Rebecca Fisher on Allied Health Professions day
To mark Allied Health Professions (AHP) Day on 14 October, Rebecca Fisher, NHS LPP’s Allied Health Professional Prescribing and Procurement Advisor shares her musings.
Three years ago I started boldly going where no AHP has been before...
One pandemic later, I’m taking time to reflect on how things have progressed and the challenges faced.
Widening from a uni (dietetic) to multi professional AHP focus is hard. This is especially true in prescribing as the nutrition budget is high profile and the procurement model is broken, conflict of interest is problematic and personalised care is available to too few patients as the profession is small.
Nevertheless I’m feeling optimistic. AHPs are now funded to be accessible in Primary Care. With the help of more training HEI and workforce opportunities such as apprenticeships and innovative practice placements, this will result in more patients being seen early on in their journey by an AHP than ever before. AHPs by their training can offer therapeutic options early on and close to home.
This very much ties in with the prevention agenda and promoting wellbeing. The more therapies we can offer early on, the better. This can and will have an impact on prescribing. An obvious example is if a physio can provide early physical therapy, opioid prescribing may reduce (Sun E, Moshfegh J, Rishel CA, Cook CE, Goode AP, George SZ. Association of Early Physical Therapy With Long-term Opioid Use Among Opioid-Naive Patients With Musculoskeletal Pain. JAMA Netw Open. 2018;1(8):e185909. doi:10.1001/jamanetworkopen.2018.5909).
There are less obvious cases where an AHP approach is the right one. We have been looking at hydration, nutrition and use of medicines. The inter-relationships between burden of treatment with thickener, eating and drinking with acknowledged risk, use of low volume nutritional supplements, prescribing of nutrition products without referencing hydration needs and care setting, fluid intake, laxative use and antimicrobial prescribing requires a joint dietetic and SLT approach, alongside pharmacy and nursing colleagues. Collectively, we can improve prescribing by reducing the burden on patients and workforce and save money.
So, as the lone AHP prescribing and procurement advisor, (I think) are we where I thought we might be when I started my AHP journey? No. Have we progressed to thinking how joint AHP practice impacts prescribing? Yes, and I’m certain my AHP colleagues can think of more examples still…