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

Background Organizational reform has been commonplace in the response to global socio-economic changes. Rising managerialism, consumerism and marketization 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 recorded, and transcribed. Data was analyzed using thematic analysis. Findings Three themes arose from the data: (1) Fulfilling professional responsibilities; (2) Changing organizational landscape; and (3) Professional reality of rationalizing 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 labor, and re-professionalization. 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-professionalization 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.

Automated summary

Organizational reform in response to global socio-economic changes has posed challenges for healthcare professions. However, the professional implications of the latest socio-economic challenge, austerity, have been scarcely researched. This study explores the experiences of physiotherapists working on the frontline of the UK's National Health Service (NHS) in relation to austerity. Findings reveal that austerity has led to increased length of hospital stay, insufficient community services, constrained resources, and understaffing. Physiotherapists have attempted to preserve their professional status and services through strategies such as re-professionalization and restratification. These findings have implications for the wider healthcare profession ecology and highlight the need for further research.