Transcript Supporting Allied Health Professions Research Prof Roland Petchey Director, Centre for AHP Research Outline • The present state of AHP research • Their performance in RAE2008 •

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
• Conclusions
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?
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
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)?
RAE 2008: Activity by quality level (Staff-adjusted mean)
35
30
25
Activity 20
(%)
15
N&M
AHP
10
5
0
4*
3*
2*
1*
Quality level
Unclassified
RAE2008: Submissions by outputs below international quality
25
20
15
% of
submissions 10
N&M
AHP
5
0
0 10 20 30 40 50 60 70 80 90
% of outputs rated below
international quality
N&M Median = 15%
AHP Median = 35%
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/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
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
High
High
High
S&LT
Medium
High
High
Medium
High
Radiography
High
Medium
Low
Low
Low
High
O.T.
Medium
Medium
Low
High
High
Arts therapies
Low
Low
Low
Medium
High
Organisation
AHPs
Nursing
Medicine
Dentistry
‘Representation’ Multiple
RCN
Independent
colleges
BMA
BDA
Regulation
(UK)
HPC
NMC
GMC
GDC
Regulation (EU)
General
system
‘Sectoral’ ‘Sectoral’
‘Sectoral’
EU professional regulation
•
‘Dual’ system
1. ‘Sectoral’ professions
•
•
•
•
•
Medicine
Nursing (General care)
Midwifery
Pharmacy
Dentistry
2. ‘General systems professions’
•
The Rest (including AHPs)
‘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……
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
BUT for AHPs…..
• Defining AHPs
• Profusion/confusion of
professional titles
• Determining equivalence
• Or, “When is a dental
technician not a dental
technician?”
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
Even for ‘identical’ professions
• 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
AHPs by HEIs (England only)
40
35
30
25
HEIs
20
(%)
15
10
5
0
1
2
3
4
Number of Professions
5
The pupillary response of cephalopods.
Treating children with expressive phonological disorders:
Does phonological awareness therapy work in the clinic?
The localisation and micro-mapping of copper and other trace elements in
breast tumours using a synchrotron micro-XRF system
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
• 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