Involving allied healthcare professionals in senior roles and leadership positions in the NHS will benefit patient care, writes Parmjit Dhanda
The NHS has seen the benefits of a diverse workforce over the past 70 years, something I think we should be proud of. But there are many types of diversity that help to make our public services better.
The importance of ethnic diversity in our public services was recently brought in to sharper focus by the Windrush scandal. But there are many types of diversity that have benefitted us as a society and we need to celebrate them all. We would be poorer without the diversity of skills sets in the NHS.
It’s been long recognised that diversity at board level generates better leadership. But if you asked 10 people on the street what an allied health professional does, you would get a blank stare from the majority.
More alarmingly, in a world where doctors, nurses and hospital beds have become the political currency of the NHS, most politicians would be left scratching their heads when posed the question too. It’s small wonder that AHPs are so underrepresented in senior roles in the NHS.
Importance of AHPs
In foundation hospital trusts underrepresentation has been institutionalised by the ring-fencing of nursing director and medical director posts on boards, largely to the exclusion of other health professionals.
Having doctors and nurses on hospital boards is a good thing, but if you want to have a diversity of medical experience and if you want to disrupt the group-think which holds back the creative thinking the NHS needs to serve patients well, then you need more AHPs at the top table too.
We know that AHPs are a crucial group of health workers, like occupational therapists, dieticians, chiropodists and podiatrists who, through their work in early intervention, can save patients from being admitted to hospital in the first place. We also know that physiotherapists, speech and language therapists and many other AHPs help to rehabilitate you from your illness and reduce the length of your stay in hospital.
It’s small wonder that AHPs are so underrepresented in senior roles in the NHS
The whole phalanx of AHPs that make up around 170,000 health workers have a particularly strong understanding of the patient’s pathway from early intervention through primary and secondary care, through hospitals and post hospital care. So why do they so rarely get the chance to use this knowledge in leadership roles?
Why is it that our health service does not reach beyond the traditional (although important) pools of doctors, nurses and administrators to lead the NHS? In the UK today, we have a diverse AHP skills base, a skills base that is equipped to join up services for the patient between community settings and our hospitals. That kind of expertise is much needed if we are to stop people turning up in droves at accident and emergency and if we are to smooth a pathway away from unnecessarily long stays in hospital.
The Allied Health Professions Federation met with then health minister Philip Dunne, shortly before he was reshuffled. We were following up our representations to the Faculty of Leadership and Jeremy Hunt about the need to transform leadership in the NHS, in part by removing the restriction that prevents AHPs from becoming executive directors of foundation trust hospitals.
To be fair to the minister it was a good meeting. We know we have a shared problem. But, at a time when Brexit is swallowing up the legislative timetable, it was clear that there will be no parliamentary time to change rules that act as barriers to AHPs taking seats around some of the major decision making tables. We will press the new minister to recognise the scale of the problem, and the need to find remedies.
If you want to have a diversity of medical experience and if you want to disrupt the group-think which holds back the creative thinking the NHS needs to serve patients well, then you need more AHPs at the top table
But until we find a way of getting the most out of the rich diversity of talent and knowledge at senior levels in the health service, we won’t see the full range of benefits from early intervention or rehabilitation that is quietly being delivered each day by AHPs.
To change the narrative, we will need to change the mindset on boards in the NHS. After all, the NHS is not just about doctors, nurses and hospital beds. This isn’t about special pleading for one group. This is about acknowledging that the diversity of people and skills in the health service workforce has made it stronger over the years. To tap in to that at leadership levels is not just the right thing to do, it’s the best thing for patient care.