Your questions suggest that there should be a rationale to the provision of
physiotherapy services. My experience suggests that within the U.K. this is
not the case. He who shouts loudest gets the biggest amount of money despite
the need for service provision. Where populations are concerned wants very
often become needs and within a resource limited health service it is
impossible to meet all the wants. If look into the evidence base for the
provision of physiotherapy we would need very few physiotherapists. If you
consider the needs of the primary or secondary health care team then most
teams would identify the need for physiotherapy in that team.
You must also consider where you are providing care is it in a hospital,
clinic or patients own home. The level of support to the service from other
team members and carers have an influence on the service.
I realise I have not answered your questions but I don't believe these can be
answered. Have a read at Calculating Physiotherapy Staffing Levels, by Joyce
Williams which is published by Pampas Publishing (I think the Chartered
Society of Physiotherapy may have the contact address) and Physiotherapy with
Older People - Calculating Staffing Need - Squires A, Hastings M,
Physiotherapy December 1996 vol 82, no.12 p 655 - 664.
I have recently benchmarked staffing levels for my own 80,000 population at 1
physiotherapist to 6,000 population with an assistant ration of 1 to 12,000
population. I would suggest that is under-resourced. In an adjoining area
there is a physio ration of 1 to 4,000 population and an assistant ratio of 1
to 36,000 population. It could be a very interesting debate on these pages to
check out PT to population ratios throughout the world - except that we are
not comparing like with like.
Margaret Hastings
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