Claire Granato on how new hospitals can help beyond medicine

Claire Granato is the Chief Allied Health Professional at Lancashire Teaching Hospitals NHS Foundation Trust and the Allied Health Professionals Lead for the Lancashire and South Cumbria New Hospitals Programme. She explains why it’s not just medical professionals who need to input into plans for new hospital facilities.

What are Allied Health Professionals?

There are 14 disciplines that sit under the umbrella term of Allied Health Professionals. These are: art therapists, drama therapists, music therapists, chiropodists and podiatrists, dieticians, occupational therapists, operating department practitioners, orthoptists, osteopaths, prosthetists and orthotists, paramedics, physiotherapists, diagnostic radiographers and therapeutic radiographers and speech and language therapists.

We have all ten of the professions which are found within hospital settings at Royal Preston Hospital, which sits within Lancashire Teaching Hospitals NHS Foundation Trust and Royal Lancaster Infirmary, which sits within University Hospitals of Morecambe Bay NHS Foundation Trust. Art therapists, drama therapists and music therapists are usually found outside of hospital settings and paramedics work within the North West Ambulance Trust.

Allied Health Professionals are integral to the diagnosis, recovery and rehabilitation of many patients. You will find them in every patient journey, from people living with long term conditions like type 1 diabetes, to recovering war veterans, those with planned surgeries and those who have had accidents. We work together with the wider health care team to support many patients across the hospital sites.

How could new hospital facilities help Allied Health Professionals?

The very specialist areas of expertise which fall under Allied Health Professionals can often be overlooked. They’re not usually the first thing people think of when they think about what happens inside hospital buildings.

However, by their nature, these areas of expertise require a lot of space, specialist equipment and access to computers within patient areas. Many of these things are just not possible with the hospitals in their current form and this creates limitations to the care we can provide.

We often have to be very creative to provide treatments which fit within the limitations of our facilities. In fact, we’re so limited for space at the moment in some areas that we’ve actually converted cupboards into offices for our teams. New hospital facilities would change everything.

What sort of experience could patients expect from Allied Health Professionals if new facilities were built?

Improving access to health and care services is the ultimate goal. We don’t want patients attending several different appointments with different experts in different areas of the hospital; we want to work towards a ‘one-stop shop’ for care.

With more care available in the community and single appointments for patients where all experts were present, we’d be able to reduce waiting times and visits to hospital. For example, take a patient with an upper gastrointestinal cancer attending pre-op clinic; we’d aim to have the consultant, anaesthetist, specialist nurse, physiotherapist and dietician all in one place and allow the patient to see everyone at once.

This is especially important since this patient may have travelled from Barrow to Preston for their appointment. This ‘one-stop shop’ approach, combined with new technologies such as remote monitoring for their prehab (pre-surgery) stage will be invaluable.

When patients do come into hospital, we want spaces to be designed and built with flexibility in mind. Spaces that can be multipurpose with movable walls would be a huge help. For example, physiotherapy space that can be divided into consultation areas for face-face or remote appointments but then opened out to deliver a class or group session.

You mentioned remote technology for monitoring patients. Could you tell us more about the sort of technology that would be available if we had the facilities to house it?

If we had the technology and environment to set up remote and app-based patient tracking, it could benefit the Allied Health Professionals in many ways:

• Dieticians could remotely monitor blood glucose levels in type 1 diabetes patients and remotely adjust continuous insulin infusions
• Our orthoptics team could use artificial intelligence to offer faster and more accurate early diagnosis of eye disease, preventing total loss of sight. This is already being done in Moorfields Eye Hospital (opens in new window) in London, in conjunction with Google DeepMind Health (opens in new window). We’d love to bring this to Lancashire and South Cumbria
• Telehealth (remote patient monitoring) could be expanded across a range of our services to improve care specifically to care home residents and prevent future hospital admissions. For example, providing physiotherapy or occupational therapy input for those at risk of a fall, and dietetic input for those at risk of malnutrition
• Patients undergoing rehab or pre-hab could use apps to allow physiotherapists to remotely monitor their progress with a home exercise programme. The programme could be made harder or simpler depending on the intelligence, and it could all be done remotely rather than patients needing to attend follow up appointments.

Finally, many Allied Health Professionals are active in research programmes. With new hospitals, we’d have a purpose-built estate and access to cutting edge treatments and technologies. This would open up the possibilities of research for us as well, ultimately meaning more options and better experiences for patients.