Thousands miss out on treatment as physiotherapists are struck off UK register

Thousands of patients have been left without vital healthcare after nearly one in 10 physiotherapists was prevented from practising after their regulator removed them from its register.

Exactly 5,311 physiotherapists were deregistered by the Health and Care Professions Council (HCPC) on 1 May because they had not renewed their registration after the HCPC decided not to send out reminder letters.

Ash James, director of practice and development at the Chartered Society of Physiotherapy (CSP), said its helpline had been swamped with calls from distressed physiotherapists, concerned for their patients and worried about dramatic losses in income.

“In one of the trusts in Liverpool, 23 physios were sent home in one day, and obviously the implication for patients is huge,” he said.

“At a time when the workforce is stretched by the Covid backlog, it’s obviously not ideal that we’ve lost 9% of the workforce overnight.”

Physiotherapists have many roles but play a crucial part in helping people leave hospital after long stays, because lengthy bed rest leads to muscle wastage that leaves patients needing physiotherapy to learn to walk again.

So far, only about 2,300 physios have been re-registered. With most practitioners seeing at least five patients a day, the number of cancelled NHS and private appointments in the past two weeks could range between 50,000 to 100,000.

The UK’s 61,000 physiotherapists are among 15 health professions regulated by the HCPC, along with paramedics, podiatrists, radiographers and occupational therapists – known as allied health professionals.

Every two years, they must fill in a renewal form showing they have continued to work on their professional development and are fit to practise. There are three months to complete the process and the date is fixed, but usually only a small number of practitioners accidentally miss the deadline. The CSP said this year’s problems were due to the HCPC decision to switch away from letters and rely on email and text message reminder.

Some physiotherapists did not receive a reminder email because they had been on maternity leave without access to email. Others had changed jobs, or lost access to old email addresses.

A senior NHS physiotherapist said two members of her team had been downgraded and lost 25% of their pay as a result.

Another physiotherapist who had left the NHS to work privately has lost two weeks’ pay so far. She turned up at the HCPC’s headquarters in tears trying to pay for her renewal, but no one would see her.

“I have had to cancel patients for two weeks,” she said. “My husband doesn’t work – I have lost two weeks’ pay. One patient had come from Germany to see me and I had to cancel.” Some of her patients are vulnerable because they have neurological problems, she added, and need help to avoid falling and injuring themselves but she was not allowed to see them.

“I’ve been waking up at 3am and crying. I feel broken and helpless and sick, just because I missed an email. Even the gas company will give you three warnings. But this has cut off my livelihood,” she said.

Andrew Smith, the HCPC’s executive director of regulation, said 99.6% of its emails had been delivered, although he was unable to say how many were opened. He said they sent a reminder on 12 April and a newsletter, and also sent text messages.

“People forget and don’t renew and it can be very stressful for someone who didn’t renew in time,” he said, adding that they worked with the CSP to find different ways to remind people. “We never see 100% of a profession renew – people retire, take career breaks, maternity and paternity leave. The normal range is between 90% and 97%. With physios this year, it’s 91%, within the normal range.”

The CSP said usually 1,000 to 1,500 people left the profession each year, which would mean a renewal rate closer to 97%.

Asked if the HCPC would expect to see similar numbers of physiotherapists removed from the register in future years, or if the body is looking at reforming the process, Smith said they would “always try to look to see if we can do things better – most organisations would want to do that”.

He said they used a similar renewal process to other healthcare regulators, and that it was also the responsibility of employers to ensure that their staff met regulatory requirements.

The CSP’s James said: “Of course, registrants have a personal responsibility to ensure they remain on the register. But the processes from the HCPC are just poor, and I’m concerned about the urgency of their response.

“It’s not acceptable from our point of view. The sole purpose of the regulator is to look after the patient. And in this instance they have failed that on a number of occasions.”

The Guardian