By Dr Denise Baker - 13 October 2020
An overlooked contribution
"Thanks to the nurses, doctors and midwives that have registered early and will join the NHS to fight COVID-19"! I'm paraphrasing, but this was the message issued by the Department of Health and Social Care in mid-April. It coincided with the Prime Minister being hospitalised 'for tests' - a time when the country knew that he would be receiving essential care which would save his life.
When the government issues messages thanking our doctors and nurses, there are a number of other professionals quietly seething (or not so quietly!) in the background. This message has overlooked the contribution made to patient diagnosis, care and rehabilitation made by allied health professionals or AHPs.
Although our AHP students are going onto a temporary register, being deployed sooner than expected and joining the same 'front line', you need to dig beyond the headlines to hear more about how they are contributing to the fight against COVID. Similarly, a number of former registrants are returning to practice and whole AHP teams have been sent to the Nightingale hospitals, though little mention is made of their essential contribution.
The role of the radiographer
My professional background is diagnostic radiography. My clinical role was to provide images which would help in the diagnosis of illness using a variety of different imaging technologies. Many are probably aware of scanners seen on programmes like Casualty or Holby City. These are not operated by nurses or doctors, but by radiographers.
Need to check if you have a broken bone? A radiographer will not only produce the image but, in many cases, send the results to accident and emergency too. If someone has had a heart attack or stroke and needs a stent or other keyhole surgery, this is all done using x-rays and a radiographer will be there as part of the multi-disciplinary team.
Testing for COVID-19
As the picture about COVID- 19 became clearer, the importance of providing not only a quick but accurate diagnosis became apparent. The availability of testing kits and the necessary time delay between the sample being taken and the results available meant that other tests were increasingly relied on.
A simple chest x-ray is one of those important tests, and modern digital technology allows images to be sent to medical teams in minutes.
In more serious cases, a CT scan of the lungs is performed. Imaging teams in China were soon able to detect the unique appearance of COVID-19 in patients' lungs - information which was shared around the world as the pandemic spread to help with a speedy and accurate diagnostic process.
The wider caring team
Once the diagnosis has been made, more allied health professionals become part of the team caring for patients. Operating Department Practitioners use their skills to help place patients onto ventilators, physiotherapists try to improve patients' lung function while the patient is ventilated.
Speech and language therapists assist patients who may be having difficulty in swallowing and dietitians provide essential nutritional advice to ensure patients have the best chance of fighting the virus. And, of course, many patients will have arrived at hospital in the first place having been cared for by paramedics - another member of the allied health professional community.
When patients are well enough to come off ventilators, physiotherapists will work to get them up and about again, while occupational therapists will work to ensure they can return to their own homes safely.
Although the medical emergency may have passed, there is a long road of rehabilitation ahead and allied health professionals will be essential in ensuring that individuals are supported to return to routine daily activities and any residual physical problems are treated effectively.
The journey to recovery
We are all conscious of the enormous toll this virus is having and will continue to have on our lives. Supporting our mental health and well-being has been a key part of the story throughout. Allied health professionals will continue to play their part in this, perhaps occupational therapists or arts therapists. While each may offer a different approach to supporting individuals to process events relating to COVID-19, these professions will be a critical part of the journey to recovery.
Other allied health professionals have continued with more routine procedures. Cancer treatment has continued in radiotherapy departments or podiatrists have been able to see the most urgent patients with foot problems, perhaps preventing future limb loss. There are 14 allied health professions in total, and the chances are that they will have continued, in some respect, to provide care to the population throughout the pandemic.
PM's moving tribute
When the Prime Minister was discharged from hospital, he gave a moving tribute to those that had cared for him, including members of allied health professions. While the message from the Department of Health and Social Care may have ignored this sector of the workforce, the impact on him as an individual was clear to see. My AHP colleagues have quickly and effectively shifted into new roles and provided the essential services they have been trained to provide.
Each AHP undergoes highly specialised training and is an autonomous practitioner. They are responsible for their own actions and so the training is rigorous to allow this to happen safely. More importantly, they are part of a team. You may have seen videos of teams working together in challenging circumstances. What shines through is the strong bond those teams have with each other. They have drawn deeply on these reserves over the last few weeks and I am proud to have played my own part in supporting our students to enter their chosen profession, some more suddenly than expected.
So, don't forget about the allied health professional, please. For me, those three little letters - AHP - mean so much. And, although all the professions are unique, we are a strong family and provide essential (and lifesaving) care alongside our medical and nursing colleagues.
