Perinatal pelvic health care is a new service created from the recommendations of the NHS Long Term Plan (2019). Fourteen early implementer sites are the first to set up these new services with guidance from NHS England. The majority of sites have experienced difficulties recruiting into specialist pelvic health physiotherapy roles throughout England.
This evaluation of perinatal services aims to explore the local implementation and contextualization of the services. Current progress and outcomes will be explored alongside the perspectives of multiple stakeholders involved in the development of perinatal services to identify best practice, barriers and solutions to service development and physiotherapy recruitment.
Perinatal Pelvic Health Services (PPHS) roll out
The NHS Long Term Plan committed to “ensuring that women have access to multidisciplinary pelvic health clinics and pathways across England” by March 2024. This commitment is being delivered by the Maternity Transformation Programme through the phased rollout of Perinatal Pelvic Health Services (PPHS), which will be responsible for improving the prevention, identification, and timely access to NICE-recommended treatment for pelvic floor dysfunction around birth.
Fourteen Local Maternity Systems began implementation as ‘EarlyImplementers’ (EIs) in 2021/22. Further ‘Fast Followers’ (FFs) will begin implementation from 2022/23, with full national rollout to begin in 2023/24.
Current guidance for the implementation of PPHS recommends that each service should recruit a band 8a pelvic health physiotherapist who is expected to take a leadership role to establish and embed services, as well as provide specialist care. The initial feedback to NHS England from Early Implementers has indicated that a number of services are facing challenges with recruiting into these clinical specialist physiotherapy roles leading to the need for a national service evaluation.
NHS England and NHS Improvement (NHS E/I) has commissioned 明星八卦 University as an independent clinical academic institution to work with EIs to evaluate the challenges of the current recruitment of specialist pelvic health physiotherapists and develop learning: firstly, in the form of guidance for Systems implementing PPHS from 23/24; and secondly any internal strategic recommendations for national stakeholders (NHSE/I, HEE and CSP) to support a sustainable specialist workforce.
The results of this service evaluation will inform the national work plan and service specification to support the full rollout of PPHS across England from 23/24.
Service evaluation
Aims and Objectives
- To understand their successes and challenges with recruiting clinical specialist pelvic health physiotherapists
- To develop solutions and support services with recruitment as required.
Identified questions to answer include, but are not limited to:
- What are the features of the pelvic health physiotherapist workforce?
- Who controls the pelvic health physiotherapy budget?
- What are the requirements for clinical specialist pelvic health physiotherapists in PPHS?
- What successes have Systems had with the recruitment of clinical specialist pelvic health physiotherapists and how have they achieved this?
- What have been the challenges with recruiting clinical specialist pelvic health physiotherapists and how might these be addressed (both locally and nationally)? If relevant, this should include consideration of why local physiotherapists have not applied for available roles.
- What are the current and potential gaps in training and career development for clinical specialist pelvic health physiotherapists and how could these be resolved? This will include consideration of undergraduate training in pelvic health physiotherapy and its role in the workforce challenges and possible solutions.
Methodology
A mixed methods approach will be taken across a range of perinatal early implementer sites. This will include two phases and a debriefing event.
Phase 1 Evaluating recruitment outcomes
This Quantitative phase focuses on outcomes of the early implementer sites 12 months after the commencement of the service starting. Data will be used from NHS Futures and a new questionnaire will be sent out.
Phase 2 Exploring processes
The qualitative phase will be underpinned by semi structured interviews and a final debrief event to share the outcomes with the participants and solutions to be put forward. The data will be peer reviewed by the expert panel before transposing into guidelines and recommendations for workforce planning and development within perinatal services.