Recovering Mind and Body (Mental Health)

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recovering mind and body

A framework for the role of physiotherapy in mental health and wellbeing

THE CHARTERED SOCIETY OF PHYSIOTHERAPYTHE CHARTERED SOCIETY OF PHYSIOTHERAPY

Contents

Acknowledgements 4

Foreword by CSP President 5

Service User’s statement 6

Carer’s statement 7

Executive Summary 8

Introduction 9

Rationale 10

Building blocks for delivery 11

Recovering mind and body action plan 2008-2013 20

References 21

3

Recovering mind and body: a framework for the role of physiotherapy in mental health and wellbeing

Acknowledgements

The Clinical Interest Group Chartered Physiotherapists in Mental Healthcare (CPMH) and the Chartered Society of Physiotherapy (CSP) would like to acknowledge and thank all those involved in the development of this framework.

Members of the Steering Group: David Tombs Service User

Gay Hughes Service User Representative

Catherine Clarke Carer Representative

Jan Evans Carer Representative – Battle East Sussex

Catherine Pope Chair Steering Group, Associate Director Allied Health Professionals, Nottinghamshire Healthcare NHS Trust

Caroline Griffiths Chair CPMH National Committee Physiotherapy Team Leader Oxfordshire and Buckinghamshire Mental Health NHS Foundation Trust

Sharon Greensill Vice Chair CPMH National Committee

Sue Coffee Head of AHP, physical health and well being services Birmingham and Solihull mental health trust

Tony Hegarty CPMH – Chair London and SE regional group

Liz John Physiotherapy Service Manager – Cardiff

Jean Picton Bentley Team Leader Physiotherapist – Maudsley Hospital

Di Pullin Physical Therapies Manager – London

CSP Staff

Jackie Clifford Professional Adviser CSP until September 2007 Rehabilitation Consultant – September 2007 onwards

Dawn Wheeler Assistant Director CSP Practice and Development

Jill Higgins Director CSP Practice and Development

Other contributors

Shelagh Morris Allied Health Professions Advisor Department of Health

Grahame Pope Associate Professor, Division of Physiotherapy Education, University of Nottingham

Sarah Bazin Chair CSP Council until October 2007

Foreword by CSP President

Over the next decade the world will see a rise in psychological disorders across a wide range of diagnoses from depression and anxiety to dementia. Many patients will be cared for in generic health services as mental health teams will be managing complex disorders. Physiotherapists need to feel confident to respond to this changing clinical environment, whether working specifically in mental health or taking a person – centred approach in any arena of health.

The views of service users and carers have been the starting point for this entire Chartered Physiotherapists in Mental Health care (CPMH) and Chartered Society of Physiotherapy (CSP) framework and so we have a vibrant and living document which can grow in response to health needs.

The framework and its sister document for commissioners provide a clear vision, identifying four building blocks to aid the development of physiotherapy within mental health: new ways of working; leadership; learning and development; delivering the evidence base. The practical action plans help this development process and will support the education of physiotherapists in an ever-changing health environment.

Whether service user, physiotherapist, member of the multi disciplinary team, manager or commissioner the framework and commissioning advice will prove to be valuable tools in planning for the future and identifying how and with whom we can achieve those plans.

These documents are important to the development of evidence based physiotherapy, with the service user central to physiotherapy provision. As physiotherapy takes an increasingly important lead in many aspects of care and rehabilitation, the individual physiotherapist will be glad to have this framework to hand for all aspects of mental health, wherever the patient is.

Professor the Baroness Ilora Finlay

of Llandaff FRCP, FRCGP

CSP President

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Service users’ statement

The greatest need of Service Users in the pursuit of modernizing psychiatry and its practice is changing its deeply engrained cultural attitude of “can’t do, won’t do”, and this profession and its people provides the solution to the problem because their core belief at the heart of their cultural being and practice is, “can do, will do”.

Because it is impossible for Physiotherapists to be negative and as they are absolute in their focus upon solution driven patient care, they are a must have, in every decision making team responsible for the care of patients as a collective and as individual service users.

I urge all who come into contact with this framework document to champion this profession, its people and their core belief “can do, will do”. As a wholly positive and pro-active approach to delivering a better quality of life for Service Users is nothing short of what they want, need and deserve.

David TombsService User

Carers’ statement

Physiotherapists have expertise in psychology related to physical knowledge, holding a unique position in their contributions to improving service users’ emotional and physical well-being. With the ‘received’ care of therapists, non critical acceptance and empathy relational attitudes, service users feel valued and empowered: validation is experienced through hands on affirmation.

The positive encouragement from therapists is motivating, providing hope and recovery for service users. Exercise, through feel good endorphins, is proven to help people feel better, speeding up recovery; whilst the ongoing physical sense of achievement increases independence.

The carer’s perspective is a vital adjunct to physiotherapy as we have the ability to provide essential feedback, especially when service users experience severe and enduring psychological distress. All of these factors contribute to keep service users out of hospital, and reduces anxiety for both service users and carers.

Catherine Clarke and Jan EvansCarer Representatives

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This document identifies how developing the role of physiotherapy within mental health can support the delivery of integrated care that is focused on the individual. Service users and carers have contributed to its development. This information should support commissioners, managers, physiotherapists, educators, service users and carers in their respective roles. The focus of the document is England and further consideration will be given on how to take this work forward in Wales, Scotland and Northern Ireland.

The table below identifies the key aims of the work.To achieve these ambitions four building blocks have

been identified – New ways of working, leadership, learning and development and developing the evidence base. Key issues and action points are identified under each of these headings.

Within the document the role of the physiotherapist now and in the future is described. Examples of liaison, leadership, multidisciplinary team management and service user involvement are given which are reproducible in other settings.

The importance of pre and post qualifying education which includes mental health as a speciality and as an integral part of physiotherapy is identified. Collection and dissemination of evidence to inform practice is clearly identified as a priority and specific actions identified.

Key messages have been drawn from across the four building blocks and action is summarised in a table at the end.

The key messages are• The views of service users and carers are central

to the development of services and education• New Ways of Working offers opportunities for

physiotherapists to demonstrate and develop their role and the contribution they can make to services

• Working with other Allied Health Professions (AHPs) and healthcare professionals will enable

efficient use of resources and maximise learning and leadership

• Developing the knowledge and skills of the workforce, both expert and generic, will support the development of service user led services

• The Chartered Society of Physiotherapy and Chartered Physiotherapists in Mental Healthcare should collaborate to increase the production, dissemination and implementation of research and evidence-based practice in mental health

Full references are given and this document should be read in conjunction with ‘Commissioning Mental Health Services: the contribution of physiotherapy to integrated services for health and wellbeing’


Executive summary

New ways of working Learning and development

Leadership

New ways of working Leadership

Developing the evidence base

New ways of working Learning and development

BUILDING BLOCKSBY 2013

The physiotherapy workforce will be equipped to deliver services tailored to individual needs that recognise and support wellness in any service setting

Services will be delivered across a range of providers to support person centred care in mental health

Physiotherapy will be commissioned as part of multi-disciplinary care pathways relating to mental health

Physiotherapists will continue to base their practice on best available evidence

Physiotherapists will be employed in a range of roles that support the delivery of innovative and person centred care

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This framework places the needs of service users and carers at its heart. Their contribution has been invaluable in framing how physiotherapy can continue to develop to meet the needs of individuals and deliver integrated care.

“We want a knowledgeable ‘doer’ who can treat our physical needs and ailments but who knows how these affect and are affected by our mental health...how we feel that day. And if they don’t know they will find out... it is no more than anyone wants” (Answer from service user to ‘Mind the Gap’ questionnaire Northampton PCT 2005).

This document should be read in conjunction with ‘Commissioning Mental Health services: the contribution of physiotherapy’. The information in this document is intended to be of value to commissioners, managers, physiotherapists, educators, service users and carers.

The key underpinning principles are:• Service users and carers should be central

to care planning• Services should be designed around the

needs of individuals• Services should incorporate all aspects of

the individual and empower a wellbeing and recovery model of care

• There is recognition of the interdependency between physical and mental health

This framework identifies where we want to be by 2013 and the building blocks needed to support this. Five years was identified as the timescale to reflect the need to review progress in light of health care developments. Our aim is that by 2013: • The physiotherapy workforce will be equipped

to deliver services tailored to individual needs that recognise and support wellbeing in any service setting

• Services will be delivered across a range of providers to support client centred care in mental health

• Physiotherapy will be commissioned as part of multi-disciplinary care pathways relating to mental health

• Physiotherapists will deliver care based on best possible evidence

• Physiotherapists will be employed in a range of roles that support the delivery of innovative and client centred care

The development of this document has taken place during a period of substantial change to the delivery of health care across the four countries. In recognition of the differences developing within the countries further consideration will be given on how best to take this forward in Wales, Northern Ireland and Scotland. The focus of this document is primarily England.

9

Introduction


At a time of unprecedented change within the delivery of health and well being services there are both opportunities and challenges. The delivery of services will be increasingly focused on the well being of the nation, prevention, empowering the individual and social inclusion. Access to physiotherapy within a multidisciplinary mental health team is fundamental to delivering this agenda.

Developing and maintaining physical health has a major contribution to make to mental health and wellbeing. One in four people experience a mental health disorder at some point in their lives, and the risk is particularly high for those who have chronic physical disability or illness. Failure to recognise and help a person’s mental health problem is likely to delay their physical recovery (Rose 2003). Working together commissioners, providers, physiotherapists, educationalists, service users and carers can ensure that access to services is increased and appropriate training is provided to ensure that there is a skilled workforce in place.

The purpose of this framework is to support this

Rationale

work by identifying building blocks for delivery. These are:• New ways of working: the changing role of

physiotherapy in mental health• Leadership• Learning and Development• Developing the evidence base

The main points related to each of these building blocks are described and actions identified at the end of each section. Key messages are summarised at the end of the document along with a table outlining the key action points and how they will be taken forward.

The document only provides an over view within each section. Inclusion of all of the material collated during the development of this resource is impossible. The Chartered Physiotherapists in Mental Healthcare [CPMH] will be utilising this information to develop supplementary documents. This also supports the intention that this is a living document which recognises the pace of change within health and social care and will therefore continue to be developed.

1.0 The changing role of physiotherapy in mental health

In the New Ways of Working publications (DH 2005, 2007), all professions working in mental healthcare have been encouraged to review their working practices to ensure that services are person-centred, needs-led and cost effective. New Ways of Working is a whole systems approach to workforce planning and development based on individual service user needs, optimising access and choice and ensuring the most flexible and effective use of resources. It discusses the development of ‘capable teams’, with the aim of ensuring that service users receive care from the person with the right set of knowledge and skills for their needs. Therefore the most highly qualified and skilled clinicians should see the people with the most complex needs, whilst supporting other multi-disciplinary team members in carrying their own caseloads.

1.1 The role of physiotherapists working in Mental Health

Physiotherapists have an extensive wealth of skills and knowledge in the physical health field and this, combined with their skills in mental health, means they are uniquely placed to meet the needs of service users who have both physical and mental health needs. Key skills include:• Understanding of the impact of mental health

on ability to function at home and work• Experts in motivation• Development and delivery of lifestyle

and weight management programmes • Experts in prescribing exercise• Management of falls• Treatment of pain• Liaison between mental and physical health

services/voluntary agencies

1.2 Developing roles

Throughout the NHS physiotherapists have the opportunities to develop specialist advanced skills that can impact on the patient journey, waiting times, cost effectiveness of services and quality of service delivery. Whilst holding the needs of service users and carers central to all treatments and interventions the physiotherapist may utilise enhanced roles to deliver comprehensive packages of care. Examples within mental health services include:• Undertaking initial mental health and social

care assessments and care coordination• Medication management and prescribing • Ordering diagnostics – X Rays/Medical

resonance imaging (MRI) scans• Cognitive Behaviour Therapy (CBT)

1.3 Linking mental health and mainstream services

For service users suffering from both physical and mental health problems, where the physical need is acute, the pathway of choice would be to access mainstream services. To deliver this, services may need to develop more flexibility. They may require more sessions for a full assessment to be completed to take account of issues with personal trust, or they may require more one to one sessions due to problems with self-motivation or memory. In these situations mental health physiotherapists can work alongside generic services or provide advice and support to the primary care physiotherapists.

Continuing to develop all physiotherapists’ knowledge of the psychosocial dimensions of health and wellbeing and deploying this in practice with all patients will support the delivery of person centred care. Access to specialist services and relevant training will support this.

1 New Ways of Working

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Building blocks for delivery


1.4 Action

Physiotherapy services should • Strengthen the contribution that

physiotherapists can make within the multi-disciplinary team by continuing to develop skills as care co-ordinators; promoting health and well-being; acting as a resource for the team to ensure individual’s needs are met

• Ensure the needs of service users inform the development of the physiotherapists role

• Develop support structures that utilise different models both uni and multi professional

• Identify competences required and therefore relevant skill mix to deliver services and input to workforce planning at a local and national level

• Advise on the learning and development needs of specialist and mainstream staff to meet service users’ needs more effectively

Consider this good practice example...

Avon and Wiltshire Mental Health Partnership Trust employ a mental health physiotherapist as part of their multi-disciplinary acute hospital liaison service. Older people with mental health problems often have a poor recovery following physical illness which can result in a delayed discharge and admission to long term care. Mental health physiotherapists have the skills required in communication and mobility to improve physical and mental health recovery, maintaining a pre-admission level of independent function, and increasing the likelihood of a timely discharge home.

New Ways of Working continued1

It is recognised that the delivery of integrated care requires the development of leadership capability and capacity. New Ways of Working (2007) describes the ability to provide effective leadership at different levels in different settings. Appropriate leadership and supervision for physiotherapists in mental health trusts can be provided through the development of a variety of approaches. For example, thinking creatively about different models of supervision can allow more flexible career pathways to be supported. Physiotherapists who have taken on multi-disciplinary team manager roles have demonstrated their ability to manage staff from other disciplines in addition to physiotherapy, and in these roles been able to promote physiotherapy as part of a whole service.

There are benefits in linking with other allied health professionals to provide strategic leadership and professional support. Positive multi-disciplinary line management can prevent professional isolation and encourage the recognition and sharing of expertise, whichever service structure is utilised.

An effective leadership model • Ensures service users and carers can access

services• Demonstrates how Physiotherapy contributes

to clinical services• Ensures physiotherapists have appropriate

supervision/mentorship that includes access to managerial, clinical and professional support

• Engages with relevant decision making fora, for example in directorates, at the Trust Board, with commissioners, in education and training

• Supports access to career opportunities for physiotherapists both as clinicians and in management.

To ensure continued access to the diversity of skills physiotherapists provide, practitioners need to be supported, both in maintaining those skills, their professional identity and registration to practice. Commissioners and service managers

should seek to meet these needs to deliver quality assured services.

The development of effective teams requires relevant competencies to be identified to support identification of the skill mix required to deliver care. Appropriate supervision and support models are required to support this, for example a newly qualified physiotherapist could be supported by a senior from another team.

2 Leadership

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• In Nottinghamshire Healthcare NHS Trust there is an AHP professional lead providing a single point of contact, and giving professional leadership and advice to AHPs, other staff, managers and clinical directors

• The post is at Associate Director Level reporting directly to the Executive Director for Nursing and AHPs who sits on the Trust Board

• This post allows for the development of a corporate AHP strategy and direct access to the Executive Team

• AHP issues remain on the Trust’s agenda and their unique contribution is recognised

• AHPs including physiotherapists are line managed within directorates, some within multi-disciplinary teams and others within therapy teams

• No physiotherapists are now exclusively managed within a profession specific team

• There are professional leads within each directorate who are all additionally supervised by the Associate Director AHPs, who also inputs into their appraisals. Within the directorates these leads are part of the management team, thus ensuring representation at a local level



2.1 Strategic Leadership – influencing policy makers

The Chartered Society of Physiotherapy (CSP) Information Papers on the Public Health Agendas for the four UK countries provide comprehensive details on the relevant policies and resources for the physiotherapy profession on health and wellbeing issues. These include several examples of physiotherapy services in mental health (CSP 2005a, 2005b, 2006, 2007a).

Chartered Physiotherapists in Mental Healthcare (CPMH) and the CSP currently work together to represent physiotherapy on mental health policy development groups, and to respond to policy documents. Activity in recent years has included working on key strategic groups, for example the New Ways of Working National Steering Group and the Mental Health AHP Advisory Group.

Leadership continued2

2.2 Action

• CPMH and senior mental health physiotherapists should be proactive in engaging with local and national policy makers and with the CSP in seeking to influence future policy direction and in raising the profile of physiotherapy in mental health

• Models of service delivery should be collated and shared

• Evidence supporting the delivery of outcomes, including patient reported outcome measures, should be collected and shared and will, under the NHS Next Stage Review (DH 2008a), be a component part of considerations for service redesign.

The Ten Essential Capabilities (DH 2004a) which were developed in consultation with service users, carers and practitioners provide, in one overarching statement, the headline capabilities required to achieve best practice for education and training of all staff who work in mental health services. It recommends their inclusion in the curricula of all pre-registration training for professionally affiliated staff as well as being embedded in induction, continuing professional development (CPD) and life long learning.

Government initiatives have acknowledged the need to modernize the workforce, which includes increasing the status, responsibility and accountability of support workers. The attached pathway (appendix one) for mental health physiotherapy development recognises the wealth of material and tools available to direct and support the whole physiotherapy workforce in meeting their educational needs, such as the NHS Knowledge and Skills Framework (DH 2004b), Competence Based Career Framework for AHP’s (DH 2008b), Skills for Health web-based tools (www.skillsforhealth.org.uk), Skills for Care National Occupational Standards, CSP Core Standards (CSP 2000), New Ways of Working (www.newwaysofworking.org.uk) and the Health Professions Council (www.hpc-uk.org).

3.1 Service User and Carer Involvement

The National Service Framework for Mental Health proposes that “service users... should be involved in planning, providing and evaluating education and training” (DH, 1999) and the role was clarified by the Mental Health in Higher Education National Institute for Mental Health in England (Tew et al 2004) who stated that service user and carer involvement enabled the development of more effective and user centred forms of practice. Service users argued that if service delivery is to be based on an ethos of partnership, then such partnerships must also form the foundation of mental health education.

In many trusts service users and carers are involved in delivering training such as the Wellness Recovery Action Plan (WRAP) programmes, however, few physiotherapy services include service users and carers in their training delivery. Incorporating service users and carers into training at both pre- and post-qualifying allows practitioners to gain first hand experience of the needs, experience and difficulties encountered, all of which can influence practice and service delivery.

3.2 Support Worker Education

Support workers are valued members of the health and social care team. Government initiatives have acknowledged the need to modernize the workforce, which includes increasing the status, responsibility and accountability of support workers.

In 2005 the CSP and the College of Occupational Therapists (COT) produced the National Framework for Support Worker Education and Development (CSP/OT 2005). Its aim is to encourage support workers to evaluate their practice and learning needs and assist them to realize their potential in education and development. Support workers’ educational needs can range from key numeracy and literacy skills through to qualifications in skills such as exercise and massage, or leading to degree entry professional training.

3.3 Qualifying Education

Mental health is currently included in the Chartered Society of Physiotherapy Curriculum Framework for Qualifying Programmes in Physiotherapy (CSP 2002). The content that should be covered, and the required learning outcomes are set by individual programmes. Variations in delivery could be addressed by adopting the following as minimum expected outcomes

3 Learning and development

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• Knowledge and understanding of the Ten

Essential Shared Capabilities (DoH 2004a)• Covering basic mental health illnesses including

depression, anxiety and dementia and evidence-based physiotherapy interventions

• The ability to adapt communication, assessment and treatment to meet people’s mental health needs

Working together, mental health physiotherapists and educationalists, can support the development of knowledge and skills in mental health by supporting opportunities both within classroom and clinical environments.

3.4 Post-qualifying Education

As part of their CPD physiotherapists may need to further develop their understanding of mental health in order to deliver person centred care.With appropriately identified learning outcomes CPD may be provided in a variety of ways for example:• Provision of band 5 rotational and static posts• Provision of in-service education, lectures, courses

and conferences

• Development of post graduate programmes with higher education institutes (HEIs) and further education colleges (FECs)

• Publication and dissemination of best practice and research

Physiotherapists are well placed to contribute to the learning and development of other mental health professions, particularly with regard to falls, physical health, well-being and exercise.

More experienced mental health physiotherapists can meet their educational needs in a number of ways, which do not solely rely on direct teaching for example: • Reflecting on critical practice or discussion with

others within the multi disciplinary team enhances practice and questions interventions.

• Through membership of clinical interest groups physiotherapists can access advice and training relating to particular specialities including mental health

• Through other networks, including e-networks such as interactive CSP

• HEIs offer mental health pathways for all professional groups and some, for example the University of Nottingham offer a mental health physiotherapy masters module

• Through peer review groups/peer supervision• Through clinical supervision

Physiotherapists who take on new roles within mental health should identify their learning needs and plan to meet these in conjunction with their line managers.

3.5 Action

• Promote appropriate mental health development opportunities by mapping current provision and a gap analysis

• Promote engagement with the CSP• Influence physiotherapy mental health education

and service user and carer involvement in its provision


Within the Division of Physiotherapy Education at the University of Nottingham mental health is increasingly implicit within the whole curriculum. Students are asked to consider mental health needs at every stage of learning, in addition to being introduced to core conditions such as depression, anxiety and dementia, and there is also access to mental health clinical placements. There is an optional third year mental health module also available to students of the MSc course which builds on these themes, increasing mental health skills and knowledge.

Learning and development continued3

There is a growing evidence base available to support the role of physiotherapy in mental health. Work by Biddle et al (2002) on exercise, and Donaghy and Mutrie (1999) on the effect of exercise in continuation of sobriety have both directly impacted on practice and the recognition of physiotherapy in mental health. Research by other professionals on the use of exercise to delay the onset of cognitive impairment (Boutcher 2002, Tanne 2004), relaxation for people with anxiety (Eppley et al 1991), and of massage for the reduction of anxiety and depression (Sunshine et al 1997), and muscle tension and pain (Andrade and Clifford 2001) also provide an evidence base for physiotherapy interventions. The CSP and CPMH continue to support and promote the use of evidenced based interventions.

With many physiotherapists now working as members of multi disciplinary teams there is value in linking to multi professional research and audits, as clinical results are rarely attributable to uniprofessional intervention, and large scale multi-disciplinary research projects are more likely to attract funding.

4.1 Action

• CPMH will work with its members and the CSP to identify how the evidence base can be developed

• CPMH will continue to support the dissemination of evidence and its implementation in practice

4 Developing the evidence base


Following research by Donaghy (1998) physiotherapists working with people with drug and alcohol addictions have used structured exercise programmes to aid reduction of relapse by improvement of physical fitness; and perceptions of self worth.

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Mental health physiotherapy development pathway

Mental Health Physiotherapy Development Pathway

Support Worker

Pre-registration

Post-registration

Specialist

Key skillsDiploma level qualificationsFoundation level qualifications

Ten essential Shared CapabilitiesSkills for HealthKSF

Curriculum Framework – integrating mental healthOption modules – increasing baseline knowledgeClinical PlacementsResearch dissertations

Clinical ExperienceLectures, Courses, ConferencesParticipation in Audit and Research

Masters level modules/degreesAdvanced clinical skillsSupporting extended rolesResearch

Leadership skills

The diagram below demonstrates the development pathway described in building blocks3 and 4, learning and development and delivering the evidence base.

The development of integrated care will require commitment, a willingness to change, openness to innovation and most importantly engagement with service users and carers. Physiotherapists are willing and able to engage with this agenda.

It is hoped that the identification of four building blocks, and action identified under each of these, will support managers, physiotherapists and commissioners alike in taking mental health services forward.

For the benefit of the reader key messages have been drawn from across the four building blocks and the action points have been summarised in a table.

Key Messages• The views of service users and carers are central

to the development of services and education

• New Ways of working offers opportunities for physiotherapists to demonstrate and develop their role and the contribution they can make to services

• Working with other AHP’s and healthcare professionals will enable efficient use of resources and maximise learning and leadership

• Developing the knowledge and skills of the workforce, both expert and generic, will support the development of service user led services

• The Chartered Society of Physiotherapy and Chartered Physiotherapists in Mental Healthcare should collaborate to increase the production, dissemination and implementation of research and evidence-based practice in mental health

The work identified in the table below will be discussed by the members of the CPMH. Timescales and action leaders will be identified to take the work forward.

Summary

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Sharing information and good practice through Chartered Physiotherapists in Mental Healthcare (CPMH), publication and conferences

Patient Reported Outcome Measure (PROMS) Audit of Service Service users as teachers Sharing of good practice and service delivery examples Engagement with Service Users

Use AHP Career Framework & Skills for Health Competence Framework, KSF Development Reviews Input to local workforce planning committees

Appraisal/KSF Development Reviews, use of latest evidence/research

Continue to seek every opportunity to represent physiotherapy in mental health at local and national level

Opportunities for collaborative working will be explored and CPMH will liaise with CSP regarding the collation of service examples and where and how they might be shared.

Networking locally and nationally

CPMH to undertake a mapping and gap analysis exercise & to support developing education programmes/use Skills for Health competence frameworks – mental health

CPMH ensure members engage with consultations and input to relevant discussions

Influence the curriculum framework by demonstrating the role of physiotherapy in health and wellness; whole person personalised services, engaging with CSP as part of the Charting the Future project.

Participate as a Clinical Interest group in discussions about research priorities. Identification of active research already taking place

Publication of research findings in CPMH journal/Physiotherapy. Grants to authors Encourage CPMH members to utilise Supporting Knowledge In Physiotherapy Practice [SKIPP] process to develop evidence

CPMH to produce a briefing paper by 2013

HOWACTION

New ways of working Strengthen the contribution that physiotherapists can make within the multi-disciplinary team by developing skills as care co-ordinators; promoting health and well-being; acting as a resource for the team

Ensure the needs of service users inform the development of the physiotherapists role

Identify competences required and therefore relevant skill mix to deliver services and input to workforce planning

Advise on the training needs of specialist and mainstream staff

Leadership

CPMH and senior mental health physiotherapists should be proactive in engaging with local and national policy makers and with the CSP in seeking to influence future policy direction and in raising the profile of physiotherapy in mental health

Models of service delivery/examples should be collated and shared

Evidence supporting the delivery of outcomes should be collected and shared

Learning and development

Promote appropriate mental health development opportunities by mapping current provision and undertaking a gap analysis

Promote engagement with the CSP about learning and development needs

Influence physiotherapy mental health education and service user and carer involvement in its provision

Developing the evidence base

CPMH will work with its members and CSP to identify how the evidence base can be developed

CPMH will continue to support the dissemination of evidence and its implementation in practice

CPMH will develop ideas on how the above can be achieved – links to CSP’s R & D strategy

Recovering mind and body action plan 2008-2013

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Beesley S and Mutrie N (1997) Exercise is beneficial adjunctive behaviour in depression, BMJ 315, 1542-3

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Boutcher SH (2002) Cognitive performance, fitness and ageing. In: Biddle SJH, Fox KR, Boutcher SH (eds) Physical activity and psychological well-being. Routledge, London

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Chartered Society of Physiotherapy/College of Occupational Therapy (2005) A national framework for support worker education and development, London CSP/COT

Chartered Society of Physiotherapy, (2006), Public Health in Wales: A guide to the public health agenda, London, CSP. www.csp.org.uk

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Dawes M et al (2005) Sicily statement on evidence-based practice, BMC Medical Education, 5, 1.

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Department of Health, (2004a), The10 Essential Shared Capabilities: A framework for the whole of the Mental Health Workforce, London, DH. www.dh.gov.uk

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Department of Health, (2007), New Ways of Working for Everyone. A Best Practice Implementation Guide, London, DH. www.dh.gov.uk www.newwaysofworking.org.uk

Department of Health, (2008a), High Quality Care For All. NHS Next Stage Review Final Report. London, DH

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Recovering Mind and Body (Mental Health)

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