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PROCEEDINGS OF COUNCIL The passing of the NHS and Community Care Act brought a change of emphasis to the meeting of the CSP Council held at the CSP offices on September 5. Members planned to make the best of the decisions which were now irrevocable, and discussed ways in which members could be supported in their efforts to deal with the new situation. Joyce Wise, chairman of Council, presided. FROM the chair, Mrs Wise welcomed Mrs Beris Jones as alternate for the Welsh Board representative, Mrs Mary Pollett as alternate for the East Anglia Board representative and Ms Vicky Hackett from the Association of District and Superintendent Chartered Physiotherapists. Apologies were received from Mr B Barton, Dr E M Boothroyd-Brooks, Miss D Budds, Professor C M Castleden, Mrs E Condie, Dr B Davies, Professor M Day, Mrs K Delpak, Miss A M D Grimley, Miss H Lawler, Ms J Neuberger, Ms J Ross and Mrs A Strawson. The minutes of the previous meeting were passed without amendment. Jennie Collins was elected unopposed as a member of the Policy and Resources Committee. Toby Simon, Secretary of the Society, reported on meetings of officers of the CSP with representatives of the Privy Council and the Physiotherapists Board to discuss the qualification Graduate Diploma in Physiotherapy. These had led to arrangements which had safeguarded the State registration of newly qualified members. Chairman’s Report Mrs Wise noted with regret the resignation of Eileen Thornton as Mersey Board representative, owing to many pressures in her workplace. A by-election would be held but the chairman was pleased that Miss Thornton would be able to honour her committee duties for the next year, so the effective date of her resignation would be in September 1991. The chairman had attended the prizegiving at Bradford School of Physiotherapy in June, and in the same month took part in a Department of Health study day on the European market and the ambulance service. She had also been invited by Lord Ennals to a conference on global ’co-operation in health care at which a main speaker had been Dr Denis Periera Gray. On July 9 Tricia Phillips, vice-chairman of Council, had officiated at the launch of the CSP Standards Document (see panell which had been very well received. She warmly congratulated everyone who had been connected with its production. She had also attended a meeting about NHS Trusts organised by the British Medical Association, at which most people taking part in the discussions opposed the new system. In August Mrs Wise had broadcast on the BBC World Service in relation to the CSP leaflet ‘Take the stress out of driving’, and had made several other public appearances. Policy and Resources Committee Tricia Phillips, chairman of the committee, presented the report. Members agreed that Dr Ben Davies and Dr Angela Shepherd, co-opted members of Council whose terms of office were drawing to a close, should be invited to accept re-co- option in view of their considerable assistance to the Society. It was also agreed to reduce registration fees for the 1990 intake to f75 per student on graduate diploma courses and €50 per student on degree courses. Consideration was given to arrangements for the CSP centenary year in 1994. Board representatives were asked to consider what members might wish to do locally as part of these celebrations. It was agreed that, subject to revision of the wording, the Society should submit a motion to the general meeting of the World Confederation for Physical Therapy next year urging member organisations to press governmental and registration bodies to accept qualifications of comparable bodies in other countries on a reciprocal basis. It was reported that the committee had agreed that the Society needed a simple mechanism for endorsing products so that the spontaneity of members was not stifled and the endeavours of a particular group of members could be suitably publicised. It agreed that the Society would continue to seek commercial sponsorship and that endorsement of advice given by third parties was acceptable subject to the approval of Standards of Physiotherapy Practice The first-ever document ‘Standards of Physiotherapy Practice’ produced by The Chartered Society of Physiotherapy was launched on Monday, July 9. It provides a framework within which local standards can be set and will be a tool for clinical audit. The document is presented in a ring binder, together with copies of five Clinical Interest Group ’Guide Lines of Good Practice‘. This will allow further booklets to be included as they become available. The package is available from the Professional Affairs Department at an all-inclusive cost of €12. Cheques, made payable to ’The Chartered Society of Physiotherapy‘, should be included with orders. two senior members of Council. The CSP does not however endorse particular treat- ment products. After discussion it was clarified that Clinical Interest Groups, being autonomous, could make their own ruling about endorsements by their own groups. Several members were concerned at the decision to allow only limited use of the Presidents’ room plus one free letting per year of the other meeting rooms in the CSP headquarters t o Specific Interest Groups. Mrs Phillips explained that the Events Unit had been set up with the policy that it should pay its way, but depth of feeling was shown so strongly that it was agreed to look again at the system of charging. A brochure about the meeting rooms was one of the new leaflets reported by the director of public relations, Stuart Skyte. Other publications issued during the last quarter included the new careers pamphlet; additions to the serviceshles series; a student pack folder; the Small Grants Scheme leaflet; the standards document; the RCGP report; and Congress 1990 material. New material in the pipeline includes two booklets for private practitioners; the PACE material; the tripartite booklet on working with nurses and occupational therapists; a back care leaflet; and a careers poster. Interest was aroused by the publication of books for the Society, the first of which came on to the market last month - Management in Physiotherapy edited by Robert Jones, available by post from the CSP at €18.50. Forthcoming books will cover arthritis, burns, incontinence and recreational therapy. Mr Skyte explained that the object of publishing them was to enhance the Society‘s status, facilitate public relations, and generate income. Education Committee Patricia McCoy, chairman of the committee, announced that student physio- therapists would be subject to student loans from autumn 1990 in the same way as other students. Valerie Steele commented that the bursary available to student nurses not on degree courses would make nurse training more . attractive to potential recruits. Alan Walker, director of education, said that the full effects of this change might not be felt until the recipients of the loans had to start paying them back. Mr Simon reported that there had been no overall increase in the number of students starting in 1990, despite the Department of Health’s request to Regions for an increase of over 100 places this year. It was reported that the Education Committee had considered the proposals of the Physiotherapy Research Foundation for means by which the Foundation could support research activity, in addition to acting as an awarding body for small grants, and it had endorsed the proposals. It felt that Physiotherapy, October 1990, ~0176, no 10 639
Transcript

PROCEEDINGS OF COUNCIL The passing of the NHS and Community Care Act brought a change of emphasis to the meeting of the CSP Council held at the CSP offices on September 5. Members planned to make the best of the decisions which were now irrevocable, and discussed ways in which members could be supported in their efforts to deal with the new situation. Joyce Wise, chairman of Council, presided.

FROM the chair, Mrs Wise welcomed Mrs Beris Jones as alternate for the Welsh Board representative, Mrs Mary Pollett as alternate for the East Anglia Board representative and Ms Vicky Hackett from the Association of District and Superintendent Chartered Physiotherapists.

Apologies were received from Mr B Barton, Dr E M Boothroyd-Brooks, Miss D Budds, Professor C M Castleden, Mrs E Condie, Dr B Davies, Professor M Day, Mrs K Delpak, Miss A M D Grimley, Miss H Lawler, Ms J Neuberger, Ms J Ross and Mrs A Strawson.

The minutes of the previous meeting were passed without amendment.

Jennie Collins was elected unopposed as a member of the Policy and Resources Committee.

Toby Simon, Secretary of the Society, reported on meetings of officers of the CSP with representatives of the Privy Council and the Physiotherapists Board to discuss the qualification Graduate Diploma in Physiotherapy. These had led to arrangements which had safeguarded the State registration of newly qualified members.

Chairman’s Report Mrs Wise noted with regret the resignation

of Eileen Thornton as Mersey Board representative, owing to many pressures in her workplace. A by-election would be held but the chairman was pleased that Miss Thornton would be able to honour her committee duties for the next year, so the effective date of her resignation would be in September 1991.

The chairman had attended the prizegiving at Bradford School of Physiotherapy in June, and in the same month took part in a Department of Health study day on the European market and the ambulance service. She had also been invited by Lord Ennals to a conference on global ’co-operation in health care at which a main speaker had been Dr Denis Periera Gray.

On July 9 Tricia Phillips, vice-chairman of Council, had officiated at the launch of the

CSP Standards Document (see panell which had been very well received. She warmly congratulated everyone who had been connected with its production.

She had also attended a meeting about NHS Trusts organised by the British Medical Association, at which most people taking part in the discussions opposed the new system.

In August Mrs Wise had broadcast on the BBC World Service in relation to the CSP leaflet ‘Take the stress out of driving’, and had made several other public appearances.

Policy and Resources Committee Tricia Phillips, chairman of the committee,

presented the report. Members agreed that Dr Ben Davies and

Dr Angela Shepherd, co-opted members of Council whose terms of office were drawing to a close, should be invited to accept re-co- option in view of their considerable assistance to the Society.

It was also agreed to reduce registration fees for the 1990 intake to f75 per student on graduate diploma courses and €50 per student on degree courses.

Consideration was given to arrangements for the CSP centenary year in 1994. Board representatives were asked to consider what members might wish to do locally as part of these celebrations.

It was agreed that, subject to revision of the wording, the Society should submit a motion to the general meeting of the World Confederation for Physical Therapy next year urging member organisations to press governmental and registration bodies to accept qualifications of comparable bodies in other countries on a reciprocal basis.

It was reported that the committee had agreed that the Society needed a simple mechanism for endorsing products so that the spontaneity of members was not stifled and the endeavours of a particular group of members could be suitably publicised. It agreed that the Society would continue to seek commercial sponsorship and that endorsement of advice given by third parties was acceptable subject to the approval of

Standards of Physiotherapy Practice

The first-ever document ‘Standards o f Physiotherapy Practice’ produced by The Chartered Society o f Physiotherapy was launched o n Monday, July 9. It provides a framework within which local standards can be set and will b e a too l for clinical audit.

The document is presented in a ring binder, together with copies o f f ive Clinical Interest Group ’Guide Lines of Good Practice‘. This will allow further booklets t o b e included as they become available.

The package is available f rom the Professional Affairs Department a t an all-inclusive cost of €12. Cheques, made payable to ’The Chartered Society of Physiotherapy‘, should be included with orders.

two senior members of Council. The CSP does not however endorse particular treat- ment products.

After discussion it was clarified that Clinical Interest Groups, being autonomous, could make their o w n ruling about endorsements by their own groups.

Several members were concerned at the decision to allow only limited use of the Presidents’ room plus one free letting per year of the other meeting rooms in the CSP headquarters to Specific Interest Groups. Mrs Phillips explained that the Events Unit had been set up with the policy that it should pay its way, but depth of feeling was shown so strongly that it was agreed to look again at the system of charging.

A brochure about the meeting rooms was one of the new leaflets reported by the director of public relations, Stuart Skyte. Other publications issued during the last quarter included the new careers pamphlet; additions to the serviceshles series; a student pack folder; the Small Grants Scheme leaflet; the standards document; the RCGP report; and Congress 1990 material. New material in the pipeline includes two booklets for private practitioners; the PACE material; the tripartite booklet on working with nurses and occupational therapists; a back care leaflet; and a careers poster.

Interest was aroused by the publication of books for the Society, the first of which came on to the market last month - Management in Physiotherapy edited by Robert Jones, available by post from the CSP at €18.50. Forthcoming books will cover arthrit is, burns, incontinence and recreational therapy. Mr Skyte explained that the object of publishing them was to enhance the Society‘s status, facilitate public relations, and generate income.

Education Committee Patricia McCoy, chairman of the

committee, announced that student physio- therapists would be subject to student loans from autumn 1990 in the same way as other students.

Valerie Steele commented that the bursary available to student nurses not on degree courses would make nurse training more . attractive to potential recruits.

Alan Walker, director of education, said that the full effects of this change might not be felt until the recipients of the loans had to start paying them back.

Mr Simon reported that there had been no overall increase in the number of students starting in 1990, despite the Department of Health’s request to Regions for an increase of over 100 places this year.

It was reported that the Education Committee had considered the proposals of the Physiotherapy Research Foundation for means by which the Foundation could support research activity, in addition to acting as an awarding body for small grants, and it had endorsed the proposals. It felt that

Physiotherapy, October 1990, ~0176, no 10 639

the provision of self-financing study days should assume priority over the convening of annual research meetings and the introduction of an associateship schema The most urgent needs in respect of research within the profession were identified as being: .To de-mystify research activity for the majority of physiotherapists. .To promote research within physiotherapy schools; for example, the Foundation's first training day could usefully focus upon the supervision of honours degree research projects.

Industrial Relations Committee William Gilchrist, chairman of the

committee, introduced its report which included a review of local bargaining issues by the director of industrial relations, Phillip Gray. The first three points of its policy and strategy were as follows:

.A bargaining policy and strategy sub- committee of the IR committee should be established. The subcommittee will meet, as necessary, more frequently than the IR Committee to approve local bargaining policy. It will make regular reports to the IR Committee, and will be composed of the three IR Committee members on the PT'A' Council, with officers in attendance.

.The Society is not in favour of local bargaining on pay and conditions. However, if local bargaining is to take place as a result of local management insistence, the Society will fully participate to protect the interests of physiotherapists.

.The salary rates set by the Review Body and the conditions set by the Whitley agreements must be the minimum in any local negotiations, below which no agreement should be allowed to go.

The importance of maintaining support to stewards in the light of the many changes being made within the NHS, and the necessity of continued training for stewards, were emphasised. Stewards would take on additional responsibilities and would be vital to the Society in local bargaining. A CSP publicity campaign would reaffirm the importance of its stewards, to make the members aware of extra pressure and demands being put upon them as a result of the many changes, thereby encouraging members to be more supportive towards their stewards.

It was noted that Mr Eric Caines, NHS director of personnel, had stated that there would be no national agreement for health

Phillip Gray I During Council's lunch interval, the chairman paid tribute to Phil Gray, director of industrial relations, who was leaving the CSP after exactly 12 years. He took up his new post this month as director of labour relations for the Royal College of Nursing.

I

care assistants. North West Thames Region and the Mersey District were pilot sites for terms and conditions. Both the Royal College of Nursing and the PT'A' Staff Side were seeking national agreements.

Members heard that the PT'A' Joint Grading Review Working Party meeting in July had nearly broken down because of the large gap between the sides. The Management Side proposals wished to abolish any national grading system and replace it with a locally 'flexible' pay structure which allowed local management unappealable discretion on where staff should be placed.

This was the first attempt in the NHS to abandon national grades and devolve everything down to local level with little consistency between employers. The Staff Side had firmly rejected this approach and would only negotiate a new national grading structure which improved the existing career structure. If this was not achievable, the Staff Side would stick to the present agreements.

The Management Side had also proposed the abolition of automatic annual increments and their replacement by increments subject to individual performance review; the abolition of emergency duty, student training and other allowances; and annual increments of 2% at half the size of present increments.

Mr Gray advised that all personnel involved in contract bargaining with the establishment of budgeting procedures should identify the starus quo and set out clearly what services physiotherapists offered and what they should be enabled to do.

He also commented that the vacancy level for NHS physiotherapists had dropped by 1% in the past year, which could be due to slowed development.

Professional Practice Committee Pennie Roberts, speaking for the

committee, put forward a paper on inter-

professional relationships between senior doctors and physiotherapists, which had been drawn up following discussion with the Central Consultants and Specialists Committee of the British Medical Association and representatives of the Chartered Society.

Many members thought that the draft was too prescriptive, and that this was not a good time to be making such a statement. Relationships between consultants and Chartered physiotherapists were generally good, and where there were problems, these were best resolved locally. Therefore the paper did not receive the support of Council.

The work achieved by the Electrotherapy Subcommittee was welcomed, and its safety guide lines and efficacy literature will be published in. Physiotherapy starting in this issue. A steering group will be set up to continue the work and composition of the subcommittee.

A report from the Physical Disability Subcommittee was presented by Mavis Sellars. It was recommended that a statement about the role of physiotherapists in helping people with disabilities should be promoted to clients, carers and profess- ionals from other disciplines. It was also proposed that the Society should hold a forum to allow exchange of information and produce a document about development of community-based services for physically handicapped people The professions should respect and understand the role of other professionals while promoting the specific expertise of physiotherapists and their contribution to teamwork.

The paper concluded: 'There is increasing recognition that "illness" or "sickness" model of care is inappropriate for most disabled people, and this has major implications for physiotherapists working with this client group. The importance of enabling people with disabilities to define their own goals and maximising choice and autonomy should be explained in education and demonstrated in clinical practice. At the same time, physiotherapists should be able to state clearly the limitations of therapy, in order to avoid unrealistic expectations and continued dependence.'

There were some criticisms of the detail of the report. Kathleen Jenkins said that it went into unnecessary detail - a general description would be wiser. Jean Bell said the paper was unclear and not definite enough.

Jill Mantle pointed out that disabled parenthood was not mentioned at all. Bridget Davies said that other professions needed practical information about orthotics

1991 WCPT Congress Council was addressed by David Teager and Lois Dyer about the 1991 Congress of the World Confederation for Physical Therapy t o be held in London. As the first Congress had been held in London and more and more countries were expected t o join WCPT, this would be a once-in-a-lifetime opportunity for most British physiotherapists t o meet colleagues from all over the world in their home country. Mr Teager and Miss Dyer welcomed the increasing interest in internationalism among UK members and urged as many as possible to make every effort t o attend next year. Al l inquiries should be addressed t o Conference Associates (WCPT), Congress House, 55 New Cavendish Street, London W1M 7RE (tel 071-486 0531).

physiotherapy, October 1990, vol76, no 10 640

and prosthetics and wheelchairs (rather than a dissertation on the role of physio- therapists). Mrs Roberts pointed out that the paper was intended as a discussion document for the committee. It would consider Council's comments before publishing any document on the role of physiotherapy with disabled people.

International Affairs Committee Eve O'Neill, vice-chairman of the

committee, proposed its recommendation that the Society should nominate David Teager MCSP DipTP for the presidency of the World Confederation for Physical Therapy. Council agreed unanimously.

It was explained that the American Physical Therapy Association was seeking nominations for the Mildred Elson Award, made in honour of the first president of WCF'T. Council agreed to nominate Elizabeth McKay MCSP, who was secretary-general to WCPT from 1970 to 1986.

Council expressed concern and sympathy for members of the Society inbolved in the Gulf crisis: four resident in Kuwait and one in Saudi Arabia, plus Barbara Richardson (n6e Girling) who had been travelling on the plane whose passengers had been held hostage. She had elected to stay in Kuwait with her husband since they did not have the responsibility of children.

Journal Committee Before the chairman of the committee,

Eirian Ricketts, gave its report she was congratulated on the award of an MBE in the Queen's birthday honours.

The report reminded members that categories had been widened for this year's Journal Prize competition and the timing altered - the closing date is December 1. The competition was publicised in the June issue of Physiotherapy and appeared again in September, and a fly sheet would be placed in the pack for everyone who attended Congress. It was too early to assess the response but some entries had already been received.

The Journal was trying to strengthen links between physiotherapists and social service personnel. So far this had been mainly through arranging an exchange of Journals but it was hoped that physiotherapists would contribute to the social work press and that social workers would submit articles to Physiotherapy.

Symposia of articles were in hand on research, incontinence, statistics, physio- logy, bioelectricity, and working overseas. Some of these are being published in groups and others individually in consecutive issues. Most of them will eventually be collated and reprinted for sale in booklet form. Suggestions from members about further topics for special issues are always welcome.

Information Systems and Resource Management Working Party

Robert Jones, chairman of the working party, presented its report which stated that Dr James Read of the NHS Centre for Classification and Coding had been approached to see whether progress could be made on a physiotherapy coding system. Dr Read's coding system for the NHS covered diagnoses, procedures, and other

aspects of clinical practice. While the working party saw no problem with coding diagnosesheasons for referral, it 2xpressed concern that procedure codes could be used by doctors t o specify physiotherapy treatment procedures. It therefore agreed to avoid coding treatments or interventions. It agreed that a small group would seek a meeting with Dr Read for preliminary discussions on creating a sub-set of Read Codes for describing physiotherapy referrals.

The working party had heard that at a recent meeting Mrs Virginia Bottomley, Secretary of State for Health, had informed representatives of the occupational therapy, speech therapy, physiotherapy, and clinical psychology professions that a group was to be set up to look at defining the best way of undertaking clinical audit within these professions. She confirmed that Chartered physiotherapists would be involved in this group. Mrs Jenkins told Council that such a meeting was shortly to be arranged.

The working party had looked at staffing norms in an attempt to help physiotherapy managers to construct staffing profiles for contract purposes. It had discussed the usefulness of nationally-based staffing norms. It acknowledged the dangers in providing either only one figure or a range of figures. It seemed preferable to negotiate with managers on a local basis according to a specific service.

It felt that in future it would be more useful to have a description of hours per case rather than number of staff per unit. This was important as physiotherapy episodes of care were often longer than hospital episodes. It was also necessary to tie in quality, otherwise figures would be meaningless. As there was clearly a demand from physio- therapy managers for guidance, the working party agreed that a standard approach to the determination of staffing levels would be helpful. This would assist contract writing and would help generally to provide an outline of how physiotherapy manpower was structured.

The working party agreed to commission a document from Joyce Williams, as she had already done a lot of work in this area. Arrangements for this are currently being negotiated.

The working party considered the Scottish National Paramedical Consu I t a t ive Committee Report on workload data collection. Mr Simon had sent a personal response to the document to the Scottish Health Service Advisory Council, with which it agreed in essence. It heard that a group of Scottish physiotherapists were coming together to try to bring some uniformity of approach towards information systems across Scotland.

Regulatory Arrangements Mrs Wise presented a draft letter to

Stephen Dorrell, Parliamentary Under- Secretary of State for Health, setting out aspects of the PSM Act which in the CSP's opinion required amendment. While the CSP's aim remained to secure regulatory arrangements for the professions allied to medicine which reflected their standing and independence, the letter represented a change of tack. While some PAMs, like the CSP. had wanted a comprehensive review of the Act, others had been more cautious. It was hoped, however, that this revised approach would be acceptable to the

Councils of all the Professions Allied to Medicine, so that it could go forward as a joint request.

NHS Review Steering Group Mrs Wise presented a report from the

group which accepted that devolution of manpower planning from Districts to Units and Trusts was inevitable, which meant that historical comparisons would be difficult. There were still problems for services which crossed these narrow boundaries.

The Society was pledged to help its members in the new situation and work- shops and other training were planned.

Members generally agreed that the decisions on reorganisation had now been made and could not be influenced - the task was to make the best of the new situation.

Mr Gilchrist added that managers and stewards should work together on this and Mr Jones agreed: 'It's the let's help everybody mode.'

Members Benevolent Fund Committee

It was reported that an autumn gift of €175 had been made to 22 beneficiaries. Fifteen cases had been reviewed and two new applications discussed. Donations, commission and interest and a legacy received during the previous quarter amounted to €6,000.

Fellowship Advisory Board Council appointed the following Fellows

to serve on the Fellowship Advisory Board: Miss A I Bromley MBE FCSP, Miss B M Graveling FCSP DipTP, Miss M A Harrison FCSP, Mrs S A Hyde FCSP, Dr C J Partridge PhD BA FCSP, Miss J M Piercy BA FCSP DipTP.

Council elected Mrs S Jackson (the current chairman) and Mrs R J Gunning to continue to serve on the Board.

Board Constitutions Council approved revised constitutions for

the South West Thames, North West Thames and Northern Boards.

Council was pleased to thank the South West Thames Board for the donation of two pictures for display in the Reading Room, one of which is shown below: 'The market cross at Chichester'.

physiotherapy, October 1990, vol76, no 10 641


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