Supporting Allied Health
Professions Research
Prof Roland Petchey
Director, Centre for AHP Research
Outline
• The present state of AHP research
• Their performance in RAE2008
• Issues
• Identity
• Organisation
• Education
...
RAE 2008
• Health warning
Incomplete partial and distorted representation of research
activity
• Institutional ‘gaming’ of...
Sub-panel commentary: Nursing & Midwifery
“transformation in strategy, performance and output quality,
evident in many of ...
Sub-panel commentary: AHPs
“heterogeneous in both substantive and methodological
terms”
“very wide distribution of quality...
RAE 2008: Activity by quality level (Staff-adjusted mean)
0
5
10
15
20
25
30
35
Activity
(%)
4* 1*
Quality level
N&M
AHP
3...
0
5
10
15
20
25
% of
submissions
0 10 20 30 40 50 60 70 80 90
% of outputs rated below
international quality
N&M
AHP
N&M M...
How did they get here?
• Issues
• The identity problem
• The organisation problem
• The education problem
Who are they? Well…….
• Department of Health
• Art therapists, drama therapists, music therapists,
chiropodists/podiatrist...
NHS (England) clinical workforce (WTEs)
Nurses
Doctors
AHPs
AHPs by NHS (England) numbers (WTEs)
Physio
O.T
Radiography
S&LT
Chiropody
Dietetics
Orthotics
Arts therapies
AHP heterogeneity II
Biomedical
orientation
Organisation Visibility Interfaces
Clinical Sectoral
Physiotherapy High High H...
Organisation
AHPs Nursing Medicine Dentistry
‘Representation’ Multiple
Independent
colleges
RCN BMA BDA
Regulation
(UK)
HP...
EU professional regulation
• ‘Dual’ system
1. ‘Sectoral’ professions
• Medicine
• Nursing (General care)
• Midwifery
• Pha...
‘Sectoral’ professions
• Regulated by profession specific Directives which
acknowledge professional uniqueness and special...
General systems professions
• General system of regulation
• Applies to ALL other professions (from accountants to
zoo tec...
BUT for AHPs…..
• Defining AHPs
• Profusion/confusion of
professional titles
• Determining equivalence
• Or, “When is a de...
The only authentic 'title' of a regulated profession is that of the language
of the country in which the profession is reg...
• Important differences remain, such as
• Scope of practice
• Multidisciplinary team-working
• Professional autonomy
• Sub...
AHPs by HEIs (England only)
0
5
10
15
20
25
30
35
40
HEIs
(%)
1 2 3 4 5
Number of Professions
The localisation and micro-mapping of copper and other trace elements in
breast tumours using a synchrotron micro-XRF syst...
Conclusions I
• Fragmentation
• Isolation
• Lack of effective national leadership
• Underdeveloped
• Overlooked
Even by the Department of Health!!
Even the Department of Health!
Conclusions II
• Lack of strategy or coherent research focus
• Weak leadership and under-developed governance
• Undevelope...
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  • AHPs by some way lowest of the Clinical Sciences in terms of 4* & 3* - 34% vs >60% (average)
  • Latest (2007) WTE figures for qualified AHPs in England: 57,065
    Nurses: 301,877
    Docs: 114,000
  • Physios: 16752
    OTs: 14439
    Radiogs:12915 (D = 11008; T = 1907)
    SLTs:5299
    Chiropody: 3095
    Dietetics: 2924
    Orthotics: 1149
    Arts therapies: 492
  • Sectoral interfaces:
    Within health:tertiary/secondary/primary/community
    Outside health: health/non-health (education, social services)
    Provider: voluntary, independent, charitable
  • Direct equivalence between professions is extremely uncommon. Patterns of AHP recognition and regulation in the various MS of the EU may not be random, but they are so shaped by individual national cultures, histories and politics as to be effectively incommensurable. This is a practical problem for European policy-makers, but it is also an intellectual nightmare for researchers trying to make sense of a field of study which consists almost entirely of quicksand rather than solid ground.
  • Petchey2009

    1. 1. Supporting Allied Health Professions Research Prof Roland Petchey Director, Centre for AHP Research
    2. 2. Outline • The present state of AHP research • Their performance in RAE2008 • Issues • Identity • Organisation • Education • Conclusions
    3. 3. RAE 2008 • Health warning Incomplete partial and distorted representation of research activity • Institutional ‘gaming’ of submissions in response to perceptions of likely rewards • Whom to submit? • To which Unit of Assessment? • Greater selectivity? • Prioritisation of quality indicators (Star ratings) over volume? • Prioritisation of status over finance?
    4. 4. Sub-panel commentary: Nursing & Midwifery “transformation in strategy, performance and output quality, evident in many of the submissions since 2001” BUT • Greater selectivity • Number of submissions DOWN on 2001 • 35 (out of 80 eligible) vs 43 in 2001 • Limited number of staff submitted as research active Number of individuals DOWN on 2001 • Evidence of uneven development • BUT also of maturation
    5. 5. Sub-panel commentary: AHPs “heterogeneous in both substantive and methodological terms” “very wide distribution of quality” • Biomedical science, nutrition and optometry singled out for special mention • Submissions (68) UP (by 18) on 2001 • Staff submitted UP by 40% “a lack of strategic focus, with often disparate research groupings” • Immaturity (teenage growth spurt)?
    6. 6. RAE 2008: Activity by quality level (Staff-adjusted mean) 0 5 10 15 20 25 30 35 Activity (%) 4* 1* Quality level N&M AHP 3* 2* Unclassified
    7. 7. 0 5 10 15 20 25 % of submissions 0 10 20 30 40 50 60 70 80 90 % of outputs rated below international quality N&M AHP N&M Median = 15% AHP Median = 35% RAE2008: Submissions by outputs below international quality
    8. 8. How did they get here? • Issues • The identity problem • The organisation problem • The education problem
    9. 9. Who are they? Well……. • Department of Health • Art therapists, drama therapists, music therapists, chiropodists/podiatrists, dietitians, occupational therapists, orthoptists, paramedics, physiotherapists, prosthetists & orthotists, diagnostic radiographers, therapeutic radiographers, speech & language therapists • Health Professions Council • Arts therapists, biomedical scientists, chiropodists/podiatrists, dietitians, occupational therapists, operating department practitioners, orthoptists, paramedics, physiotherapists, prosthetists & orthotists, radiographers, speech & language therapists
    10. 10. NHS (England) clinical workforce (WTEs) Nurses Doctors AHPs
    11. 11. AHPs by NHS (England) numbers (WTEs) Physio O.T Radiography S&LT Chiropody Dietetics Orthotics Arts therapies
    12. 12. AHP heterogeneity II Biomedical orientation Organisation Visibility Interfaces Clinical Sectoral Physiotherapy High High High High High S&LT Medium High High Medium High Radiography High Medium Low Low High Low O.T. Medium Medium Low High High Arts therapies Low Low Low Medium High
    13. 13. Organisation AHPs Nursing Medicine Dentistry ‘Representation’ Multiple Independent colleges RCN BMA BDA Regulation (UK) HPC NMC GMC GDC Regulation (EU) General system ‘Sectoral’ ‘Sectoral’ ‘Sectoral’
    14. 14. EU professional regulation • ‘Dual’ system 1. ‘Sectoral’ professions • Medicine • Nursing (General care) • Midwifery • Pharmacy • Dentistry 2. ‘General systems professions’ • The Rest (including AHPs)
    15. 15. ‘Sectoral’ professions • Regulated by profession specific Directives which acknowledge professional uniqueness and special requirements • Agreed “job specification” • Harmonisation of education and training • Automatic recognition of qualifications and right to practise • A doctor is a doctor is a doctor……
    16. 16. General systems professions • General system of regulation • Applies to ALL other professions (from accountants to zoo technicians) • No harmonisation of education/training • Major differences • Recognition of qualifications via case-by-case consideration of individual applicants • ‘Compensation measures’ • Right of host state to require a test of aptitude or period of adaptation (≤ 3 years) Revision of regulations (Lisbon process) under DG Markets & Competition NOT DG SANCO
    17. 17. BUT for AHPs….. • Defining AHPs • Profusion/confusion of professional titles • Determining equivalence • Or, “When is a dental technician not a dental technician?”
    18. 18. The only authentic 'title' of a regulated profession is that of the language of the country in which the profession is regulated. Any translation of this title on this website is purely indicative. Two regulated professions under the same profession heading can cover different activities. At the same time, two regulated professions falling under separate profession headings can cover similar activities. EC Europa website
    19. 19. • Important differences remain, such as • Scope of practice • Multidisciplinary team-working • Professional autonomy • Subordination to medicine • Values and practice regarding • Patient autonomy • Patient confidentiality • Psychosocial dimensions of health & illness Even for ‘identical’ professions
    20. 20. AHPs by HEIs (England only) 0 5 10 15 20 25 30 35 40 HEIs (%) 1 2 3 4 5 Number of Professions
    21. 21. The localisation and micro-mapping of copper and other trace elements in breast tumours using a synchrotron micro-XRF system The pupillary response of cephalopods. Treating children with expressive phonological disorders: Does phonological awareness therapy work in the clinic? 
    22. 22. Conclusions I • Fragmentation • Isolation • Lack of effective national leadership • Underdeveloped • Overlooked
    23. 23. Even by the Department of Health!!
    24. 24. Even the Department of Health!
    25. 25. Conclusions II • Lack of strategy or coherent research focus • Weak leadership and under-developed governance • Undeveloped research infrastructure • Isolation from the main body of research and research groups in the disciplines [and lack of insight into this] • Small and disparate research groups / lone researchers • Researchers [dabbling in] other disciplines to their work, rather than collaborating with disciplinary experts

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