Allied Health Professionals
Luke Akehurst Excerpts(1 week, 4 days ago)
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Luke Akehurst (North Durham) (Lab)
I declare an interest as a member of the all-party parliamentary group on allied health professionals. I thank my hon. Friend the Member for Dudley (Sonia Kumar) on initially securing this important debate before her well-deserved promotion to Parliamentary Private Secretary, and thank my hon. Friend the Member for Thurrock (Jen Craft) for leading it.
It is right that we talk about doctors and nurses when we talk about the NHS and the difference that it makes to people’s lives and the lives it saves, but we often overlook the incredible contribution that is made by the group of 14 professions known as allied health professionals. Today I want to share my personal experience of the importance of these key workers. Without them, I would literally not be stood here today in this Chamber, speaking and serving as the Member of Parliament for North Durham.
Allied health professionals worked alongside doctors and nurses, as well as a host of other clinicians and non-clinicians, to save my life when I had a life-threatening illness in 2009 and then, to my mind, gave me my life back as they worked across disciplines to rehabilitate me following severe illness and disability. In 2009, I was hit by a sudden onset neurological illness called POEMS syndrome. It is a rare type of neurological disorder caused by a tumour that can affect multiple systems in the body. I spent five months in hospital being treated for and recovering from this illness, followed by an extensive process of recovery and rehabilitation in the months and years following it.
The symptoms of my condition were similar to multiple sclerosis, meaning that they affected my nervous system, which impaired my mobility, causing me to spend a year using a wheelchair and now to use a walking stick and orthotics, which Members cannot see but—[Interruption] —can just about hear.
Looking through the list of the 14 allied health professions, I was staggered by just how many of them I had been helped by. I will confine myself today to talking about the six or seven professions in this group from which I have personally experienced help and care.
At the beginning of my illness, when I was diagnosed, it was radiographers who contributed to diagnosing the tumour causing my condition, using a range of techniques from skeletal surveys to MRI scans to, eventually, a PET-CT scan. Once the tumour and its role were identified, they mapped its location to prepare me for radiotherapy and administered 30 days of 30 Grays of radiotherapy in the basement of University College London hospital. As I recovered, they measured the shrinkage and eventual elimination of my tumour using further PET-CT scans.
More recently, I have been back to see radiographers. I can actually remember the day of my last MRI scan, because when I went in, Liz Truss was Prime Minister, but when I came back out, the people looking after me said that the Prime Minister had resigned—she was not there for that long, but it felt like a long time inside the MRI machine. The radiographers were using the MRI not because they think there is a risk of recurrence of my illness, but to measure the long-term regrowth of my nervous system.
Following on from that, physiotherapists taught me to walk again. In fact, before that, they got me standing using a standing frame, because I could not stand independently. I had an intensive two-month period of in-patient physiotherapy on the rehabilitation ward of the National Hospital for Neurology and Neurosurgery, Queen Square. That was followed by almost a year of out-patient physiotherapy at home and in Saint Leonard’s hospital in Hackney. Support from my physiotherapist took me from being unable even to stand to taking the first faltering steps using a back slab, foot-ups and a walking frame, and then to using two crutches, one crutch and now a walking stick and ankle orthotics. As part of our recovery, the physiotherapists ask every neurological patient on the ward to set themselves a higher-level balance task to walk towards. They told me that I was the first patient they had met who set a higher-level balance goal of leading a canvassing team while carrying a clipboard and pen.
The dietitians in hospital were tasked with helping me rebuild my wasted muscles. They rather kindly asked me what food I like. Fortunately, when I answered “red meat and cheese”, they agreed that, at that stage, those were the ideal sources of protein to rebuild the muscles that had wasted away over five months spent predominantly in a hospital bed. My dietitians also ensured that friends or family occasionally took me from the hospital, in my wheelchair, to Carluccio’s restaurant in the nearby Brunswick centre, because the Italian-style liver and bacon served there very usefully contained the vitamins necessary for nerve regrowth.
As I prepared for, and then adjusted to, life outside a hospital ward, there came the support of occupational therapists, who taught me how to use a kitchen from a wheelchair—and later a perching stool. They taught me how to safely pour boiling water from a kettle when my arms were weakened. They taught me how to write again using a biro, when my ability to grip a pen had gone. Unfortunately, they did not get very far in teaching me how to cook again, as I had never got to grips with cooking even before my illness and disability. They taught me how to transfer safely from a wheelchair to a piece of furniture, and then back to the wheelchair again. They asked me what I needed to do in my life, and then worked as hard as they could to get me back to doing it.
One of the most fundamental tasks that the occupational therapists succeeded in—[Interruption.] Sorry, this is a little emotional. They succeeded in enabling me to get down on to the floor so that I could play with my three-year-old son, and then to get back up again, when my legs were too weak to lift me up and down. When I left hospital, they equipped my wheelchair-accessible flat—which my amazing wife had organised at five days’ notice, after moving from a non-wheelchair-accessible home—with the equipment that I needed to use it safely, such as a seat across the bathtub to shower myself safely.
My occupational therapists oversaw my return to work, explaining to my then employers what adaptations were needed to make to my workplace. They advocated on my behalf for a graded return to work because of the severe fatigue that my illness and disability had caused. They signposted me to the support available to my employers for transport to, from and within work, and for physical adaptations from the Access to Work scheme. They also assessed my workplace to ensure that I could physically get around it from a wheelchair.
Alongside that work, podiatrists helped me with a horrible side effect of having impaired sensory nerves in my feet: I was very susceptible to ingrown toenails. At first, I could not feel them because of nerve damage, but when they cut through, the pain was excruciating. I thank the podiatrists for dealing with that, and alleviating those nasty side effects, in the first few months after I left hospital.
I still receive ongoing support from the orthotists, who, once I was able to walk, fitted me with the ankle/foot orthoses—often known as splints—that I wear on each foot. They stop me from tripping over my feet—even now my weak ankle nerves cause foot drop. I continue to rely on the orthotists’ services when having my orthoses repaired, refurbished or replaced as necessary. That reminds me: I have an outstanding appointment to schedule with University Hospital of North Durham to have my orthoses refurbished in the coming months.
I am fairly sure that operating department practitioners were involved in my treatment, when I had an operation to enable analysis of the tumour once it had been located, but as I was under general anaesthetic and completely unconscious at the time, I cannot speak for who was in the room with the surgeon.
By now, it will be clear to Members across the House that I owe an enormous debt of gratitude to a wide array of people across the allied health professional workforce. It is that gratitude that drove me to speak in this debate in order to call for greater prioritisation of AHPs in NHS workforce planning and for parity of esteem with medics and nurses. I join colleagues in asking the Minister to recognise the critical contribution that allied health professionals make to allow people like me to live happy and healthy lives.
To back that recognition, the Government could retain in the Department for Health and Social Care the roles of chief allied health professions officer and director of rehabilitation, confirm which Minister holds responsibility for AHPs—although, given the very welcome presence of my hon. Friend the Minister for Secondary Care on the Front Bench, I think I might be able to guess—and restore quarterly ministerial meetings with the Allied Health Professions Federation.
Some of the specific professions involved in my treatment face their own unique challenges, which I want to ask the Government to address. The Chartered Society of Physiotherapy, with which I have worked closely in recent months, is campaigning to embed physiotherapy leadership in neighbourhoods. I back its calls for the upcoming NHS 10-year workforce plan to expand the capacity of core community rehabilitation services. Given the record number of physiotherapy graduates, and the high level of public trust in physiotherapists, who empower people to manage symptoms and improve general health, now is the time to take advantage of the healthy supply of physiotherapists to ensure that people can live as well as possible for as long as possible.
It is clear to me that physiotherapists can play a role in the Government’s ambitious healthcare shift away from hospitals and closer communities. However, in recent years recruitment freezes in physiotherapy have risked wasting the potential of newly qualified physios, so will the Minister meet me and representatives from the CSP to discuss widening access to physio careers through apprenticeship programmes, guaranteed NHS jobs for all newly qualified physio graduates—as has been rolled out for nurses—and other challenges facing this vital workforce? [Interruption.] I will come to a conclusion as quickly as I can, Madam Deputy Speaker.
The British Association of Prosthetics and Orthotics is asking for the creation of a formal “small and vulnerable profession” designation within NHS workforce and education policy in order to trigger proportionate safeguards and guarantees for those workers. The Royal College of Occupational Therapists is calling on the Government to establish national commissioning guidance to make occupational therapy a central component of the neighbourhood health systems that the Government are delivering. Will the Minister address those particular industry concerns and outline the Government’s broader support for the whole family of AHPs?
Without those professionals, I would not have got my life back. I want to use this platform to thank them, and to say that their fantastic professions need the pay, incentives and career structure to encourage the next generation of allied health professionals to support future generations in the way that so many of them have supported me.
Type 1 Diabetes: Infant Testing
Luke Akehurst Excerpts(1 month, 3 weeks ago)
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Irene Campbell (North Ayrshire and Arran) (Lab)
I beg to move,
That this House has considered e-petition 728677 relating to type 1 diabetes testing for infants.
It is a pleasure to serve under your chairmanship, Sir Alec. I thank the petitioner, Mr John Story, for starting the petition and telling us the devastating story of what happened to his daughter Lyla, who tragically died when the warning signs of type 1 diabetes were missed. I also congratulate him on gathering over 120,000 signatures from across the United Kingdom on a topic that I know is incredibly important to him and many others: in my North Ayrshire and Arran constituency, there were 204 signatures.
The petition, which is called “Funding so all infants are offered Type 1 Diabetes Testing in routine care”, states:
“Fund mandatory offer of testing for Type 1 Diabetes in babies, toddlers, and young children as a routine part of medical assessments at the point of care.”
The petitioner met me to further explain the intent of the petition, which includes legislating so that National Institute for Health and Care Excellence guidelines 18 and 17 ensure that type 1 diabetes testing is carried out when any symptoms appear, and including information on type 1 diabetes in the red book for babies. His campaign for Lyla’s law also asks for public awareness campaigns, to help parents to recognise the signs of type 1 diabetes, and for increased accountability in primary care. The aims of the proposed law include the introduction of a “test, don’t guess” framework to guarantee timely access to care and resources and stop children reaching the point of life-threatening DKA, diabetic ketoacidosis.
The red book for babies is a personal child health record of information such as weight, height, vaccinations and necessary medicines. There is also a newborn blood spot test offered by the NHS, which tests for 10 rare conditions but not for type 1 diabetes. NICE provides guidelines and quality standards for the treatment of type 1 diabetes, and general practitioners are expected to follow the advice in those guidelines. However, it is important to note that they are not legally binding—a point that the petition addresses.
Guideline 18 provides guidelines on type 1 and type 2 diabetes for the diagnosis, treatment and care of children and young people, while guideline 17 provides the guidelines for adults. Guideline 18 states that clinicians should be aware of the signs of type 1 diabetes, and that children and young people who are suspected to have it should be referred immediately to confirm the diagnosis and provide any necessary emergency care. The petitioner’s ask is to ensure that every parent, health visitor and doctor understands that excessive thirst, frequent urination, unexplained weight loss and fatigue are not just a bug or a virus; they could be type 1 diabetes.
There is currently no national screening programme for type 1 diabetes. However, it is important to highlight an ongoing diabetes screening study called ELSA: early surveillance of autoimmune diabetes. While preparing for the debate, I met Professor Parth Narendran, a professor of diabetes medicine and consultant at the University of Birmingham, who leads the ELSA study. A University of Birmingham article states:
“Currently, over a quarter of children aren’t diagnosed with type 1 diabetes until they are in diabetic ketoacidosis (DKA), a potentially fatal condition that requires urgent hospital treatment.”
The hope of the study is that screening children for antibodies could reduce those emergency diagnoses. After a similar pilot programme in Lombardy, Italy became the first country in the world to mandate national screening for type 1 diabetes in children.
The Government response to the petition addresses screening by saying:
“The UK National Screening Committee advises the NHS on screening programmes and, in 2019 concluded that more research and evidence for the benefits of screening for autoimmune type 1 diabetes was required.”
On the ELSA study, the response advises that
“NHS England is working closely with researchers…to ensure that emerging evidence is considered in the development of future national guidance”
on type 1 diabetes screening programmes. It also refers to NHS England’s close work with Diabetes UK, which is leading a “four Ts” campaign to raise awareness of the signs of type 1 diabetes.
Luke Akehurst (North Durham) (Lab)
It is a pleasure to serve under your chairship, Sir Alec. Does my hon. Friend agree that the ELSA study proves the need for wider screening, because of the 17,000 children screened, seven were already living with undiagnosed type 1 diabetes severe enough to require immediate treatment and a further 160 had early-stage type 1 diabetes? The study results from Birmingham show that screening needs to be rolled out across the country to save lives.
Irene Campbell
I agree with the points that my hon. Friend raises. The research and emerging information from the ELSA study should be considered as soon as possible.
In Diabetes UK’s campaign, the four Ts stand for “toilet”, “thirsty”, “tired” and “thinner”. Recognising those symptoms is key to the campaign.
In preparation for this debate, I met representatives of the Royal College of General Practitioners, who advised me that after hearing Lyla’s story, they urgently reviewed their curriculum and made sure that their continuing professional development resources adequately covered type 1 diabetes symptoms in children and followed NICE guidelines. They also said that they are working with NHS England colleagues on the availability and use of point-of-care capillary blood testing for type 1 diabetes. That is a rapid finger-prick glucose test.
Oral Answers to Questions
Luke Akehurst Excerpts(1 year, 6 months ago)
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Stephen Kinnock
I find it extraordinary that yet again we see a total lack of humility and contrition from the Opposition. The key difference that we will see in how our United Kingdom works is that we now have some grown-ups in charge in Westminster, who will work with colleagues in Cardiff Bay to ensure that a rising tide lifts all boats and we improve the state of NHS dentistry across the United Kingdom.
Luke Akehurst (North Durham) (Lab)
Chris Webb (Blackpool South) (Lab)
The Minister for Care (Stephen Kinnock)
Our mental health service is on its knees, thanks to 14 years of Tory neglect and mismanagement. A staggering 1 million people are waiting to access mental health services, and vacancy rates are around 10%, the highest across the NHS. This Government are committed to fixing our broken NHS so that people can be confident of accessing high-quality mental health support when needed. That includes recruiting 8,500 more mental health workers, introducing specialist mental health professionals in every school, rolling out Young Futures hubs in every community and modernising the Mental Health Act.
Luke Akehurst
Patients tell me they cannot get access to community mental health nurses, putting huge pressure on GP practices and leading to people going to A&E in desperation. Can the Minister confirm whether the 8,500 extra mental health staff pledged in Labour’s manifesto will include much-needed nurses in the community?
Stephen Kinnock
I pay tribute to my hon. Friend, who is doing excellent work for the people of North Durham. I would also like to take the opportunity to thank our mental health nurses, who do such vital and valuable work. The Government are committed to shifting from hospital to community, and that of course includes the mental health sector. I can assure my hon. Friend that we are working with NHS England on how best to deploy those additional 8,500 mental health workers.