will get longer and the number of places at six months or more, which is outrageous, because of lack of investments. We know that the government will not be able to deliver on its 18 week target, if in fact the numbers of physiotherapists are not increased. These young people can deliver it, what's the government doing if it's not actually helping to deliver that? ATKINSON So what are the practical solutions in your view to getting these juniors into jobs because during the NHS financial crisis a lot of jobs were frozen, is it feasible to unfreeze those jobs now? GRAY Yes it is possible to unfreeze those jobs and a number are being unfrozen but not at sufficient speed. Secondly, there has always been a serious shortage of physiotherapists at senior level and accelerated promotion could help to resolve that problem and create space for junior physiotherapists. And finally, strategic health authorities should have an obligation to actually create new posts in line with government priorities in order to employ these people, if not we will lose them. ATKINSON One of the ideas is for junior physios to be guaranteed a one year NHS job, rather like midwives and nurses are in Scotland, do you think that would actually help? HOLLINGWORTH I think it addresses some of the short term issues. Graduates are very concerned about losing touch and losing their skills in this long extended period of finding a job, so in a way it addresses those problems. But if there isn't a job for them to go into after that guaranteed one year then we've just got one year graduates who are still out of work. ATKINSON And I understand that literally in the past few days the senior physios have been taken off what's called the 麻豆约拍 Office skills shortage list, where foreign physios were coming in and able to be senior physios, what effect will that have? GRAY A big effect over quite some time. Back in 1999-2000 it was 500 a year coming in, it got to close to 1500 just a year or so ago. We can look at the numbers all day, what it really comes down to is individual graduates being faced with total disillusionment and the feeling of being betrayed by the NHS and by the promises that they were made when they started off. ATKINSON Well we have a statement from the government. They say: We accept there are particular problems in physiotherapy. We're working very hard with employers and the Chartered Society of Physiotherapy to address this. There's more to be done to help existing physiotherapists to progress their careers thus creating vacancies for new qualifiers and improving access for graduates to opportunities across the wider health and social care sectors. They say: In some parts of the country, such as West Yorkshire, newly qualified physios are using their skills in new innovative roles, working as community care officers for local authorities, helping to support hospital discharge. This enables physios to carry on practising their skills when the availability of posts in the NHS is very competitive. Phil Gray, your reaction to that. GRAY The Yorkshire innovation is a new one to me. I'm more than pleased to hear it. However, the real problem we've got here is that we have had a lot of I think very well intentioned statements from the Department of Health and from NHS employers. What we're lacking at the moment is a sign of real urgent action. This will not wait for another year for us to finally get up to speed. The speed is needed now or we're in danger of losing the huge number of people, paid for by the taxpayer, from every taxpayer in this country who is in pain and in trouble at the moment needs the services of. ROBINSON Phil Gray from the Chartered Society of Physiotherapy talking to Carolyn Atkinson. And Linda Hollingworth and her staff at Salford University are so worried about their students they've just set up a website and workshops for unemployed graduates. They're even inviting them back to help teach this year's students so that they can keep up their skills. Back to the Transcripts homepage Back to the You and Yours homepage The 麻豆约拍 is not responsible for external websites

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