Memorandum by the Chartered Society of
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
THE CSP POSITION
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.