Judy Mead (left), Head of Clinical Effectiveness, CSP, and Christine Sealey-Lapes, Chair of the Forum

The Clinical Effectiveness Forum for Allied Health Professions (CEFAHP) is part of an Allied Health Professions Forum, which exists to foster collaboration and encourage liaison between 12 professions whose members are currently or prospectively registrants of the Council for Professions Supplementary to Medicine, the Health Professions Council, or who are state registered.

A Research Forum for Allied Health Professions also exists. This deals with issues concerning research and development, and works particularly to increase the resources available for research in the allied health professions.

The CEFAHP comprises the following member organisations:

  • Association of Professional Music Therapists
  • British Association of Art Therapists
  • British Association of Prosthetists and Orthotists
  • British Dietetics Association
  • Chartered Society of Physiotherapy (CSP)
  • College of Occupational Therapists (COT)
  • Royal College of Speech and Language Therapists (RCSLT)
  • Society of Chiropodists and Podiatrists.

The purpose of the CEFAHP is to:

  • Take a strategic view of clinical effectiveness, as it relates to the allied health professions.
  • Communicate the work of the Forum and its position on clinical effectiveness to members of participating organisations and to other national bodies, including the NHS Executive, NICE, other professional bodies and royal colleges.
  • Discuss the implications of new initiatives, such as the NHS Plan.1
  • Provide joint responses to current developments/documents, e.g. responding to the NICE consultation document Developing Clinical Guidelines.2
  • Provide representation in wider groups and settings related to clinical effectiveness.
  • Facilitate joint working on specific projects related to clinical effeciveness, e.g. guideline development and endorsement.
  • Share information about clinical effectiveness across the allied health professions.

Increasingly, members of the Forum find they are working on similar projects in parallel with each other, and it has been beneficial to members to be able to share that work and begin to look at the commonality across professions.

Òhis has allowed professions to learn from each other and may lead to a greater degree of collaboration on projects. For example, most of the professions have standards of practice for their membership, and there is the potential to develop these centrally or commonly in the future.

Table 1 (below) shows some of the existing standards of practice.

Table 1: Examples of existing standards of practice

Dietetics

National Professional Standards for Dietitians Practising in Healthcare (1997)

A project to use the standards in developing an accreditation scheme is in progress.

An audit on the use of the standards was undertaken in February 2000.

Occupational therapy

Standards for Practice in Occupational Therapy (1993-2000)

A range of standards documents are available. These documents cover all areas of practice including referrals, record keeping, consent to therapy, home assessment, clinical supervision, and student placements. Some standards relate to specific practice, e.g. mental health, learning disability, physical disability and private practice.

Physiotherapy

Standards of Physiotherapy Practice Pack (2000)

The Standards pack contains:

  • Core standards (responsibility of individual physiotherapist) – standards relating to patient partnership, assessment and treatment cycle, communication, documentation, promoting a safe environment and continuing professional development.
  • Service standards (responsibility of physiotherapy manager/organisation) – sections on clinical governance, human resources and service provision.
  • Audit tools – ready made, for measuring conformity with every criterion in the standards, including patient record audit, patient feedback audit, guidance on peer review, continuing professional development audit and service standards audit.
Speech and language therapy

Communicating Quality 2 - Professional Standards for Speech and Language Therapists (1996)

Under developmentCompetency Standards for Speech and Language Therapists – due for publication in Summer 2001.

Members of the Forum have endeavoured to be involved in national clinical guideline development projects and this will continue with the new NICE Collaborating Centres.

There will be six Collaborating Centres charged primarily with developing multiprofessional guidelines. There will be one centre for each of the following: acute care; chronic diseases; mental health; nursing and supportive care; primary care; and women's and child health.

It is hoped that there will be Forum representation in at least three Collaborating Centres, and two of the member professions will be independently associated with another two centres.

Representation of the Forum in the Collaborating Centres will be valuable in identifying those allied health professions and resources that can inform the work programmes of the Centres, particularly in guideline development.

NICE has commissioned the CSP, with the Royal College of Physicians, to develop a clinical guideline for the management of multiple sclerosis. This project is now under way, with publication due in September 2002.

The CSP already has a system in place for the endorsement of clinical guidelines developed by physiotherapists. These are guidelines that focus on physiotherapy-specific aspects of care, e.g. the early management of soft tissue injuries.

Some of the other allied health professions are considering introducing a similar system, which may be established collaboratively, for economies of scale, to facilitate learning from each other and the endorsement of multiprofessional guidelines.

Guideline work in progress within the Forum member professions is shown in Table 2 (below).

Table 2: Guideline work in progress within the Forum member professions
Dietetics

The Association is looking at the appraisal of dietetic guidelines with a view to accreditation. Work to date has focused on:

  • Diabetes and hypertension
  • Diet in secondary prevention of coronary heart disease.

Occupational therapy
The establishment of a clinical guideline endorsement process is currently under consideration.
Physiotherapy

Clinical guidelines endorsement process. Four clinical guidelines have been endorsed to date:

  • Physiotherapy Management of Osteoporosis
  • Management of Soft Tissue Injuries in the first 72 Hours
  • Use of Injection Therapy by Physiotherapists
  • Management of Females aged 16-65 with Stress Urinary Incontinence.
Speech and language therapy

Clinical Guidelines by Consensus for Speech and Language Therapists (1998)

Evidence-Based Clinical Guidelines for Speech and Language Therapists – due for publication in April 2001.

A number of the professions have produced information resources to support their members in auditing their own practice:

  • The COT has published a clinical audit information pack.
  • The CSP is developing a number of audit tools to support the implementation of their endorsed clinical guidelines (see above). Following the National Sentinel Audit of the Guideline for the Collaborative, Rehabilitative Management of Elderly People who have Fallen, in 1999, the report's recommendations are now being implemented, including revision of the audit tool for local use.
  • The RCSLT has developed an audit tool for speech and language therapists and members of the primary healthcare team – specifically health visitors, GPs and practice nurses.

The package provides step-by-step methods for evaluating services to preschool children with speech and language difficulties, developing the practitioner's skills in conducting an audit while encouraging self-reflection and changing practice. In addition, the RCSLT has established a Professional Accreditation Scheme for Speech and Language Therapy Services.

The CSP is promoting the routine use of outcome measures by physiotherapists. A database of relevant outcome measures has been established and can be found on the CSP website at www.csp.org.uk (see Figure 1, below).

Figure 1: Home page of the CSP website
csp home page

Recommendations for specific measures are being developed for falls in older people and pain management.

A series of workshops has been held around the UK to help participants understand the place of measurement in practice evaluation, to teach them how to find, obtain, select and appraise the quality of measures, and to examine ways of analysing results to attribute change to intervention.

The COT is in the process of producing an outcomes information pack for occupational therapists.

The CEFAHP has proved to be a useful network to share work and progress on activities, and to discuss common issues and national initiatives that can be more difficult to address as a single, often small profession.

The Forum has helped to raise the profile of the allied health professions by enabling its membership to present common views and therefore be taken more seriously as a larger body of opinion.

While the purpose of the CEFAHP has been primarily to facilitate better collaborative working between the allied health professions, this does not preclude, and in many ways has supported, greater collaboration with other professional groups, including all the medical royal colleges.

The Forum had a relatively low profile when it was first set up, but it is now well established and known nationally. To date it has been tremendously helpful to its members in moving forward work on clinical effectiveness, and there is clearly great potential for collaborative working in the future.

The CEFAHP would be happy to hear from anyone on national issues of clinical effectiveness or with ideas for collaborative work. For further information or copies of documents cited in this article, contact the relevant organisation as shown in Table 3.

Table 3: Contact details for the CEFAHP
Contacting the Forum as a whole (one-stop shop)

Chair, Clinical Effectiveness Forum for Allied Health Professions

c/o Research and Clinical Effectiveness Unit

Chartered Society of Physiotherapy

14 Bedford Row

London WC1R 4ED

Email: cefahp@csphysio.org.uk

Dietetics

Jane Eaton

Professional Affairs

British Dietetics Association

5th Floor, Charles House

148/9 Great Charles Street

Birmingham B3 3HT

Email: j.eaton@bda.uk.com

Occupational therapy

Christine Sealey-Lapes

Clinical Effectiveness Officer College of Occupational Therapists

106–114 Borough High Street

Southwark

London SE1 1LB

Email: clinical.effectiveness@cot.co.uk

Physiotherapy

Judy Mead

Head of Clinical Effectiveness

Research and Clinical Effectiveness Unit

Chartered Society of Physiotherapy

14 Bedford Row

London WC1R 4ED

Email: meadj@csphysio.org.uk

Speech and language therapy

Sue Bright

Quality Assurance Officer

Royal College of Speech and Language Therapists

2 White Hart Yard

London SE1 1NX

Email: information@rcslt.org

Prosthetics and orthotics

June Burgess

Association Administrator

British Association of Prosthetists and Orthotists

Sir James Clarke Building

Abbey Mill Business Centre

Paisley, Renfrewshire PA1 1JJ

Email: admin@bapo.com

Chiropody and podiatry

Joanna Brown

Director of Industrial Relations and Professional Practice

Society of Chiropodists and Podiatrists

1 Fellmongers Path, Tower Bridge Road

London SE1 3LY

Art therapy

Katrina Millhagen

Chairperson

British Association of Art Therapists

5 Tavistock Place,

London WC1H 9SN

Email: baat@ukgateway.net

Music therapy

Mrs Diana Asbridge

Administrator

Association of Professional Music Therapists

26 Hamlyn Road

Glastonbury

Somerset BA6 8HT

Email: APMToffice@aol.com

 

CLINICAL EFFECTIVENESS FORUM FOR ALLIED HEALTH PROFESSIONS

Set up 1998
Objectives To provide a central focus for clinical effectiveness activities within the allied health professions
Status/funding Shared funding from member professional associations
Key personnel College of Occupational Therapists and Chair of the Forum: Christine Sealey-Lapes
  Chartered Society of Physiotherapy: Judy Mead
  Royal College of Speech and Language Therapists: Susan Bright
  British Dietetics Association: Fiona Ford
  Society of Chiropodists and Podiatrists: Marcel Pooke
  British Association of Prosthetists and Orthotists: Tarsem Hunjam
  Association of Professional Music Therapists: Angela Fenwick
Contact details Address: Clinical Effectiveness Forum for Allied Health Professions, c/o Research and Clinical Effectiveness Unit, The Chartered Society of Physiotherapy, 14 Bedford Row, London WC1R 4ED
  Tel: 020 7306 6635
  Email: cefahp@csphysio.org.uk

  1. Secretary of State for Health. The NHS Plan: A plan for investment, a plan for reform. London: Department of Health, 2000.
  2. National Institute for Clinical Excellence. Developing Clinical Guidelines: Consultation Document. London: NICE, 2000.

Guidelines in Practice, April 2001, Volume 4(4)
© 2001 MGP Ltd
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