Select Committee on Health Written Evidence

Memorandum by the Chartered Society of Physiotherapy (SP26)


  1.  The Chartered Society of Physiotherapy (CSP) is the professional, education and trade union body representing the UK's 45,000 physiotherapists, physiotherapy students and assistants. More than 98% of all physiotherapists in the UK are members of the CSP and physiotherapy is the third largest health care profession. Approximately 60% of chartered physiotherapists work in the NHS. The remainder are in education (including students), independent practice, the voluntary sector and with other employers, such as sports clubs or large businesses.

  2.  Physiotherapy involves the skilled use of physical interventions to promote, maintain and restore physical, psychological and social well being. Using problem solving and clinical reasoning, physiotherapists work to restore functional movement or reduce impairment utilising movement, exercise and the application of electro-physical modalities.

  3.  The Chartered Society of Physiotherapy welcomes the Health Select Committee's inquiry into the smoke free elements of the Health Improvement and Protection Bill. Health promotion is a crucial aspect of the work of physiotherapists. They have a primary interest in the cessation of smoking and reduction in exposure to cigarette smoke, as so many come in to direct contact with the harmful effects of smoking on patients. This is particularly true for physiotherapists working in oncology and in respiratory care. Physiotherapy also plays an important role in cardiac rehabilitation and amputee rehabilitation, conditions that often result from smoking.


  4.  The CSP advocates a total ban on smoking in enclosed public spaces. It would be both a progressive step for the health of the nation and a necessary step to protect non-smokers from the harmful effects of tobacco smoke. We have drawn on three major elements to support this policy.

  5.  The physiotherapy profession is heavily involved in the treatment of patients suffering diseases caused by tobacco inhalation, and has a primary interest in supporting moves to ban smoking in public places. While the main and obvious effects of smoking are in respiratory conditions and oncology, cardiovascular conditions are also exacerbated by smoking. Physiotherapists often see the impact of smoking when undertaking cardiac rehabilitation and amputee rehabilitation.

  6.  Chronic Obstructive Pulmonary Disease (COPD) also deserves particular mention by the Society with reference to the harmful effects of tobacco smoke inhalation. COPD is the name for a collection of lung diseases including chronic bronchitis, emphysema and chronic obstructive airways disease. It is directly caused by smoking and results in around 300,000 deaths a year in the UK. Physiotherapists are able to help people with COPD to manage their condition, but it is not reversible.

  7.  Chartered physiotherapists in respiratory care report that over 50% of their workload is devoted to this patient group. Physiotherapists are involved in the care of COPD from acute hospital admissions through to maintaining patients in the community, employing evidence based initiatives such as early supported discharge, non invasive ventilation and pulmonary rehabilitation. This patient group often has complex management problems and physiotherapists often assist in helping to manage chest clearance, coping strategies, breathlessness and anxiety management in conjunction with other multidisciplinary team members. Physiotherapists report that people who have been smoking for as little as five years could start to suffer symptoms of COPD.

September 2005

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Prepared 19 October 2005