Finding Joy and Hope through Empowered Systems: Visiting a Community Appointment Day
14/10/2025 -
Helen Moores-Poole is a Professional Advisor for the Allied Health Professions in Scottish Government
Key to my work as a Professional Advisor in Scottish Government is network building and forever remaining curious. The best part of my job is having the absolute pleasure of meeting health professionals, especially Allied Health Professionals (AHPs), across the country to hear their stories. In celebration of AHP Day (14th October) I wanted to share with you a recent example of joy and hope.
Across Scotland we have been thinking about empowering systems and their key ingredients; being responsive to local community needs, working together to deliver outcomes that matter to people, building trust, breaking down traditional barriers to provide care closer to home. I believe that the recent initiative to bring Community Appointment Days (CADs) to Scotland contributes to all of these.
CADs are a real example of a grassroots, collaborative initiative, held in local community sports centres in areas with significant levels of inequalities. People are invited over the course of one or two days to come and have a What Matters to You? conversation with a senior clinician and tailored support. They may be directed to a talk on managing an aspect of their condition, receive direct therapy, or see a specialist. There is a partner’s area with a wide range of community stalls, perhaps smoking cessation, pelvic health, walking groups, link workers, AHP groups, benefits and mental health support or organisations such as Versus Arthritis or Alzheimer Scotland.
Developed in NHS Sussex, NHS Lanarkshire brought CADs to Scotland to address musculoskeletal waiting times. At the CAD I attended, 500 people were booked over 2 days. It was a massive coordination project and involved the whole physiotherapy team. There was a role for everyone, administrators welcoming people at the door, helping them feel settled, issuing patient passports with a smile; students supporting them to move between the various zones; support workers swapping equipment and answering questions; registered staff delivering therapy, signposting or shadowing senior colleagues to develop their practice. We’ve learned from large vaccination centres and there was a staff wellbeing zone (with cake!) and quiet area too.
It’s hard to describe the quiet industry and joy in watching this all happen and I’ve added a few links below to give you a sense. There was privacy and time to listen, connect and explore options. Wait lists not only impact the people who wait but also our staff. ‘THE LIST’ has been variously described to me as a monster that keeps you awake at night, a dark cloud, a battle to be fought…at the CADs, I saw joy and hope from staff and attendees, a feeling of working together. Run in addition to regular services as some people may not want this approach, they provide an option for a less hierarchical, community approach that’s not just new and different but maybe even better for some.
It’s an evolving model, still under longer term evaluation, using quality improvement methodologies that allows those delivering it to fail fast and learn fast; maybe moving a zone or changing the way people book.
Ruth Currie (Head of Physiotherapy), Craig Grant, (Programme Manager) and Brian Slattery (Physiotherapy Musculoskeletal Strategy Lead) in NHS Lanarkshire have shared some of their patient feedback.
“I think it’s a fantastic idea to bring together all the agencies that can help someone to improve their circumstances or health in one place and give direct access to them instead of referrals and just information. This is far more immediate and saves so much time, benefitting everyone.”
“I can’t thank the staff I have seen today enough. I felt listened to and supported. Staff were helpful, informative and understanding. The service provided today was exceptional and I hope this method of treatment continues.”
Their staff delivering the CADs reported a positive impact on their wellbeing from the pre-event preparation and training, on the day peer support and presence of the Physiotherapy Consultant who provided a vital source of clinical expertise and leadership, facilitating imaging and referral to Orthopaedics as clinically indicated.
And it’s those unintended consequences which interest me equally…the breaking down of silos between services as a result of being part of such a day. We better serve our communities when we work together and part of that is knowing who each of us are and what we offer.
CADs have also been successfully run in other NHS Boards, for example in NHS Ayrshire and Arran, in NHS Grampian for chronic pain and post diagnostic dementia support and most recently in NHS Dumfries and Galloway.
I left that sports centre in Wishaw feeling energised and in awe of our fabulous staff. This brings me joy at work.
Reflective Challenge: What brings you joy and energy at work?
Professional Advisor for the Allied Health Professions in Scottish Government
Helen Moores-Poole is a Professional Advisor for the Allied Health Professions in Scottish Government. A Speech and Language Therapist by background, she is passionate about the value of collaborative working, networks building outwith echo chambers and spanning traditional boundaries to spark bright conversations, listen deeply and grow together. Her doctoral thesis explored where health and social care meet with work around the perspectives of care at home staff supporting people with communication and swallowing difficulties. Bright ideas need space to steep and mature, brains and bodies need time to rest; in the darker months walking through the leaves along the river, being part of a street choir and book club and working with wools and textiles allows her to do this and brings her joy.
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