Rocking the boat, but knowing you have an awesome crew

1 day on from #TheBigRs conference in Manchester, my caffeine levels are on the wane and I am starting to take stock of what the whole thing means. My overriding feeling is one of motivation and positivity; you only have to look at The Big R’s hashtag to see that I am not alone.

I’ve blogged twice before on the Reasoning, Responsibility and Reform agenda. So I thought that I would have another go, mainly as the conference has marked a shift in my feelings about the future for our profession.

My previous blogging lead to JC asking me to be a panellist at the second meeting in Birmingham. Here I tried to put forward my case for greater leadership and a more defined structure for people wishing to flourish in an MSK physiotherapy career.

I have to say, following my proposition for change I felt that I was either misunderstood, or my worries were not ones felt by others. I strongly felt that leadership should come from the CSP, as they are the only body (barring the HCPC) that tie us all together.

I was working at a large teaching hospital at the time, delivering a community MSK service. I had been living the frustrations of an MSK clinician dealing with complex cases within a service that was exclusively operationally led. Clinical skill, God forbid clinical excellence was left up to the individual. Management of risk was done after the fact, and often not even then.

I could see pockets of great practice around the country, I had become fed up of trying to improve matters from within the monolith I was working in and wanted OUR profession to be universally as well led as I know it can be.

Reflecting on my own stance, I had been a boat rocker (and probably always will be), but in such a way that I was in danger of falling out, no one wants to see that.

Image courtesy of Naomi McVey [@NaomiMcVey]

I suggest that lots of you people reading this blog will recognise my previous predicament, maybe you are doing a little fist pump, or maybe you’re just annoyed at my grammar. If you do not recognise this then you are lucky! But you are not the norm.

Jack and his team genuinely put on a revolutionary conference. Not one that will lead to revolution, but one that I am sure will lead to the evolution of our profession.

Erik Meira, Neil Langridge and the simply mesmerising Jo Gibson delivered affirming keynotes; we have some brilliant leaders in our profession, whether they see themselves as that or not. However this is not where the evolution will come. These guys and gals have been epic for a while. However they cannot affect change in our day-to-day lives. Transplanting Eriks brain into mine and sitting there in clinic would not have reduced my frustration with the dysfunctional manner in which my previous employers pathways ran. In some respects, knowing how great things can be, but still having to work in a broken system is a recipe for burn-out.

So why was this conference revolutionary? It was because of the delegates. In the Big R’s movement we have a groundswell of MSK clinicians that, devoid of ego, simply want to improve our profession. The best thing is that we are ALL part of this movement. There is no entrance requirement.

As an NHS MSK clinician I know the expectations that are being put on all NHS MSK physios, from band 5 to 8. Whether we like it or not we are now MSK case managers, NHS MSK physiotherapy is often no longer about assessment to provide a physical therapy intervention. We are expected to, and should see as our role, the management of MSK health, giving advise on reducing MSK risk factors, managing MSK conditions, but also escalating when appropriate for investigation or other management. This is a complex operation, requiring high levels of clinical skill but MUST be supported by clinical governance. A system delivers this, not a single clinician.

We have people like Paula Deacon who are perfectly happy to help our whole profession deliver better services. We have working groups being set up to enable development and dissemination of best practice in this area. Now all we need is MSK physiotherapists that do not accept poorly governed MSK services that potentially allow clinical practice which does not live up to our high standards. Without this we CANNOT see ourselves as the MSK specialists that we wish to be. It is up to US to not accept second best, then be enabling of improvement of our services. The Big R’s movement is totally unique in the fact that it will do this with you.

As for the CSP, I’m not waiting for them to help. This agenda has been around for a while, they attended the conference and were a uniquely confrontational voice. I get that there are some great people working for the organisation, but they have their own agenda and what we as members are crying out for, is not what they wish to do. So like a friend who is great to have a pint with down the pub when times are good, but goes missing in a time of need, they don’t stop being a friend but I’m just not going to expect anything of them, then I cannot be disappointed.

Jack and The Chews Health team cannot change our profession, but WE can. I can. I now get that this is possible, because there is enough momentum and drive within the Big R’s movement to make this happen. Some fabulous people from all areas of our profession are behind this. We have the skills and the influence. So sign up and get involved!