Priorities for the Sixth Senedd

www.senedd.wales

Welsh Parliament

Health and Social Care Committee

Priorities for the Sixth Senedd

Share your views

Your details

1.          Name:

Ross Barrow

2.          Email address:

Ross.Barrow@rcpod.org.uk

3.          Would you like to be added to the Health and Social Care Committee’s contacts list in order to receive updates about our work?

Yes

☒

No

☐

You can unsubscribe at any time by emailing SeneddHealth@senedd.wales.

4.          Please tell us in what capacity you are responding to this consultation.

I am an individual responding in a personal capacity

I am an individual responding in a professional capacity (please tell us what your job title is)

I am responding on behalf of an organisation (please tell us which organisation and what your job title is)

Royal College of Podiatry

Policy and Public Affairs Officer

If you are under 13 years old, we will only be able to accept your response if your parent or guardian has confirmed that you can participate. They can do this by sending us an email to SeneddHealth@senedd.wales.

5.          Are you under 13 years old?

I am under 13 years old

☐

I am 13 or over

☒

6.          Please choose one of the following options to confirm whether you would prefer that your name is not published alongside your evidence.

We will not publish the names of people under the age of 18.

I am aged 18 or over and I am content for you to publish my name alongside my evidence

☒

I am aged 18 or over and I would prefer that you did not publish my name alongside my evidence

☐

I am under the age of 18

☐

7.          Please choose one of the following options to confirm whether you have agreement from any third parties referred to in your evidence that you can share information that may be used to identify them and that they understand that it may be published.

I confirm that any third party I have referred to in my evidence has agreed that I can share information that may be used to identify them, and that they understand that it may be published.

☐

I do not have the agreement of one or more of the third parties I have referred to in my evidence.

☐

I have not referred to any third parties in my evidence.

☒

Q1. Which of the issues listed above do you think should be a priority, and why?

You can comment on as many or few of the issues as you want.

In your answers, you might want to think about:

• What impact or outcomes could be achieved through any work by the Committee?
• How the Committee might address the issue?
• When any Committee work should take place?
• Whether there are any specific groups, communities or stakeholders that the Committee should involve or hear from in any work?

The Royal College of Podiatry agrees with the priorities listed above.  Out of all of these issues, we see the Health and Social Care workforce, and public health and prevention, as the most urgent priorities.

Health and Social Care workforce

We would like to see the Health and Social Care Committee influencing Welsh Government and Health Education and Improvement Wales to produce a co-ordinated plan for the sustainability of the podiatry profession across Wales.  The outcomes that we would like to see include development of alternative routes to training Podiatry in Wales.  Currently there is only one way to become a Podiatrist in Wales which is to study the undergraduate programme at Cardiff Metropolitan University.  This makes it difficult for potential students from outside South-East Wales to study, and in particular affects potential mature students.  We would like to see the development of a degree apprenticeship for Podiatry, as well as the setting up of alternative undergraduate entry routes, for example in North Wales, through the setting up of hub and spoke podiatry degree courses. 

Public Health and Prevention

Podiatry has a vital role to play in public health and prevention.  The demand for Podiatry services amongst the Welsh population is increasing as the number of people developing foot and lower limb complications linked to long term conditions and co-morbidities rises.  At the same time, the numbers of Podiatrists working in the NHS is decreasing.  This is leading to increased waiting times to access NHS Podiatry services, especially for people with non-acute injuries, meaning opportunities to provide early intervention to keep local populations healthy, mobile and active are being missed.

It is vital that Podiatry services are sufficiently resourced, so they fully meet the foot and lower limb health needs of their local populations. Podiatrists should be placed within appropriate clinical areas and integrated into multidisciplinary pathways within the Health and Social Care system so that patients can see Podiatrists, in the right place at the right time. In practice, this means that patients should have timely access to Podiatry in primary and community care, who have the requisite skills and knowledge to work as first point of contact practitioners, this reduces delays in treatment and increases preventative interventions.

In order that the above can happen, both the Strategic Programme for Primary Care in Wales and Regional Partnership Boards will be important stakeholders which the Committee may like to hear from.  The Committee may like to examine the operation of cluster model in Wales which has been tricky for Allied Health Professionals to navigate for the following reasons:[1]

·       There is a lack of awareness of what AHPs do, leading to AHPs being used inappropriately within the cluster system.

·       Within the cluster model, individual AHPs are often expected to provide complex services all under one roof.  Very few AHPs can provide all of these services as individuals specialise in different areas.

·       Many AHP services are too small to be divided into clusters, which leads to a dilution of the service.  Cluster working is supposed to be about integrated MDT working but often leads to clinicians feeling isolated without the clinical support mechanisms around them to support patients. 

·       The links between clusters and community resource teams (CRTs) are pivotal for effective integration, however in some areas these links are stronger than in others, which leads to a disparity across Wales.

·       Clusters do not operate consistently throughout Wales.  They all have their own individual interests.  Some clusters invite AHPs, whilst some do not.

·       Clusters allocate money to time limited projects.  However, there is never any budget for the Health Board to take these over at the end of the agreed cluster period.  So, the service stops, even if proved successful, which is hugely frustrating for clinicians and patients alike.

The Committee may like to consider working with stakeholders named above to identify some solutions to these challenges.

Q2. In your view, what other key priorities should the Committee consider during the Sixth Senedd in relation to:

a)    health services;

b)    social care and carers;

c)     COVID recovery?

You can comment on as many or few of the issues as you want.

In your answers, you might want to think about:

• What impact or outcomes could be achieved through any work by the Committee?
• How the Committee might address the issue?
• When any Committee work should take place?
• Whether there are any specific groups, communities or stakeholders that the Committee should involve or hear from in any work?

a) Health services

b) Social care and carers

c) COVID recovery

Following the pandemic there are extreme demands on health services, with waiting lists for treatment longer than ever before.  The Royal College of Podiatry can demonstrate that Podiatry services can help clear the backlog and improve waiting times, for example by treating people closer to home in the community.

Where this happens, people receive tailored treatment plans earlier, and there is a >90% drop in the number of people who are unnecessarily referred to vascular specialists within secondary care for assessment.[2]

In order that these pathways can be established it will be critical that podiatry services are provided with the investment to fund vascular posts.  This money would be well spent as it would free up vascular surgeons to deal with priority cases and also reduce waiting times, allowing people to be assessed, diagnosed and treated closer to home.  It is essential that money which is used to support these pathways is permanent and sustainable.

Q3. Are there any other issues you wish to draw to the Committee’s attention?

Student Streamlining Scheme

The Committee may be aware of Health Education and Improvement Wales streamlining process,[3] which has been established for student nurses, healthcare science and allied health professional graduates.

The purpose of the streamlining process is to match students who have received a healthcare bursary to jobs within Health and Social Care across Wales.  There are a number of concerns that stakeholders including the AHP Welsh Policy Officers Group, of which The Royal College of Podiatry is part, have regarding this process.  These include Boards being prevented from employing graduates from outside Wales, including those who may be Welsh speakers or have family ties to Wales.  This is a particular problem for Betsi Cadwaladr Health Board in North Wales, who currently recruit Podiatry students from Salford University, which is their closest training provider.

It has recently been confirmed by HEIW that Podiatry will come into the streamlining process.  Given the significant workforce shortages for Podiatry in Wales, The Royal College of Podiatry is concerned that the Student Streamlining Scheme will compound the problems for recruitment of NHS Podiatrists across Wales.

We would welcome the Committee looking into the Student Streamlining Scheme to consider if it is an appropriate solution to the challenges of AHP recruitment in Wales, and to investigate whether this one size fits all approach is damaging to particular professions, including Podiatry.