Tell me a bit about your background as a physiotherapist.
I qualified as a physiotherapist in 2010 and began my career with the NHS in Brighton, where I gained experience across various specialities. In 2013, I moved back to London and joined Guys and St Thomas, initially working with adults before transitioning to paediatrics.
For the past seven years, I have been part of a community team focused on children’s physiotherapy. This role has allowed me to be creative in my approach, providing therapy in diverse settings such as schools, swimming pools, play centres, and soft play areas, homes and in clinical environments. My goal is to deliver physiotherapy support that is tailored to each child’s unique needs, ensuring that therapy is both effective and accessible, no matter where it takes place.
Why did you decide to specialise in physio for babies, children and young people?
Even before I began my career in physiotherapy, I knew I wanted to work with children. The variety in medical presentations among children, from orthopaedic to neurological conditions, fascinated me. I enjoy the challenge of treating a wide range of conditions and getting to know the children, their families, and their schools.
Physiotherapists often become closely involved with families, taking on roles that include signposting and liaising with other professionals. This aspect of the job is similar to case management, as it involves coordinating care and building strong relationships with families. Children can remain in the service from birth until they turn 19, allowing me to follow their journey and support them throughout their development.
Why the change from physiotherapy to case management?
I had been contemplating a career change for some time and wanted to leverage my transferable skills while moving away from the NHS and a purely clinical role. Case management offers me the opportunity to utilise my experience in a more flexible and dynamic environment, allowing me to continue making a positive impact on people’s lives.
Can you give an example of how you’ve supported a child to achieve a specific goal?
I once supported a child with a brain injury to get involved in disability football. Initially, we focused on rehabilitation at home and in the clinic, followed by exercise programmes that could be done at home and school. As the child progressed, we moved on to more dynamic activities like football skills. I also researched and found places where he could play football with peers who had similar disabilities. This not only helped maintain his strength and fitness but also provided significant mental health benefits.
What approaches do you have to take when it comes to supporting parents and managing their expectations? How do you build relationships and what’s important when it comes to building relationships?
I always make sure to tailor my approach to each individual child and family. In the area I worked as a physio, there is significant diversity in socio-economic status, education, culture, and language, so I would take these factors into account and provide as much or as little education and support as they were ready for. Some families are in a grieving cycle because their children have gone through a lot, so my communication style depended on where they were in their journey.
I maintained open communication channels, whether through WhatsApp, email, or phone calls. Families often sent me pictures and videos to review their children’s progress. I regularly taught families and others involved in the child’s life, such as teachers, to help them support with physiotherapy. I also assisted families in adapting their interactions and playtime with their children to support physiotherapy, including modifying toys and techniques.
Additionally, I got involved in organising equipment trials for items like walkers, aids to help children stand, and specialist chairs, ensuring that families had access to the tools they needed to support their child’s development.
Is there a particular case throughout your career that has really made an impact on you and why?
One of the first families I worked with had a newborn baby who suffered a severe brain injury due to medical negligence. I worked with this family until the child started school, building a strong relationship with them over the years. Physiotherapists often spend a lot of time with the child and their family, and I found myself helping them navigate their care beyond just physiotherapy.
For example, when I first started working with this family, I created a photo library of all the different professionals who would be supporting their child. This helped the family understand who each person was and what their role would be, making the process less overwhelming.
I also focused on helping the family bond with their child, whose communication was severely affected by the injury. Since the child couldn’t smile or laugh, we had to find other ways to foster a connection and ensure a good quality of life. Some of the interventions included spending time in a sensory room, where the child enjoyed music and lights, and showing the family how to support their child in the swimming pool so they could have those experiences together outside of physiotherapy sessions.
I always involved the child’s siblings to ensure they could build their relationships as well, doing activities like reading books and singing songs to make sure the child was fully integrated into the family. I supported the child and the family until they started primary school, helping them choose the right school by setting up visits and accompanying them to understand what each school could offer. This made the transition to school life much smoother for the child.
What are some examples of birth-related neurological injuries? Symptoms?
Cerebral palsy is the most common birth-related neurological injury we encountered. I used to work on neonatal units in hospitals, providing physiotherapy. The earlier children receive support, the better their neurodevelopmental outcomes. There is substantial evidence suggesting that early intervention can promote brain remodelling, leading to improved outcomes. Although the diagnosis of cerebral palsy often comes later, around 1-2 years of age, we provided support from birth to help the child.
In addition to cerebral palsy, I have also worked with children with various conditions, including Down syndrome.
Can you tell me about some of the innovative solutions you’ve put in place to ensure excellent care?
I always tailored my approach to each child’s interests. For example, I would create an exercise programme that includes Pokémon to make it more engaging for a child who enjoyed Pokémon. I often worked in play-focused settings, like soft play environments because children respond better there than in clinical settings. I’ve even joined PE sessions at school and completed Jo Wickes YouTube classes with children. Whatever they’re interested in, I adapt to that. They can bring their toys, and I’ve done sessions in the swimming pool using their bath toys to make it fun. It’s important to keep therapy enjoyable, especially if they’re in it for many years.
As children get older, much of their therapy might take place in school. I would aim to engage them in clubs and extracurricular activities because it’s fun and helps maintain their strength and fitness. This could include activities like disability sailing, horse riding, or wheelchair sports such as boxing and basketball. I do the research for families to help them find suitable activities for their child. These activities not only help with physical fitness but also boost their confidence and allow them to find peers with similar conditions, which has huge benefits for them.
Tell us something interesting about yourself.
Much of my spare time is spent with my children. We love outdoor activities, and one that’s a bit different is attending ‘forest school’, where we toast marshmallows on the campfire and make mudcakes! I also enjoy practicing yoga and being outdoors, especially at the beach.
What attracted you to HCML?
I didn’t know much about case management initially, but a colleague recommended it to me. I was drawn to the role because I had the relevant transferable skills. The flexibility and variety the role offers are also a huge plus.