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AHPs as agents of change in health and social care - The National Delivery Plan for the Allied Health Professions in Scotland, 2012 - 2015

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3. Improving health and well-being

"Taking an asset-based approach involves mobilising the skills and knowledge of individuals and the connections and resources within communities and organisations, rather than focusing on problems and deficits. The approach aims to empower individuals, enabling them to rely less on public services."
NHS Health Scotland (2011)

AHPs are fully committed to improving the health and well-being of the people of Scotland. Improving health is often integral to their specific role: many are involved in health screening, health promotion, public health, social inclusion and participation initiatives and in advising individuals, family members and carers who access their services.

They are also involved in health improvement activity across areas of national priority, such as cancer and mental health services. AHPs deliver a wide range of cancer services, including diagnostic and screening programmes and radiotherapy. They also provide support throughout the cancer journey, including rehabilitation after surgery, radiotherapy and chemotherapy and when palliative care services are accessed.

Improving mental health is a key priority area for Scotland, and Realising Potential: an action plan for allied health professionals in mental health (Scottish Government, 2010b) spearheads the AHP contribution to improving mental health and well-being. Realising Potential doesn't ask AHPs to do extra: it asks AHPs to do differently. The work carried out under Realising Potential has achieved many successes to date, including the establishment of AHP leads for mental health across all NHS boards. AHP directors will wish to continue supporting these leaders and strengthen their role in ensuring full delivery of the 12 recommendations of Realising Potential.

While there is a strong tradition of community capacity building in social care, there is an equally strong tradition of AHPs building capabilities at an individual level. These approaches have been used very effectively across a range of care groups, particularly by mental health AHPs, to address aspects of social determinants of health and well-being and to mobilise communities to build capabilities, strengthen resilience and promote assets.

AHPs, in partnership with all health and social care professionals, make a significant contribution to improving health and reducing health inequalities as a component part of their delivery of services. There is now an opportunity to strengthen and promote their role in the area of public health, focusing on the promotion of good health through primary and secondary prevention in partnership with other agencies, including the third sector.

Now, more than ever before, AHPs must use each and every consultation as an opportunity to improve people's health and well-being. The AHP−individual relationship is built on engagement and trust. This allows AHPs opportunities to interact with individuals on issues that are important to their general health, such as physical activity, good nutrition, mental well-being and work, and alcohol, tobacco and substance use. AHPs' understanding of their local communities and wider national resources enables them to signpost individuals to services, organisations and information that will help them to develop and maintain better health and well-being.

AHP directors, in partnership with the Scottish Government's Physical Activity Champion, have recently established the AHP Directors' Pledge to Increasing Physical Activity in Scotland (Scotland's AHP Directors, 2012) to support an increase in physical activity as a normal community-based activity for all. This important piece of work builds on the valuable contribution AHPs are already making to the health and well-being of the people of Scotland through initiatives such as those focusing on supporting return to work and vocational rehabilitation.

The evidence base within Scotland, the UK and internationally that being in work is good for health is now well established. In addition to having a negative impact on the health of the individual affected, worklessness also has a significant impact on children and families, with health inequalities strongly evident. Employability status correlates highly with perceived well-being in individuals: low levels of job satisfaction (or no work) has close links with increased reported illness, disability and health problems.

Health and social care workers are frequently the first or only point of contact for an individual of working age who has health issues affecting their ability to work. This is why we need health and social care services that help individuals improve their physical and mental well-being so that they can return to full function, including work if appropriate.

All of these factors mean that the role of the AHP professions has never been more vital. AHPs are recognised as being among the principal groups of professionals who can make accurate functional capacity assessments, intervene through vocational rehabilitation activities as part of treatment and recovery and advise colleagues, the individual and the employer on reasonable adjustments for rapid and successful return to work.

As first-point-of-contact practitioners, AHPs also make a vital contribution to faster diagnostics and earlier interventions in primary care. They work closely with general practitioners and community teams to provide alternative pathways to secondary care referral and prevent admissions to hospital and care settings. Indeed, AHPs are experienced and competent in working in teams across partnerships with social care, education, third and independent sectors. They will also need to ensure the communication needs of people who use services, their families and carers are effectively met and to mainstream best inclusive communication practice throughout AHP services and across health and social care more generally.

A significant amount of work still has to be done, however, in strengthening partnership working at community level to enhance access to, and delivery of, "enabling" services and intermediate care. This will include interventions aimed at improving the health and well-being of adults of working age who have health conditions.

ACTIONS

No. Action by Delivery by end of
3.1 AHP directors will work with primary care leads, general practitioners and across their NHS board to support enhanced pathways in primary care which maximise AHP expertise as first-point-of-contact practitioners to improve the care experience and reduce unnecessary referrals to secondary and unscheduled care. 2014
3.2 AHP directors and AHP leads in local authorities will work in partnership with the third and private sectors, as well as other agencies, to enhance community capacity building and support early interventions as part of the implementation of the asset-based model and redesigning "enabling" services. 2013
3.3 AHPs from health and social care will ask people who use their services about their work status as an essential component of their consultation and will initiate support to individuals to enable them to remain in or return to work. 2013
3.4 AHPs from health and social care will use each consultation as an opportunity to improve overall health and well-being with people who use their services, focusing on issues such as physical activity, nutrition and mental well-being, and including signposting to relevant resources. 2014