Date of release: 15 July 2020
As we continue to work our way into the ‘new normal’, I’d like to share with you how some of our Allied Health Professionals (AHPs) have changed the way they work during the COVID-19 pandemic.
These roles include dietitians, occupational therapists, operating department practitioners, orthoptists, physiotherapists, podiatrists, prosthetists and orthotists, radiographers and speech and language therapists.
Many AHPs working in outpatient areas have had to significantly change their ways of working from a direct care, face-to-face approach, which ended in March when lockdown started, to what we’re now calling virtual. Patients previously seen in person are now receiving telephone and video consultations in almost all cases, although staff - wearing the appropriate Personal Protective Clothing (PPE) - are still seeing some patients in their own homes.
These new ways of working have presented numerous challenges to AHPs as they continue to try to maintain the same levels of care. Some staff have fed back to me that the change from seeing patients face to face to working from home with a phone and a laptop has produced some of the most challenging times of their careers, both mentally and professionally. I have been indebted to my colleague Dr Rosalind Leslie PhD, Group Manager, Therapies and Ambulatory Care, who has provided extensive support to staff to reassure them of the importance of continuing to provide an excellent service and remind them just how vital their skillsets are. The same staff also reported their telephone assessment skills have improved and they have received very positive feedback from patients.
Many staff embraced the changes that have been forced upon them by the restrictions of COVID-19. One physio of many years’ experience reported that the speed of change required meant that on day one of lockdown, patients were contacted by telephone and by day three, video consultations had started.
In a growing number of cases, smart phones have been a lifeline between staff and patients as they have enabled face-to-face contact, which has proved invaluable. Examples include patients displaying their medication to camera, physios prescribing exercise programmes which they can talk them through, and even patients filming areas of their homes so staff can order equipment to assist them. AccuRx - a text messaging and video consultation platform between staff and patients and has been widely used by outpatient teams - has also been used by stroke specialists prescribing exercises. Telehealth - where advice is given by clinician to patient via their devices - has helped in speech and language therapy. All of this benefits the patient recovery.
Patients now have a greater choice of how they receive their treatment. They have seen video consultations via AccuRx quickly become the norm, which would not have been considered or at least may have taken longer to implement pre-pandemic. The greater flexibility has been welcomed by patients, some of whom are still nervous about attending hospital for clinic appointments, or having someone visit them at home.
Physios have reported that having rapidly implemented remote consultations and developed a patient feedback questionnaire, they are now involved in a research opportunity to investigate patient and therapists’ perceptions of remote consultations to help inform best practice for the future.
Our Cardiac Rehabilitation Therapy team have been particularly innovative. They created an exercise workout for patients which has attracted over 1,000 views on YouTube and have since uploaded two more similar videos to the social media channel, all of which are to become part of their new Cardiac Rehabilitation Exercise programme model. The team have also provided workouts through Physio Tools, an online exercise software resource for physiotherapy, rehabilitation and fitness. They also have an app so patients can view their workout on their phone. For those without internet access, staff can print off PDFs of personalised workouts to post to patients.
The number of cases referred to the Cardiac Rehabilitation Therapy team from admissions to the Heart and Lung Centre used to be between 60 to 65 per cent. They have changed the process because they wanted to ensure they spoke to all patients during lockdown to try to make sure the patients stayed motivated and now the referral rate has increased to over 95 per cent.
Another physio reported that by two weeks ago they had completed 5,599 remote out-patient therapy consultations. Telephone and video consultations are here to stay as staff have embraced the challenge of life in the ‘new normal’.
I am incredibly proud of the work undertaken by the allied professional group at RWT.