Supporting Allied Health Professions Research

1. Supporting Allied Health Professions Research Prof Roland Petchey Director, Centre for AHP Research

2. Outline • The present state of AHP research • Their performance in RAE2008 • Issues • Identity • Organisation • Education • Conclusions

3. 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?

4. 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

5. 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)?

6. RAE 2008: Activity by quality level (Staff-adjusted mean) 3* 2* Unclassified

7. RAE2008: Submissions by outputs below international quality N&M Median = 15% AHP Median = 35%

8. How did they get here? • Issues • The identity problem • The organisation problem • The education problem

9. 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

10. NHS (England) clinical workforce (WTEs)

11. AHPs by NHS (England) numbers (WTEs)

12. AHP heterogeneity II

13. Organisation

14. EU professional regulation • ‘Dual’ system • ‘Sectoral’ professions • Medicine • Nursing (General care) • Midwifery • Pharmacy • Dentistry • ‘General systems professions’ • The Rest (including AHPs)

15. ‘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……

16. 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

17. Defining AHPs Profusion/confusion of professional titles Determining equivalence Or, “When is a dental technician not a dental technician?” BUT for AHPs…..

18. 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

19. 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

20. AHPs by HEIs (England only)

21. 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

22. Conclusions I • Fragmentation • Isolation • Lack of effective national leadership • Underdeveloped • Overlooked

23. Even by the Department of Health!!

24. Even the Department of Health!

25. 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