COVID 19 is here with us now, but today’s news will hopefully become a historical narrative as we move forward and look back on this unprecedented global health and economic crisis.
The historical context is important as past events considered together, especially events of a particular period, country, or subject, should give us guidance on strategies for rehabilitation and the growth of the profession.
In the context of COVID-19, and a global pandemic requiring rehabilitation is unprecedented in living memory. Therefore history tells us little about the subject that we can meaningfully learn from. However, we can learn from one country to another, and the early learning from China and subsequent learning from Italy has helped the UK and the rest of the world in preparing for the rehabilitation requirement. The historical context may only have been measured in weeks and a few months but even that short time has enabled learning to expect the wide range of rehab requirements to be identified and plans put in place to address.
Therefore the learning is that history can be as brief an interlude as to be measured in days. By looking widely with an open mind to share, learn and analyse outcomes from one another in the global physiotherapy community, we can ensure that come the next pandemic, we are well prepared.
I wanted to take this time to put down the for the record, the fantastic opportunity that COVID -19 has presented for AHPs, with physiotherapists very much involved in leading change and delivering innovations at a pace and scale never before seen. This is worthy of note in both a contemporary and historical perspective.
I am the Executive Director of Therapies and Health Sciences (AHPs and scientists) in Cardiff the capital city of Wales UK.
Like other towns and cities worldwide we prepared for the pandemic, putting in plans to try and give capacity so we weren’t overwhelmed by the surge of COVID-19 patients requiring hospitalisation.
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On top of our 1800 inpatient beds, we took over the national rugby stadium and turned it into a 2000 bed hospital in a month. We required an innovative AHP staffing model, which was developed and overseen and clinically led by our Head of Physiotherapy. We were thankful that in the first wave of COVID only a small portion of the beds was required for use, but we were agile and innovative and more than met the needs of patients.
We have has fantastic cover for critical care physiotherapy, staff working 7/7 and all physios with respiratory competencies stepping up to deliver acute COVID work. Our lead physio for respiratory has educated the MDT in tracheostomy care and we have ensured good flow from critical care to our intensive rehab wards and out into our community and COVID step down facilities – including the Dragon’s heart field hospital.
As we also provide primary and community care we have given specific attention to ensuring continuity of care for those being discharged home, as well as those who haven’t required hospitalisation.
We have defined rehabilitation as being critical to ensuring our population recovers from the impacts of the pandemic and for the long-term sustainability of our Health and Social Care system. AHP’s being at the centre in shaping the rehabilitation agenda while working as part of the wider multidisciplinary and multiagency teams across all sectors. This collective approach is necessary.
We anticipate an increase in the need for rehabilitation across four main population groups:
- People recovering from COVID-19, both those who remained in the community and those who have been discharged following extended critical care/hospital stays.
- People whose health and function are at risk due to pauses in planned care.
- People who avoided accessing health services during the pandemic and are now at greater risk of ill-health because of delayed diagnosis and treatment. Patients will present with chronic conditions rather than acute conditions.
- People dealing with the physical and mental health effects of lockdown.
- We have set out our COVID-19 rehabilitation plan for these 4 groups and launched it on 30 May 2020. It will be supported by a suite of digital resources which will go live during June 2020.
We hope this will give a legacy to this period, which will be reviewed historically as the time that AHPs came to the forefront and really stepped up to help our population recover and thrive.
Our COVID-19 Rehabilitation model can be found here.
