A brief history of the MACP
Greg Grieve, together with Joe Jeans and John Conway, was the driving force behind the formation of the MACP in 1968.
Greg Grieve trained as a physiotherapist after the war and had a particular interest in rehabilitation of function and reduction of pain. He read extensively and made contact and collaborated with several national and international colleagues including James Stoddard the author of many osteopathic textbooks, Stanley Paris, Freddy Kaltenborn and Geoff Maitland. Through this contact Greg realised that there was a global trend in physiotherapy to further our understanding of musculoskeletal problems, through a process of precise examination and clinical interpretation.
He went to work at St Thomas’s Hospital in London where Jenny Hickling, another tour de force in this field, was based and at the time that Dr James Cyriax was there. The three worked together, Cyriax having already produced his definitive textbooks on Orthopaedic Medicine and Examination. This hub of activity attracted visitors from abroad, one of whom was Geoff Maitland. This led to Greg, Geoff and Jenny running two CSP endorsed courses in manipulation at the Middlesex hospital in 1966. Geoff went back to Adelaide to set up his post graduate course.
In the UK, Greg started work on the formation of the Manipulation Association of Chartered Physiotherapists and persuading a somewhat reluctant CSP of the need to have structured validated post registration courses culminating in an exam. However, he gained support from, amongst others, Elvira Hobbs and Margaret Stewart who could see that this was the way forward and in 1968 the MACP was established as THE manipulation group recognised by the CSP. The MACP was the first CIG (clinical interest group) which required membership through examination, within the CSP.
In addition to the courses leading to MACP membership Greg and others also ran lectures and workshops, on a regular basis, which were open to any physiotherapist with an interest in this clinical field. Greg also produced a regular MACP Newsletter, which in the 90s developed into the journal Manual Therapy under the editorial leadership of Prof Ann Moore. This is now, as you know, a successful and important international peer reviewed publication, with a large readership.
A white paper proposing professional independence for physiotherapists was put forward to parliament in 1977 and in 1978 the Privy Council allowed Physiotherapists to treat patients without prior medical referral.
During the 80s the Schools of Physiotherapy gradually moved their pre-registration courses into the Polytechnics, and in 1992 all Polytechnics were converted into Universities and Physiotherapy became an all-Graduate profession. With the establishment of Academic Departments of Physiotherapy through the 80s and 90s there was now the possibility of building a further academic ladder in Physiotherapy.
The MACP already had the material for MSc level courses, so the conversion into the Universities of a MSc in Manipulative /Musculoskeletal Physiotherapy was not as far-fetched as it could have been, although persuading the Universities that it was possible to run a course leading to an Academic award and a clinical specialty was an arduous task.
The bulk of this work was led by Jill Guymer and colleagues for the Coventry University MSc and Ann Thomson and colleagues for the University College London MSc, and in the Autumn of 1992 the first 2 MSc courses leading to Membership of the MACP took their first cohorts of students at these Universities.
It was such an exciting time for the MACP but also incredibly important for the profession. The MACP led the way for post graduate education in a clinical field through an academic award. It was the first CIG of the CSP to do this. Although academic awards are not the only way to demonstrate clinical excellence it helped pave the way for our voices to be heard. Physiotherapists could now apply for research funding whereas previously applications had to have a medical practitioner or a scientist as the lead investigator.
Since this period, the number of MACP MSc programmes has grown, with the 2016 IFOMPT Educational Standards embedded successfully within programmes due to the inspiring work of Dr Alison Rushton. Dr Rushton was chair of the IFOMPT standards committee for many years and her guiding hand enabled musculoskeletal physiotherapy to flourish in the UK and internationally.
Most recently, in collaboration with the UK Musculoskeletal partnership (the UK committee that represents the interests, quality and growth of healthcare in the musculoskeletal specialty- across professions and subspecialties), a number of members supported the the UK Advanced Practice Musculoskeletal (AP MSK) Standards (2022) embedding the 2016 IFOMPT standards as the foundation. This has formalized the enacting of the 2016 IFOMPT Standards at an advanced practice level and is reflective of the scope of contemporary physiotherapy practice in the UK
The establishment of the UK MSK Standards with the IFOMPT educational standards at their core has enabled formal recognition of the rigour, quality and skill of education and practice required by MACP members across professions in the UK. It is hoped that these standards will enable the development of more MACP accredited programmes reducing unwarranted variation in post-registration Musculoskeletal specialization programmes, with student places funded directly by the NHS in England.
What is the current status of the MACP and what are the challenges we face now:
The current status and challenges for the MACP is to remain the MSK physiotherapy lead organisation, and support the multi-professional workforce re-designs required as part of Covid recovery within the private and public sectors.
The opportunities of collaboration with national education organisations in the development of advanced and consultant practice also remains central to our strategic aims.
How do we see the future of our organisation:
The future for the MACP rests on collaboration, opening across the multi-professional networks, driving the advanced practice agenda and supporting members to enact it on the ground.