A blog by @lauraneilAHP , Laura Neil, Lead for Allied Health Professionals and Interim Head of Clinical Governance and Quality Improvement, NHS 24.
I was very humbled to be asked to feature on a QI podcast recently and although the recording of the podcast was a free-flowing discussion, to help me prepare I couldn’t help but reflect on my career to date.
I am an occupational therapist who for the past few years has been fortunate enough to work both in AHP roles and in QI roles both within the organisations I have worked for and also fortunate enough to sit on national groups for each. Although separate worlds and separate roles in many ways, I have frequently reflected on how each role influenced the other and how AHPs just seem to fit with QI!
Looking back, I was always interested in service improvement and ‘projects’; I have probably always been curious and trying to make things better. Although I did some training in clinical audit and research many years ago, I only realised that what I was trying to do had a name and methodology when I fortuitously stumbled upon an opportunity (what’s for you won’t go by you!) to join one of the Academic Health Science Networks in London as a Frailty Fellow and subsequently programme manager. It felt like a huge gamble at the time, leaving stable NHS employment, but this was where I was introduced to the world of Quality Improvement and very fortunate to be learning and working with some of the leaders in this field in the country.
The post at NELFT therefore felt like a dream to me; the chance to both continue my QI journey but also to step back into the AHP world where my heart and professional identity lay. Although at NELFT we developed a QI programme open to all staff regardless of role and banding, something I am very passionate about; it was also heartening to see that AHPs were probably our most engaged group (speech & language therapists in particular!). We also attracted some AHPs into working in the QI team, our QI manager was a physio and after I left, it was another occupational therapist who took up the director role. There is obviously something that resonates for AHPs. I think there are two key reasons for this:
We tend to think very logically and pragmatically. The QI process very much aligns to the rehabilitation process – we assess, we plan an aim, we plan our intervention, and we measure the outcomes, then adjusting our intervention accordingly.
I also think AHPs are also curious (that word again); we want to understand, we want to think holistically and system wide and we want to make things better.
And I think there are many benefits to AHPs engaging in QI, at all levels.
As professions we tend to struggle to evaluate the outcomes of our interventions. QI often feels like a more accessible starting point than traditional research to try and do this. Yet QI, when done well and following a robust methodology, is increasingly publishable and presentable.
Thinking about my dual roles I also feel that it is important that we step out of AHP silos. Working in wider roles has given me the opportunity to influence at a strategic level and bring a different lens, whilst hopefully bringing AHPs along in the journey. Whilst in the Incident Management Team in my previous organisation, a nursing colleague commented that I tended to think about things differently as an AHP and that he felt that this was a positive influence to that team; it may also have been my QI background, or perhaps the combination of both. AHPs ended up leading a number of our trust-wide workstreams during the pandemic and the subsequent recovery planning; and did this very well. As AHPs we shouldn’t be afraid of stepping out of traditional AHP leadership roles into wider leadership roles where we can often bring a very important and useful different perspective. This doesn’t mean stepping away from our AHP identity, more bringing our perspective to the wider system.
So what is my advice? Be curious. Ask questions. Think of how things could be different and better. QI can give you a methodology to test out new ways of working and prove the impact. And don’t be afraid of bringing a AHP lens to wider discussions.
‘I have no special talent. I am only passionately curious’ – Albert Einstein
Laura Neil,
Lead for Allied Health Professionals and Interim Head of Clinical Governance and Quality Improvement, NHS 24.
Previously Director of AHPs & Psychological Therapy and Director of QI, NELFT.
Additional information
The Quality Improvement Zone ( QI Zone) is a learning and resource site from the NHS Education Scotland Quality Improvement team;
AHPs across health and social care. 