Austerity on the frontline- a preliminary study of physiotherapists working in the National Health Service in the UK

Tucker, Rachael; Moffatt, Fiona; Timmons, Stephen

Abstract

Background
Organisational reform has been commonplace in the response to global socio-economic changes. Rising managerialism, consumerism and marketisation has accelerated reforms; providing challenges for the healthcare professions. The latest socio-economic challenge, austerity, and its professional implications have scarcely been researched. This study aims to explore the lived reality of austerity as experienced by physiotherapists working on the frontline of the National Health Service (NHS) in the UK.

Methods
Ethical approval was granted by the University of Nottingham; the study was advertised via the Chartered Society of Physiotherapy online network. Two participants took part; semi-structured interviews were completed, audio record and transcribed. Data was analysed using thematic analysis.

Findings
Three themes arose from the data: fulfilling professional responsibilities, changing organisational landscape and the professional reality of rationalising and accommodating austerity. The clinical implications of austerity included increased length of hospital stay, insufficient community services, constrained resources and understaffing. Participants demonstrated attempts to preserve their professional status and services through restratification throughout the intra-professional hierarchy, changing division of labour and re-professionalisation.

Conclusions
Despite claims that austerity is coming to an end, it remained a reality for these clinicians in the NHS. Physiotherapists in this study used similar methods to preserve practice when faced with exogenous constraints as seen in medicine, such as re-professionalisation and restratification. However, this attempt to defend professionalism by a non-medical healthcare profession was met with both successes and losses and has implications for the wider healthcare profession ecology, identifying an area for future research.

Citation

Tucker, R., Moffatt, F., & Timmons, S. (2022). Austerity on the frontline- a preliminary study of physiotherapists working in the National Health Service in the UK. Physiotherapy Theory and Practice, 38(8), 1037-1049. https://doi.org/10.1080/09593985.2020.1812139

• Journal Article Type: Article
• Acceptance Date: Jul 18, 2020
• Online Publication Date: Aug 31, 2020
• Publication Date: 2022
• Deposit Date: Oct 27, 2020
• Publicly Available Date: Sep 1, 2021
• Journal: Physiotherapy Theory and Practice
• Print ISSN: 0959-3985
• Electronic ISSN: 1532-5040
• Publisher: Taylor & Francis Open
• Peer Reviewed: Peer Reviewed
• Volume: 38
• Issue: 8
• Pages: 1037-1049
• DOI: https://doi.org/10.1080/09593985.2020.1812139
• Keywords: Physical Therapy, Sports Therapy and Rehabilitation
• Public URL: https://nottingham-repository.worktribe.com/output/4993629
• Publisher URL: https://www.tandfonline.com/doi/abs/10.1080/09593985.2020.1812139
• Additional Information: This is an Accepted Manuscript of an article published by Taylor & Francis in Physiotherapy Theory and Practice on 31.08.20, available online: http://www.tandfonline.com/10.1080/09593985.2020.1812139