Please find below details of some example commissions that JJ Consulting has conducted in recent years.
AHP Service Review University Hospitals North Midlands 2016 (confidential to UHNM)
4 other AHP Service Reviews in the UK (confidential to Commissioners)
Physiotherapy Staffing Levels in the United Kingdom: A Scoping Review, September 2013.
Robert Jones and Fiona Jenkins – JJ Consulting
A Report Commissioned by the Chartered Society of Physiotherapy.
EXECUTIVE SUMMARY
Following the publication of the Francis Report5, the commissioning of further investigations and reports, widespread concern about staffing levels in the National Health Service, (NHS) and long standing interest within the physiotherapy profession about the determination of appropriate staffing levels, JJ Consulting Healthcare Management was commissioned by the Chartered Society of Physiotherapy to undertake a scoping project on staffing levels in the NHS with particular reference to physiotherapy services. The work commenced at the end of April 2013 with an agreed completion date for submission of the paper to the CSP Chief Executive Officer (CEO) on 31st October, 2013. The CEO specified that the project should constitute an overview – scoping review – of published material, comment and policies in place in the United Kingdom and of physiotherapy in particular. A review of international publications on staffing levels in physiotherapy was also to be included. It was agreed that the scoping would include reference to any methodologies for determining appropriate physiotherapy staffing levels. JJ Consulting were asked to identify whether further work is needed in this area and to make recommendations arising out of the scoping, and were also invited to outline their own methodology for determining appropriate staffing levels for NHS physiotherapy services.
Briefing Paper for Physiotherapy Managers. The Contribution of Physiotherapy Management and Leadership in Healthcare, May 2012.
Robert Jones and Fiona Jenkins – JJ Consulting
A Report Commissioned by the Chartered Society of Physiotherapy.
A Survey of NHS Physiotherapy Waiting Times, Workforce and Caseloads in the UK, 2010-2011 Report.
Robert Jones and Fiona Jenkins – JJ Consulting
A Report Commissioned by the Chartered Society of Physiotherapy.
EXECUTIVE SUMMARY
JJ Consulting were commissioned by the Chartered Society of Physiotherapy (CSP) to undertake a questionnaire survey of Physiotherapy Out-patient Waiting Times and Workforce and Caseload levels in the United Kingdom. The format of the report was commissioned to be based on that agreed for the first two reports in the series. The survey included Northern Ireland, Scotland and Wales for the first time. This Report was also more extensive in the range of data collected, with the intention of giving a comprehensive overview of the UK physiotherapy services, adding to the evidence-base for the Society.
Together with the data collected on waiting times, qualitative data was gathered reviewing waiting time trends, possible reasons for increase and decrease in waits, the volume and impact of “Did-Not-Attends”, levels of implementation of self referral and where possible making comparison with the results of the surveys for 2009-2010 and 2008-2009. The extensive remit for this survey included, not only further work on musculoskeletal workforce and caseloads, but also data on trauma and orthopaedic in-patient services, accident and emergency physiotherapy and services for patients with stroke. The Report provides a wide range of valuable and significant information fulfilling the remit of data collection and analysis with interpretation and recommendations for the Society to consider.
This year one important objective was data collection from the most senior physiotherapy managers/leads in NHS providers across the whole UK; this proved to be extremely challenging in the context of NHS re-organisation, upheaval and reconfiguration on an unprecedented scale. Most English organisations were being re-configured, with many physiotherapy managers changing jobs, roles and organisations, as well as posts being disestablished and downgraded. It was therefore unsurprising that the response rate was reduced.
Data were received from 109 respondents on behalf of 141 NHS organisations, representing 401 Physiotherapy out-patient departments; an individual physiotherapy manager response rate of fifty percent but a provider organisational response rate of sixty four percent.
This level of response rate is generally regarded as excellent in the context of questionnaire surveys, further strengthened by the nature of an homogenous group of physiotherapy managers/leaders working in the NHS, confirmed by several authorities (Mori, Gallup, University of Brighton, University of Plymouth, University of Kent and Cardiff University). For GP surveys 20% response rate is considered good.
The organisational response rate was less than 2009-10 (86%), but was similar to 2008-09 (70%). A comparison of responses for the three years surveyed showed that 401 Departments were represented in 2010-11, compared with 569 in 2009-10 year and 204 for the financial year 2008-2009.
The survey took place during the summer of 2011 and the data collection was completed at the end of August, after several reminders. The data collected was for the financial year 2010-11.
Analysis has been undertaken providing the number of respondents and percentages for each question. Not all respondents answered every question; therefore caution should be taken where respondent numbers were low.
The average longest wait reported by the majority of organisations this year was 6 to 8 weeks, which was broadly similar to last year’s seven weeks, while the minimum longest wait reported this year was less than one week compared with 2 weeks in 2009-2010. The maximum longest wait was 30-40 weeks this year compared with 18 weeks in the previous year.
In common with last year the participants were asked to divide their waiting time reports into six major categories; musculoskeletal, neurology (including stroke) paediatrics, pain management, women’s and men’s health and occupational health.
The report includes a wide range of information related to waiting times, for example; the numbers of managers who have systems capable of sub-dividing waiting times into weekly categories (only fifty percent of those who responded to this question were able to do this) which suggests that this will be a significant problem for those in England who will be required to collect and report the DH RTT data. The Report also sets out comparative data on waiting time trends, possible reasons for changes in waiting times and the use of demand and capacity management techniques. “Did-Not-Attend” figures for 2010-2011 were comparable with those for the previous year, 9.45% as against 9.58% last year.
54% of services responding provide some form of self referral compared with 41% in 2009-10, though the response rate was smaller than last year. First to follow-up ratios last year were 1 to 3.41 in 2009-10 and 1 to 2.31 in 2010-11, indicating a significant decrease.
The report contains a section on physiotherapy activity, caseloads and workforce in: musculoskeletal out-patients, in-patient trauma and orthopaedics, accident and emergency and stroke services. There is also an overview of non-HPC registered assistants (associates) and admin and clerical staff support. The information in this section is wide ranging including, for example: numbers of referrals, average face-to-face contacts, and “did-not-attend” data and first to follow-up ratios, caseloads by bands for HPC and non-HPC registered staff.
Survey of NHS Physiotherapy Waiting Times and Musculoskeletal
Workload and Caseload in England 2009-10.
Robert Jones and Fiona Jenkins – JJ Consulting
A Report Commissioned by the Chartered Society of Physiotherapy.
EXECUTIVE SUMMARY
JJ Consulting were commissioned by the Chartered Society of Physiotherapy (CSP) to undertake a questionnaire survey of physiotherapy out-patient waiting times in England and musculoskeletal physiotherapy out-patient activity levels. In addition the survey was to include a review of waiting time trends, reasons for increases and decreases in waits, the volume and impact of “Did-not-Attends” (DNAs), levels of implementation of self referral and, where possible, make comparisons with the data obtained from a pilot study in 2008/2009.
The remit included data collection, analysis and interpretation and a report of the findings. An important objective was to collect data from senior physiotherapy managers to provide the CSP with a national picture and a benchmark for physiotherapy managers; it was also intended to identify whether managers would be able to capture the data required for the proposed Department of Health (DH) mandatory collection of Allied Health Professional (AHP) referral to treatment times (RTT).
The survey took place during December 2009 and January 2010. Questionnaires were sent to 260 senior physiotherapy managers in acute and primary care organisations in England for whom contact details were known. The researchers made personal contact with a large number of managers to develop the database of contact email addresses and also lobbied managers to take part in the survey. There were 224 valid responses from NHS provider Trusts and organisations representing an 86% participation rate; outstripping the return from the previous year in which 70.9% responses were received (154 valid returns from 180 sent out). Of the 224 provider organisations, 201 provided physiotherapy out-patient services. A total of 569 individual physiotherapy out-patient departments were identified across England. This compared to 204 departments in the previous year’s survey.
The return indicated an aggregated workload of approximately 7.4 million face-to-face contacts with patients during the financial year 2009/2010. Waiting times ranged from less than one week to over fifty-two weeks with the majority of patients waiting four to five weeks for treatment. For the purposes of this survey participants were asked to divide their waiting time reports into six major categories: musculoskeletal, neurology, paediatrics, pain management, women’s and men’s health and occupational health. Those managers able to sub-divide their waiting times into these categories reported no waits longer than 18 weeks. 54% of managers reported waits longer than last year. The increased waits were attributed to unfilled vacancies and the imposition of vacancy controls within Trusts. 32.5% of respondents reported decreases in waiting times with nearly half of these citing service re-design as the reason for waits reducing. Capacity and demand management was widely undertaken with a significant focus on reducing DNA rates and changes to appointment booking systems. Referral to treatment targets were reported by 56% of respondents. Of the 107 the most commonly set target was 6 weeks, though the range was from 2 to 19 weeks. Self-referral to physiotherapy was reported by 42% of respondents, with 29% reporting some resistance to the introduction of this referral method, with the largest resistance coming from commissioners and GPs.
This year’s report contained a significant section on musculoskeletal workforce and activity. 66% of respondents were able to provide data on activity for the previous financial year 2008-09. This highlighted lack of IM&T support for physiotherapy services for those who were unable to provide data. Altogether 110 respondents who could provide this data reported 1,066,292 patients referred to their service. 97 respondents reported a total of 3,310,067 face-to-face contacts during the year. The average number of contacts for an out-patient musculoskeletal physiotherapy episode was 4.41.
Workforce data was captured. Band 6 was the most commonly occurring band, followed by band 7 and band 5. As expected the band 2, 3 and 4 support staff were much smaller in number compared to Registered staff. There were 539 administration staff. There was a ratio of physiotherapists to assistants of 10:1 and physiotherapists to administrative staff of 4:1. Respondents indicated that assistant and administrative staff frequently provided support to the whole inpatient and outpatient service, not just the musculoskeletal service.
The full report was published by the Chartered Society of Physiotherapy in January 2011
East Lancashire NHS Trust Service Review, Physiotherapy and Occupational Therapy- June 2010
(Confidential to East Lancashire NHS Trust).
A Survey of NHS Physiotherapy Waiting Times in England- March 2009
Robert Jones and Fiona Jenkins – JJ Consulting
A Report Commissioned by the Chartered Society of Physiotherapy.
EXECUTIVE SUMMARY
We were commissioned by the Chartered Society of Physiotherapy to undertake a questionnaire survey of physiotherapy out-patient waiting times in England, to provide an evidence-base for the Society. Our starting point for the project was to develop a reliable database of physiotherapy managers’ e-mail addresses, their employing Trusts and Strategic Health Authorities.
The main objective was to collect data from senior physiotherapy managers to provide the Society with a national and regional picture of waiting times. We also took the opportunity to obtain data about in-patient physiotherapy services response standards and other associated issues included waiting time targets, managers’ views on waiting times, possible reasons for increases or decreases in waiting times and whether services were providing self-referral.
The survey took place in November 2008. There was a 70.9% response rate representing 154 Senior Physiotherapy Managers, with responsibility for 180 Trusts. Analysis was undertaken for the two systems of waiting list management in use; those who hold one waiting list for all out-patients and those who sub-divide physiotherapy waiting lists by clinical specialty.
The waiting times ranged from less than one week to 104 weeks, with the majority of waits reported at less than 11 weeks.
Self-referral to physiotherapy was reported by a significant proportion – 45%, including 4.7% offering this service in all out-patient specialties – therefore, it is not yet fully embedded. Only 31% of senior physiotherapy managers were satisfied with the length of time patients had to wait to access their services. Where waiting times have increased, 41.6% of respondents reported increased numbers of referrals and 9.1% reduced staffing establishment. Where waiting lists have decreased, 18.2% reported increased staffing establishment.
Following the analysis of waiting lists and associated findings, the report concludes with a discussion and 17 recommendations for consideration and action.
