Allied Health Professions (AHPs) are the third largest workforce in the NHS, with over 2,200 employed in mid and south Essex. In the main they’re degree level professions and are independent professionals within the health and care.
AHPs work with all age groups and within all specialities, they cover a wide number of professions working in partnership with health and social care colleagues across primary, secondary, and social care, as well as in the independent and voluntary sectors, in people’s homes, clinics, surgeries and schools.
In our latest AHP blog we meet Ruth Barlow (Phys Dip Ed, MSc) from The Mid and South Essex Community Collaborative, whose training as a physiotherapist led her on a career journey to becoming the Mid and South Essex and Integrated Care System lead for long COVID.
About Ruth
I live in Braintree and I’ve three grown up children; two living close by and one in New Zealand. Running is something I enjoy and ran my first and only marathon five years ago. In my spare time also enjoy music and I’m involved in different charities raising money for disabled children going to Lourdes and locally with the St Vincent De Paul (SVP), for people who need help.
Why did you want a career in health and care?
As a child I knew I wanted to work in health care and decided physio was the role for me as it’s very diverse, combines exercise and improves people’s lives. So back in 1986 I did my training in Nottingham to become a physio and then 13 years ago I went onto to complete a respiratory MSc, as well as non-medical prescribing not long after.
I started working in Colchester Hospital, specialising in respiratory in intensive care and paediatrics, as well as working for St Andrews burns and plastics on the on-call rota to gain more experience. The work for St Andrews was challenging as the patients were far sicker than the patients in Colchester intensive care unit. Yet they were more likely to be out of bed and were even treated in a bath while on a ventilator. It was also challenging as I was working with children and adults with awful burns, especially difficult with patients who had burns to the face.
The paediatric work in Colchester was with children and babies with asthma, bronchiolitis, pneumonia, cystic fibrosis and some work with children with fractures. This work was interesting. Every day was different, and it was great to see the children improve with chest physio and exercise.
Then 20 years ago I moved to Mid Essex Community Services, later to become Provide Community and part of the Mid and South Community Collaborative, to work in respiratory, which was a big change as I moved from the hospital to community. I then went from acute to chronic respiratory conditions, which I loved, as I had more autonomy and was able to see people in their own home, which I prefer.
When you visit a person at home, in their own environment, you find out a lot about them and their situation, such as if they’re taking their medication and what support they have around them. Also, once they’ve invited you into their space for their treatment, they tend to become more relaxed than when you see them in an artificial hospital environment.
I set up pulmonary rehab programme when I first started in this job which led to me working with colleagues at University of Essex to publish research about this pulmonary rehab programme, as well as being a visiting lecturer for 20 years at the University for their physio course. It was after being the team lead for the rehab team that I then became the lead for the respiratory team, which was where I was working when the COVID pandemic reached our communities in mid and south Essex.
What happened to your role during the COVID pandemic?
At the start of the pandemic, I set up long COVID rehabilitation clinic, working with the mid and south Essex pulmonary rehabilitation leads and the Essex fatigue consultant. The outcomes for the programme showed a statistically significant change in the walking distance, quality of life and fatigue for our patients.
The advice I gave to the patients was about managing their symptoms and I worked with them for pacing, avoiding ‘boom and bust’ and encouraging rest. Exercise is difficult with people with fatigue, it has to be managed well, so patients are guided to find the level of exercise that does not exacerbate their symptoms and then gradually increase what they are doing. It’s a very different way of working as a physio, as normally we are encouraging people to exercise more, in fatigue we ask the patients to exercise less and rest more.
When funding was announced for long COVID I was involved in the application for this money, becoming the lead for the team. I also had the job of recruiting to the programme and now we’ve a great team of nurses, physiotherapists, occupational therapists, speech and language therapists, psychologists, GPs, and band three and four admin.
Last year I also started working as the Mid and South Essex’s Long COVID Integrated Care Board Lead, which this has allowed me more time to plan and consider the strategy for long COVID.
What are you doing now?
Now I mostly manage the long COVID team, as the team has grown, meaning I now see fewer patients, although I really do miss patient contact. However, I found I couldn’t do both jobs of being clinical and managing the team, although the real positive is that working as the team lead means that I can make bigger changes that affect more people.
Going forward, our focus is mostly on health inequalities, which includes repurposing the COVID ‘vax van’ as a respiratory van enabling us to continue to access seldom reached groups.
The team is helping people with long COVID to recover, something that wouldn’t otherwise be available as a service, as it can be a debilitating condition where fatigue may be severe enough that people lose their jobs and are bedbound for periods.
It’s thought almost three per cent of the population will have long COVID and this is not likely to change in the future, so we hope that the funding will continue after 2024 as it’s likely there will still be a lot of people with long COVID.
Why should someone become a physiotherapist?
If you want to improve people’s lives in a practical way, physio could be the job for you. Physio roles are very different in health care, often exercise is part of the treatment and encouraging an active, healthy lifestyle.