SEQOHS standard: how an OH physiotherapy service blazed a trail to accreditation

Crystal Palace Physio Group has become the first occupational health physiotherapy service to achieve the SEQOHS standard for occupational health services. Miles Atkinson looks at lessons learned in the process.

The announcement that Crystal Palace Physio Group (CPPG), a nationwide provider of OH physiotherapy services, had been awarded the Safe, Effective and Quality Occupational Health Service (SEQOHS) standard is a testament to how far the accreditation body has come since its launch in 2010.

Dame Carol Black’s review of the health of Britain’s working-age population, “Working for a healthier tomorrow”, published in March 2008, advocated clear standards of practice and formal accreditation of all providers that support people of working age. The Government’s response to the review, “Improving Health and Work: changing lives”, endorsed that recommendation.

A broad stakeholder group led by the Faculty of Occupational Medicine (FOM) developed standards and accreditation for occupational health services. These were launched as SEQOHS in January 2010, and FOM commissioned the Royal College of Physicians to develop and manage the accreditation scheme, which was launched in December 2010.

Since the launch, the accreditation scheme has rapidly become an integral part of the OH service landscape, accepted in both the public and private sectors as the recognised industry standard. In fact, SEQOHS is nearing the 200th OH service accreditation, which is a testament to the success of the programme.

Physiotherapy’s involvement in SEQOHS

As part of the launch of the 2015 standards, SEQOHS opened up and extended the scheme to occupational health physiotherapy services. The decision followed a successful pilot scheme run in collaboration with the Association of Chartered Physiotherapists in Occupational Health and Ergonomics (ACPOHE) in 2015. The pilot tested the applicability of the SEQOHS standards and underpinning processes for this type of service.

SEQOHS and ACPOHE worked in collaboration to ensure that the support tools for OH physiotherapy services were service-specific and practical. Although the SEQOHS standards are identical for all types of OH services, a bespoke evidence guide was designed for OH physiotherapy services.

CPPG’s experience of undergoing the assessment

CPPG provides OH physiotherapy services to a variety of public and private-sector organisations in the UK. It provides a variety of services, including onsite physiotherapy, network physiotherapy, work station assessments, functional restoration/work hardening programmes, and health and wellbeing services.

CPPG took part in the successful pilot and was keen to follow on from this and achieve accreditation. Subsequently, as soon as the full accreditation was made available to all physiotherapy providers, it wasted no time getting the assessment booked in.

Following months of preparation for the assessment, the SEQOHS assessor evidence review was scheduled and undertaken at their site in South-East London on 7 June.

Miles Atkinson, head of occupational health services, and Kathryn Moore, clinical governance lead, were the two members of the team closely involved in undergoing the assessment procedure.

The assessment team was comprised of an experienced SEQOHS assessor with a background in OH nursing alongside a newly trained OH physiotherapy assessor.

This element is unique for the SEQOHS assessment procedure where a variety of OH practitioners are involved in the assessment. It is necessary to ensure that profession-specific elements are considered, and this has the added benefit of allowing for cross-profession learning.

The standards that were covered in the physiotherapy services assessment were largely the same as those for comprehensive OH services ranging across five areas, from business probity and information governance through to people, facilities and relationships with purchasers.

While most of the standards were directly relevant and applicable to physiotherapy services, a number of unique challenges were encountered. This was largely a result of the manner in which many physiotherapy services are delivered, where the service is often sub-contracted into the larger OH service provision.

The information governance standard posed some interesting issues where the ownership and control of medical records needed to be carefully considered. As physiotherapists often keep their own separate clinical records as independent practitioners, integration into the existing employees OH records needed to be accounted for.

In situations where the OH physiotherapy service used the existing OH service provider’s record management system, consideration of transfer and access to medical records needed to be clarified and considered.

The assessment of the relationships with purchasers was another area that required careful consideration. Clarity on the specific service level agreements and key performance indicators was required. This is an area that many OH physiotherapy providers would need to tighten up on, to ensure the contracted services are clearly defined and delivered upon.

Improved measurements of the effectiveness of the service through needs assessments and outcome measures was also part of this standard and required thought on how this could be achieved and implemented in a physiotherapy context.

This is an area that OH physiotherapy needs to work harder on and is currently building its resources to provide evidence of the effectiveness of OH physiotherapy in conjunction with ACPOHE and the Charted Society of Physiotherapy.

The future for the SEQOHS standard and physiotherapy

SEQOHS is looking abroad to become an internationally recognised set of standards, with Canada, in particular, interested in using the service.

The next step is promoting the importance of choosing a provider that is SEQOHS accredited to purchasers of OH services.

Many more OH physiotherapy providers are signed up for assessment and hopefully within the next few months will successfully achieve accreditation. SEQOHS is a unique opportunity for improved cross-professional learning and collaboration and will hopefully build on the multidisciplinary approach required when delivering an OH service.

In a time where cost is often prioritised over quality, it is encouraging to see there is an organisation that puts quality at its heart. This can only be a positive result for all those involved:

• For the providers, who can feel confident they are delivering a high-quality service.
• For purchasers of services, who will know they are paying for a service with an independent stamp of approval.
• For the individual employees, who will ultimately receive a service of the highest possible standard.

CPPG is one of the largest independent physiotherapy providers in the UK, offering physiotherapy services to the NHS, private and occupational health sectors.

Its mission is to be a leader in the UK physiotherapy industry, through a commitment to excellence in clinical standards and customer service. Further information can be found at www.cppg.co.uk or by contacting Miles Atkinson at [email protected]

Comments on the process

Dr Robert Hardman, chairman of SEQOHS

“Congratulations to Crystal Palace Physio Group on becoming our very first occupational health physiotherapy service to achieve SEQOHS accreditation.

“This is a significant achievement, which is testament to the company’s hard work and commitment to deliver a high-quality care service, and is something that they should be immensely proud of.

“We now look forward to working with and supporting other occupational health physiotherapy services in working towards the accreditation standards set by SEQOHS.”

Miles Atkinson, head of OH physiotherapy services at CPPG

“We found the whole experience extremely thorough yet ultimately very rewarding. The process forces you to really examine the service that you are delivering and view it in a more holistic manner.

“It ensures that you consider multiple stakeholders when delivering effective OH services, including the client that is purchasing the service, the employee that is accessing the service, and right through to the staff members delivering the service.

“By measuring yourself against a set standard, it allows you to ensure that the services you are delivering to your customers/patients are of high standard.

“It also ensures that the health, safety and professional development your own staff are considered, thereby allowing them the optimal working environments to better meet the clients’ needs.

“We also hope that as more physiotherapy providers undergo the assessment and that the importance of using a SEQOHS accredited provider is promoted, that the overall profile of OH physiotherapy is raised.

“It is hoped that being a SEQOHS accredited provider will afford us some commercial advantage by putting us at the forefront of quality assurance.

“It will allow purchasers of OH physiotherapy confidence in the standard of services they are investing in.”

Mark Armour, chairman of the ACPOHE

“The SEQOHS standards allow OH physiotherapists to demonstrate their commitment to excellence and quality.

“It is a great opportunity for physiotherapy services to work towards an established and respected mark of accreditation. The benefits of SEQOHS are diverse.

“It is a process that can help to generate a culture of continual improvement, and offers independent validation of a safe, effective and quality service.”

Stuart Paterson, founder and director of CPPG

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“SEQOHS is recognised as the gold standard assessment in the OH industry, and it is fantastic that it has now been extended to OH physiotherapy.

“As a result, we are absolutely thrilled and delighted to be the first occupational physiotherapy provider to be assessed and accredited. To receive this and be recognised is quite an achievement for the whole of our team.”