How far that little candle throws his beams! So shines a good AHP in a weary world.

ProfileBy Fiona McQueen (@FionaCMcQueen)

Chief Nursing Officer for Scotland

How far that little candle throws his beams! So shines a good AHP in a weary world. (Merchant of Venice)

ShakespeareWith apologies to lovers of Shakespeare for modifying this quote from the Merchant of Venice. However when I think of the impact AHPs have on people’s lives, I have images of highly professional practitioners, who are often not at the forefront of the general public’s minds. I rather suspect if you ask the general public about clinicians in the NHS – they are most likely to talk about doctors and nurses……….

But a bit like a secret ingredient in a much favoured recipe, care and support for people is often never complete without AHP input. And how far the professions have travelled in recent years.

As a practicing clinician, and also in my personal life, I’ve witnessed the transformation AHPs can bring about in people’s lives; so why then is some of the work invisible to the public, and does this matter? Mark you, AHPs are only invisible to the public who haven’t been supported by one of the professions. The lives that are touched by AHPs are improved, at times beyond recognition; and lives can be saved. So what have I found since taking up the post of CNO Scotland?

x-rayWell, there’s no doubt that Jacqui the Chief Health Professions Officer has certainly (ably supported by Tracy) created the climate for AHPs to flourish. Whether it’s securing a debate in Parliament to showcase the work that AHPS do, or ensuring effective leadership within each NHS Board area, there has been real leadership shown by senior AHPs across the country. And a great example of professions working together for the greater good of patients and the public. It’s easy to forget that it was only recently Boards didn’t have Board AHP leads; and where they have – they have made remarkable differences in people’s lives. Reporting radiographers have reduced complaints about missed fractures and improved reporting times. Consultant AHPs in dementia are also enriching people’s lives and making real differences to communities.

However I do think there are some areas where more could be done. And I would ask, in every health board area, can AHPs truly say they are working as well as they can together? Are they a real force to be reckoned with? Because they should be! The first ever National Delivery Plan for AHPs was ambitious. But fortune favours the brave and the National Delivery Plan challenged AHPS to focus on the contribution they can make, and the impact they can have on the delivery of national policy, patient experience and outcomes across health and social care. It gave a renewed focus to AHP policy when it was launched in 2012 and much has been achieved since then, including:

  • MSKThe National Falls Improvement Programme has made progress through co-production across health, social care, the ambulance service and local communities leading to reductions of up to 50% in hospital admission after a fall;
  • People with dementia are staying a part of – rather than apart from – their communities through the dementia friendly community initiative, supported by AHP consultants in dementia;
  • Introduction of self-referral to musculoskeletal therapists, including physiotherapists has helped redesign orthopaedic services, reducing waiting times by up to 25%, reducing MRI scans by up to 30% and improving patient experience as well as ensuring those who need surgery will get it sooner.

A refresh of the National Delivery Plan was announced by the Minister for Public Health on 19 May 2015. The refresh will take the form of an Active and Independent Living Improvement Programme and will focus on improvements in population health, experiences and quality of care for people who use services and better outcomes for lower cost across health and social care.If you haven’t taken part in the engagement sessions – then make your views known.

EngagementAHPs have always been ingenious in the ways they find to support people improve health, avoid hospital admission, or reclaim their lives. Showing creativity and ingenuity, the strides AHPs have taken are an example to us all. Keep being bold and ambitious-and show the way.

The government’s 2020 Vision of people living longer healthier lives at home or in a homely setting, and accessing world class healthcare can only be reached if the potential of AHPs is truly exploited. The cracks we see in some services, I have no doubt can be replaced with strong sustainable services when AHPs’ contributions are felt. So keep throwing that beam and shining the light on new and novel solutions.

N.B: If you’d like to hear more about the progress of the Active and Independent Living Programme to date take a look at the community of practice.



  1. Very interesting,well thought out and encouraging piece, as usual , nothing about Orthoptists ! the invisible AHP who probably have more patient episodes than most AHPs and through our vision screening programmes virtually eliminated undetected vision problems by school age . Suppose we are used to it now , that quizzical look from people and “what? ,who? where?” when we mention our profession (even from fellow health professionals ) yet almost every child in Scotland would have been tested by an Orthoptist before school age . Still the fight goes on !! Sorry about the whinge .

    1. I would certainly be able to endorse the work of orthoptists in relation to Children’s Services. I manage specialist services in education and the partnership working with our orthoptists has been great. The screening helps identify children with less obvious conditions and needs prior to entering school and has allowed us to consider how best to support the child and family and also how to advise and support the entry into formal education in relation to adaptations that may need to be made prior to school entry.

      The key theme here is that we need to recognise and acknowledge the input of each professional group and the unique contribution they make, but to see this within a framework of supporting the child in a holistic way.

      Good to be able to comment on this group.

  2. This is a really timely post. In Highland we have an integrated children’s service within a Lead Agency model. The AHPs working with children in the community are managed alongside other colleagues from health, social care and education. They have made a fantastic contribution to the broad agenda in relation to the early years and also to closing the attainment gap wthin the context of schools. They have supported developments around positive behaviour and developing attuned relationships in families and schools, by improving access to the curriculum and improving communication skills. Our Physios and OTs have provided high quality therapeutic input to individual children and families, but have also increased understanding and capacity to support children with additional support needs and have provided the strategic direction to equipment purchase and adaptations to schools and homes, managing the Council’s budgets and policy in these areas. It’s fantastic to have the broader scope and understanding that AHPs bring to a holistic assessment of a child’s situation and to be able to utilise their skills to improve outcomes across a much wider range of situations than would be possible if working solely within a clinic or within a purely health related focus. I agree that they have perhaps been unsung hereos within NHS Boards, but within our Lead Agency approach in Children’s Services in Highland, AHPs most definitely are welcome to occupy a seat at almost every table.

  3. Having recently attended the Grampian AILIP event (and subsequuently directed to your blog), and as a stroke survivor, I heartily concur with the sentiments in this post.

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