Moving with the times: the lasting impact of Covid-19 on the Allied Health Professions

As a former Occupational Therapist, the pandemic has brought me down memory lane. I have been thinking about the time I spent covering acute wards, which were always chaotic even before a pandemic, what with the many conversations on discharges and rehabilitation time required for every patient. I’ve also been thinking about my time working in the community and all the rehabilitation and support we provided to new parents, young children and families. Knowing the roles Allied Health Professions in both acute and community settings very well, I am aware of their crucial importance not only now but also during the COVID-19 recovery journey.

Responding to COVID-19 requires all Allied Health Professions (AHPs) to work differently, including rehabilitation/ therapy-based roles e.g. Physiotherapy and Occupational Therapy) and technical roles (e.g. radiography and operating department practitioners).

Changes made to services during the crisis have impacted AHPs. For instance, some non-acute services have been paused until further notice, with AHPs redeployed to acute roles. Other services, such as community mental health, have moved some of their delivery online through web-based applications such as ‘NHS Near me’. Allied Health Professionals working in these services have quickly adapted their ways of working to ensure service users were brought on the ‘online’ journey.

Returning to ‘normal’, i.e. how things were before the pandemic, is not an option. Neither is delaying rehabilitation, ongoing support services or clinical and technical services for those who need them.

In this context, how can AHPs resume safe, person-centred services at the right place and at the right time, and what can they learn from the changes so far?

There’s no one answer to this question but the following key learnings can support AHPs in their journey to rebuild safe and effective services for all users.

Ways of working:

  • Telehealth

While telehealth has been quickly rolled out in many community support services, an over-reliance on these digital solutions can exclude vulnerable populations. To ensure that no one is left behind, AHPs will need to screen and assess whether this is an accessible option for service users and develop a pathway for delivering services if this is not the case.

  • Use of PPE

Infection control training and the use of PPE is and will be essential for the future work of all health and care professionals. While this may be straightforward for some AHP services, specific rehabilitation activities which require the use of shared tools may need specific consistent infection control processes, e.g. checking in / out equipment.

Managing expectations and resources:

AHPs were identified for redeployment to acute hospitals in order to:

  • Lead and deliver the crucial cross sector rehabilitation services to drive hospital flow, minimise admissions of frail and elderly patients, and promote early discharge and recovery at home.
  • Maximise imaging capacity, and build critical care and ambulance service capacity.

Redeployment has required AHPs to quickly adapt to a change in their work environment (location and team), in the type of work they do and the service users they see. While efforts have been taken to ensure AHPs are redeployed appropriately, this has no doubt been a steep and quick learning curve. The emotional and psychological wellbeing of AHPs throughout this experience will require ongoing consideration and support.

Additionally, as acute and non-acute services restart, systems will need to assess the availability of AHPs resources. This is especially the case for physiotherapy which is playing a central role in the management of Covid-19. Demand for in-patient physiotherapy has increased greatly since the virus outbreak and will remain this way for the foreseeable future. As orthopaedic surgery and outpatient services recommence, resources will need to be distributed appropriately to meet the different demands.

Upskilling to manage more complex patients:

  • The disruption to routine services combined with the physical and psychological impact of the pandemic on service users will lead to more complex and longer rehabilitation journeys. Appropriate resources and training need to be in place to support AHPs in managing and addressing these higher levels of need, supported by guidelines for caseload management.

What does the future hold…?

There is no doubt that the world of work for Allied Health Professions will be very different moving forward. While these changes will be demanding for the Allied Health Profession workforce, they also provide opportunities. Firstly, even after the pandemic, it will be possible to continue offering more flexible services for the service users, e.g. online appointments or face to face depending on their preference and need. Secondly, AHPs have the opportunity to redefine rehabilitation services, creating an additional pathway for service users which addresses and focuses on their post-Covid rehabilitation needs. Finally, as experts in holistic rehabilitation, AHPs have the potential to step-up and lead the way in how person-centred care should be resumed in a health and care system on the road to recovery from a pandemic.