As a founding member of the Chartered Society of Physiotherapy’s Support Worker Reference Group, Christopher Richards been instrumental in advocating for and developing the role of physiotherapy support workers in the UK.
We had a chat with Christopher about how support worker innovations can improve access to quality care and contribute to effective healthcare transitions, including faster patient discharge from hospital. Christopher shares his insights on developing support worker leadership and capacity, as well as projections for growing the support worker network to meet future workforce demands.
Tell us a bit about your professional journey and experiences as an allied health support worker. How did you get started, and where has it taken you?
I’m a Physiotherapy Assistant Practitioner. For over seven years I have been working in the Community Physiotherapy team, in Hywel Dda University health board, based in West Wales, United Kingdom. Before I joined the NHS, I spent the best part of a decade working in the health and fitness industry, including personal training, teaching swimming, and delivering lifesaving and first aid courses.
I joined the Community Physiotherapy team because I wanted a job where I could be more hands on, and use my skills to promote physical activity and exercise to people with disabilities, injuries, and other difficulties. I knew this type of support could offer improvements, management and rehabilitation for these clients. I learned very quickly that this is a most rewarding role.
Although I work in a community role, over the years I’ve spent time on a multitude of wards including cardio-respiratory, palliative, trauma, orthopaedics, and A&E, learning valuable skills that can be transferred to the community setting.
During my time on the wards, I noticed that we engaged with patients on a one-to-one basis. I felt that creating a ward-based exercise class could be a good way of promoting activity, while also encouraging patients to socialise. This idea was brought forward to my lead and a plan was made: I created an exercise class on a discharge ward.
Following the success of that exercise class I worked with the NHS Transformation Unit on creating another exercise class for the trauma and orthopaedic ward. With the transformation team on board, were able to analyse patient flow over 3 months before the exercise class, and 3 months during and after, which demonstrated that patients were being discharged from hospital more quickly. I focused on patients’ physical outcome measures and knew improvements were occurring as I gathered data using the elderly mobility scale outcome measure.
By tracking the progress of our patients post-surgery/injury, it became clear that there was a correlation between the implementation of the exercise class, where we provided restorative and rehabilitative treatments in a timely way, and faster patient discharge from hospital. It was great to have the transformation team on board to see the whole picture.
Unfortunately, all ward-based exercise classes were forced to stop due to the COVID-19 pandemic and have not yet resumed.
My initial work in developing exercise classes led to a nomination and award for employee of the month from my health board. The award was well promoted on Twitter, and it was also promoted in the Chartered Society of Physiotherapy’s (CSP) Frontline Physiotherapy Journal. I began to use Twitter to promote the role I love and network with other people within the allied health professions and beyond. This prompted me to find a volunteer role within the allied health space, but nothing that purely focused on clinical work. That’s how I began my work with the Support Worker Reference Group.
In 2020 the CSP created a group called the Support Worker Reference Group. The plan was to recruit ten physiotherapy support workers within the UK to link with the CSP and help highlight and develop the support worker role. I was one of its founding members.
I wasn’t aware of any other group dedicated to support workers, and I was unsure how successful or well received the group would be. The group launched in March 2020, the beginning of the COVID-19 pandemic. so there were challenges. We used Zoom to meet once a month, and being very IT literate I became a digital champion for the team and supported online and virtual ways of working. It took courage for all of us to step into these roles—we worked together collaboratively and have gone from strength to strength. I believe we have been successful in raising the profile of support workers in physiotherapy.
Many of us, myself included, were relocated into hospital wards during the pandemic. Eventually I returned to my work in the community, adapting to changes such as virtual video calling to review patients. I found this to be a great way of working. I have developed my skills virtually and, fast forward to present day, I now use a mix of reviewing patients physically and virtually.
By developing my skills in virtual support work, I was successful in applying for a secondment working in prostate cancer; a 100 % virtual service, working across physiotherapy, occupational therapy and dietetics. I started part-time in November 2021, working alongside my community physiotherapy role. Funded by the Welsh Government, the service is called P.A.C.T which stands for Prostate Active Care Together. The P.A.C.T team supported my continuous professional development and in March 2022 I became a level 4 specialist exercise and rehabilitation instructor in cancer and applied these skills to the service.
My skills have developed by working across professions and learning more in the areas of occupational therapy and dietetics. Although I have helped patients with a multitude of conditions, I do feel helping people with cancer is my calling and hope to develop more in this area.
In April 2022 my health board was chosen to run a pilot a level 4 therapies diploma, through the University of Wales Trinity St. David’s, and I was fortunate to be one of the first candidates. I am now halfway through the course, and it’s been great to develop my skills and think differently about my role. One of my favourite areas has been learning about leadership styles and applying them.. I now feel more comfortable to say ‘yes, I am a support worker leader’ and leadership can be found at all levels.
In addition to my studies, I continue to work in the community physiotherapy team and P.A.C.T within Hywel Dda University Health Board, and volunteer with the CSP as a member of the support worker reference group.
What has been a defining event or highlight of your career/experiences?
A defining moment of my career was when I attended the CSP Annual Representatives Conference (ARC) in June 2022. This conference is designed to bring the networks within the CSP together and present motions for change which are then voted on by members.
This conference was the first time the CSP reference group members were able to meet in person; after 2 years of seeing each other virtually, it was truly amazing.
Another reason this conference stands out so much was I represented associate members in a debate on climate change and presented a motion for developing a leadership programme for support workers. Presenting this motion, I felt that my own development, as well as all the achievements of reference group, had come together, and that the physiotherapy profession was in full support of further developing the physiotherapy support worker role; many associate members and chartered members stood up in support of this motion and we had over 96% of the vote.
Can you tell us about your involvement in the Support Worker Reference Group?
The Support Worker Reference Group was created to help highlight and develop the physiotherapy support worker role. Being as passionate as I am about the role, I put my name forward and became one of the founding members of the group.
In the CSP we are known as associate members. We started off as ten CSP associate members. None of us had any specific tasks or titles as part of the reference group, but we were led by a professional advisor who was very passionate about the support worker role.
Our aim was simple: we would be the voice for physiotherapy support workers within the CSP, offering our opinions on what we think support workers should and can do across the UK.
The professional advisor led many webinars highlighting the importance of our roles for the physiotherapy profession and how best the industry can utilise our skills and knowledge. This also empowered us as a support worker industry, knowing how much we can develop within our roles.
It’s important to note that originally the reference group was not a permanent addition to the CSP. Initially we were supposed to run for two years but an extra year was added due to Covid-19. A submission to the CSP council was submitted to create a permanent recognised network for associate and student associate members called the associate network. This was submitted at the end of Summer 2022 and CSP council approved this later in the year.
Currently the Support Worker Reference Group members are transitioning to the associate network and have taken up informal positions, I was voted in as the informal chair of this network, and we will be running an AGM in April 2023, where members can vote, and we will be formally placed into our positions of interest.
What have some of your learnings been through your involvement with the Support Worker Reference Group? What were some of the biggest challenges, or perhaps opportunities?
The area where I have learned the most is leadership. Along with other members of the group, I’ve learned to be a voice for CSP associate members and to raise the profile of our work throughout the UK. There have also been opportunities for us to speak at events and develop resources. Despite these experiences, I only recently recognised that I have been showing leadership. Perhaps because of my status as a support worker, I was unsure if being called a leader was correct? However, I now fully understand that leadership can be found at all levels. I am a support worker leader, and leadership is needed for development of the support worker role. We need more leaders in this sector.
We were all uncertain of how receptive the industry would be to a group of support workers. I had not heard of any other group of support workers in the UK, and we were told early on that our faces would be known throughout the nation. Safe to say it took a level of bravery for us to start this campaign, unsure if it would succeed. I’m happy to say that we had many people support us from different areas of the profession who thought this was needed and would be great for the profession. And over the course of three years, we have accrued many achievements, going from strength to strength.
I have been given many opportunities due to my involvement in the support worker reference group. I’ve been involved in a video demonstrating how physiotherapy support workers can join as associate members in the CSP. I felt very passionate about engaging people through social media and created a Facebook group for both associate and non-associate members of the CSP. In Wales, the CSP network invited me to attend as a guest at one of their meetings. I did a presentation on quality improvement for the CSP south central network. I am a Stronger My Way ambassador which is a campaign designed to encourage strength training. I attended and presented at the ARC (which I highlighted earlier). I was a finalist in the award for outstanding achievement by an AHP or healthcare science apprentice, support worker, assistant or associate in the AHA Wales awards.
Why is establishing a national network for Allied Health Support Workers so important? Where do you see it heading in the future?
The Support Worker Reference Group highlighted just how valuable physiotherapy support workers are to the industry. It is fantastic to be moving forward as a permanent recognised network within the CSP. This associate network will be run by associate members working with the CSP, and will contribute to highlighting developments of the role.
NHS health care support workers provide 60 % of care to patients in my experience, and no service can work to its full potential without them. I hope that everyone working in these roles are given opportunities to develop themselves and services, and that physiotherapy support workers are utilised their full potential which will not only benefit the patients they see but give further job satisfaction. By doing this we hope that more responsibility can be given to people working in these roles, within their scope of practice.
I see the associate network continuing to go from strength to strength. We will continue to work with the CSP, offering equity, diversity and belonging to members, particularly support workers. We will continue working with the CSP to develop a leadership programme for associate members. We would like to see higher level roles developed throughout the UK. We would also like to see more involvement of associate members with students on placements, to learn from key areas taught in universities and the latest research. This will also give students a greater understanding of the support worker role, ready for when they become registered members of the workforce. We hope to see growth as a network and work with the CSP to identify what members want and help develop these areas.
It’s an exciting time to be a part of the associate network and already we are creating links with others doing this type of work – it’s been very exciting to meet with AHANA, listening to how they have developed. Although we are miles apart across the globe it seems that Australia has had many similarities with their support worker / allied health assistant workforce, and I feel we can learn from one another. Moving forward I do hope we can collaborate more together and I’m sure there will be many opportunities for this to happen.
Christopher Richards , thank you so much for sharing these insights into your career and the support worker experience.
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