Starting a new service and the blurring of roles – High volume irrigation: a retrospective and futurespective

Lucy Allen BSc, MSc, MCSP, HCPC

Lucy Allen, Clinical Specialist Physiotherapist, joined us at our recent webinar to talk about how she uses high volume irrigation in her private practice as a pelvic health physiotherapist, as well as starting a new service and the impact a blurring of roles has had on this.

Lucy previously worked at St Mark’s Hospital, London, where she had her own caseload of patients who used high volume irrigation as an adjunct to conservative therapies. She now runs her own business, Lucy Allen Physiotherapy.  Lucy stated,

“When I started at St Mark’s, I hadn’t had any prior practical experience of using high or low volume irrigation just because of the role and setting I was in.”

Once at St Mark’s, Lucy was in a team that blended the roles of both physiotherapists and nurses. This enabled her to extend her scope of practice, including the use of transanal irrigation. She also had her own caseload and was able to develop her skills in relation to transanal irrigation.

Her experience within this blended role has allowed for a smooth transition into a private practice setting. Lucy explained she has been able to use teaching aids and tools such as the Decision Guide within her practice. The Decision Guide has developed her reasoning for introducing transanal irrigation as a treatment option at her clinic.

So, what benefit did the blending of roles have for Lucy’s current role?

Lucy explains how traditionally, a physiotherapist does not have access to offer transanal irrigation to patients and instead must refer for this treatment out of their service. She was able to gain experience from a nursing point of view, this, in combination with her physiotherapy skills, allows her to offer the whole package in one place. She can provide irrigation during one appointment, meaning patients can start straight away, rather than having to attend multiple appointments in different places. This is hugely valuable and makes a big difference to patient care. 

Lucy also provided us with some great tips on what to consider when starting your own service:

  • Establish connections and networks with your referring consultants and other team members/departments who will have patients you can help.
  • Inform people about your skills and what your service can offer patients.
  • Use tools such as the Decision Guide to help instigate transanal irrigation, ensuring a smooth journey for your patient and increasing the chance of safe and effective irrigation. 
  • Having the skills and expertise on when to bring in transanal irrigation is helpful. Look into courses that use patient scenarios to learn what conditions would benefit from irrigation, as well as practical practice. 
  • Most importantly, keep learning, look out for courses and conferences where you can upskill keep up with your knowledge about bowel dysfunction and irrigation. 

To learn more about the blurring of roles, Brigitte speaks with Alice Henderson, Clinical Scientist, to hear her opinion on the topic on The Bowel Blog here.