Our purpose was to produce, expose, and evaluate our rehabilitation manifesto. Here we report on the evaluation outcomes of the first decade of implementation.
Records of team outputs were reviewed over 20 years, 2003-2013 (pre-manifesto) and 2014-2024 (post-manifesto). Outputs were operationalised into accepted and published abstracts, peer-reviewed papers, and competitive grant income. Totals and means (95%CIs) were computed to enable comparison between the two decades. To account for annual impact (growth) independent of the strategy, an IPAT equation was configured; impact = population (UK population) xaffluence (gross-value-added (government health/education)) x technology (UK patents filed). Proportions of outputs (% of 20-year total) and standardised PAT product were computed and compared pre and post manifesto using z-tests of proportions.
Counts (%), and mean (95%CI) outputs per year increased pre-post manifesto; 49(14.6%), 4.90(1.05-8.75) to 287(85.4%), 28.70(17.44-39,96) accepted abstracts; 15(15.0%), 1.50(0.44-2.56) to 85(85.0%), 8.50(6.27-10.73) published abstracts; 15(15.0%), 1.50(0.66-2.34) to 85(85.0%), 8.50(5.79-11.21) peer-reviewed papers; and £315k(20.2%), £52k(£28k-£77k) to £1,241k(79.8%), £124k(£53k-£195k) grant income. There were statistical differences in proportions pre-post manifesto within all outputs, except for PAT product (37.5% to 62.5%).
A contiguous leadership effort to invest in the quality of physiotherapy rehabilitation team leaders and evaluate the effect on their outputs has been successful over its first decade. The IPAT approach suggests that increases in outputs were independent of any impact change experienced over the same timescale.
The project outcomes provide welcome stabilisation to the inadvertent yet material managerialism felt in healthcare as an unconvincing prioritisation toward transactional practice and incursions on critical thinking which have been observed in other public industries. Investment in staff including support of longevity in leadership can be realised in objective outputs that mean rehabilitation interventions are more, not less likely to be of a higher quality over time. Investment in clinical leadership quality generates value for patients and the NHS.
Quality
Strategy
