The idea of political awareness within a Masters in Physiotherapy was a concept that I didn’t necessarily associate with the profession. Although, I have come to realise this domain is often at the heart of healthcare decision-making throughout the NHS (1), highlighting the significance this area may play in my future career. My first placement at an MSK trust was introduced me to the policies that drive NHS decision-making. This is where I noticed a trend that physiotherapists were often only seeing patients once or twice before referring onto a band 4 rehabilitation instructor for group classes (Reflection: Group Classes). The decision around this appeared to be around reducing waiting times for physiotherapists and reducing costs by utilising group classes ran by a lower banded individual. This did turn out to work well for patients but this highlighted that I understood the political, economic and institutional factors influencing the delivery, organisation, design, delivery and development of physiotherapy (2).

Further experiences of politics in healthcare became increasingly more apparent during the ‘Contexts for Contemporary Practice’ module during our second year during debate day. We discussed a range of topics in pairs in front of the class (Debate Day Picture) to create a motion for or against a given topic. The subject in which we discussed was around a lack of job roles in physiotherapy being fulfilled due to a lack of applicable applicants for the required job position, and if the position was not filled, the post was removed, resulting in staff shortages. This sparked a realisation that there are over 100,000 staff shortages nationwide and the NHS has acknowledged this as an issue that needs to be addressed (Debate Day Presentation) (3,4). My debate pitch in Debate Day Presentation – highlighted in yellow, brought me to the conclusion that further investment into individuals in order to upskill physiotherapists, increasing desirability to apply for these jobs in order to reduce staff shortages, demonstrating an understanding of the political and institutional factors influencing the delivery and organisation of health and social care (2).  

I had the opportunity to engage with implementation and development of policy (2) during my third placement, where I felt a lower back group class would be beneficial. I reasoned this due to the high frequency of patients coming into clinic (Evidenced – Reflection: Group Classes), and felt this would help patients whilst being in line with NICE guidelines for effective non-invasive management (5), demonstrating an understanding of making informed decisions (6). Political awareness is something that is continuously being imbedded into reasoning and considerations within a physiotherapy context. The business proposal (Evidenced – Business Case PowerPoint Presentation) was another opportunity to test my understanding of this domain through a service proposal for an NHS service. I considered key drivers for national, local and strategic policies (4,7,8) during my business proposal in order refine my business idea for a population with respiratory disorders (Evidenced – Business Case Presentation Video), in order to ensure they could get the most effective patient-centred care, evidencing an understanding of political, social and  economic factors influencing the development of physiotherapy services (2), where I believe I have put the needs of service users at the centre of their decision-making (6).

Reference List

1. Liverani M, Hawkins B, Parkhurst JO. Political and Institutional Influences on the Use of Evidence in Public Health Policy. A Systematic Review. Derrick GE, editor. PLoS One [Internet]. 2013 Oct 30 [cited 2020 May 15];8(10):e77404. Available from: https://dx.plos.org/10.1371/journal.pone.0077404
2. Physiotherapy CS of. Chartered Society of Physiotherapy Framework [Internet]. 2013 [cited 2020 Mar 23]. Available from: http://www.csp.org.uk/professional-union/careers-development/cpd/csp-eportfolio/my-eportfolio/cpd-
3. Evidence from NHS Improvement on clinical staff shortages A workforce analysis. 2016.
4. NHS England. The NHS Long Term Plan [Internet]. 2019 [cited 2020 Apr 14]. Available from: www.longtermplan.nhs.uk
5. Recommendations | Low back pain and sciatica in over 16s: assessment and management | Guidance | NICE.
6. Chartered Society of Physiotherapy xx Professional Values of Members’ Code and Behaviour 2 Code of Members’ Professional Values and Behaviours [Internet]. [cited 2019 Aug 12]. Available from: https://www.csp.org.uk/system/files/csp_code_of_professional_values_behaviour_full.pdf
7. Mid and South Essex Trusts. The STP Plan – Mid and South Essex Sustainability & Transformation Partnership (STP) [Internet]. [cited 2020 Apr 14]. Available from: http://v1.nhsmidandsouthessex.co.uk/about-the-stp/the-stp-plan/
8. Essex NM. Mid Essex Clinical Commissioning Group. 2013;