British Association of Hand Therapists

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BAHT History - Its Formation and Development

Nathalie Barr

The development of hand therapy within the UK

The recognition of hand therapy skills began in the 1940’s during the Second World War. Servicemen suffered severe injuries to their hands, faces and limbs. Specialist rehabilitation units were established, where plastic and orthopaedic surgeons developed their expertise in hand surgery.  Working alongside them, occupational therapists and physiotherapists also improved their knowledge and skills in rehabilitating hand injuries.

In 1946, the first civilian day rehabilitation centre was opened in Grimsby, Lincolnshire, with R. Guy Pulvertaft in charge – an orthopaedic surgeon internationally renowned for his work in hand surgery. Working alongside him was Nathalie Barr then Smythe (one of the pioneers of hand therapy).

In 1947, Farnham Park Rehabilitation centre opened in Slough, Berkshire. Here, the therapist Mary Jones developed expertise in industrial hand injuries, producing some of the earliest recorded work of hand therapists.

Hand surgeons continued to develop hand services during the 1950s and occupational therapists and physiotherapists became recognised as integral members of the hand team.

The 1960’s and 70’s produced further advances in knowledge and interest in the field of hand therapy. Skills in the treatment of peripheral nerve injuries were developed by Maureen Salter, a qualified physiotherapist while working closely with Wing Commander Kit Wynn-Parry at RAF Chessington.

During the 1970’s and 80’s, teams of occupational therapists and physiotherapists who specialised in rehabilitating the hand began to evolve.

These teams included:
Lynda Gwilliam and Ann Birch at the Wrightington Hospital
Sheila Lawton and Bobby Jarvis at the Canadian Red Cross Hospital, Taplow, Bucks
Carole Bexon and Megan Greenstock at Odstock, Salisbury
Sue Boardman and Annette Leveridge at Mount Vernon, Northwood
Victoria Frampton and Alison Monteith at the Royal National Orthopaedic Hospital, Stanmore
Carol Robertson and Dawn Gillie in Newcastle.

Established hand centres including Farnham Park Rehabilitation Centre, Derby Royal Infirmary and the London Hospital and clinical groups in physiotherapy and occupational therapy held study days, workshops and seminars.  Development of new materials and skills for splinting were pioneered across the UK,  Lynn Cheshire at Farnham Park being one of the exponents of this speciality.

The Start of BAHT
The British Association of Hand Therapists was formed on 4th February 1984, with the support and collaboration of the British Society for Surgery of the Hand, which continues to this day, the first Chairman of BAHT being Maggie Ellis.  The first Newsletter was distributed to all members in Summer 1984 and the original Hand Logo was designed by Heather Unsworth.

The first conference was held at Warwick University in 1986, the opening paper was given by Nathalie Barr, and entitled “Development of the Hand Therapist”. The formation of BAHT was described as “a crucial step in the development of hand surgery facilities in the United Kingdom” by the then honorary president, Frank Burke.

During the late 80’s, a working party on postgraduate education was formed. It was agreed that “hand therapists should be able to recognise their lack of training in certain skills” and that the aim of BAHT was to “provide the means for acquiring these skills where possible”. In 1990 the first basic hand course was piloted at Harlow Wood Hospital, Nottingham. The first validated BAHT course was run at the Bristol Royal Infirmary a year later. It proved to be a most successful venture, meeting the needs of hand therapists across the UK – the start of what has become a prestigious postgraduate BAHT training programme.

International Links
International liaison began, initially between the United Kingdom, United States, France and Belgium. BAHT was represented at meetings of the French and Belgian Hand Societies, culminating in the formation of the International Federation of Societies for Hand Therapy in 1989 and the European Federation in 1990.

In June 1994, the second EFSHT meeting was organised by BAHT with the Irish Hand Therapy Association in Dublin, led by Lynda Gwilliam and Ann Birch. The guest speaker was Dr Wynn Parry giving a historical account of the development of hand therapy.

Nathalie Barr Award
In 1993 Nathalie Barr died and in her memory an award was set up to honour those that have made outstanding contributions to the development and recognition of hand therapy. Award winners are nominated by their peers.

To find out more about the Nathalie Barr award, click here

In 1994, Maureen Salter was given the first Nathalie Barr Award. Between 1994 and 2010 there have been six Nathalie Barr award winners – Maureen Salter, Annette Leveridge, Victoria Frampton, Kate Beresford, Lynda Gwilliam, and Tina Jerosch-Herold.

1996 brought changes in the organisation of BAHT.  Having previously had charity status, BAHT was registered as a company with the Chairman and Treasurer named as Directors.

Since 1996 there have been further development of standards and validation, educational advancement and research. Members now have the opportunity to apply for various awards and bursaries to further their careers.

There are now set pathways for therapists to gain the award ‘Accredited Hand Therapist’.  The first award of “Accredited Hand Therapist (BAHT)” was presented to Bridget Ellis in September 2001. And in 2011 we hope to have one of the first European Accredited Hand Therapists.

BAHT could not succeed without the dedication of its committee members, but it is only by the work of all members of the association and the interchange of ideas, research and enthusiasm, both in this country and abroad, that the work, pioneered by Nathalie Barr, Mary Jones, Maureen Salter and others continues to progress the development of hand therapy.

References
Barr N (1986)  Opening Paper at 1st BAHT Conference. BAHT Newsletter No 5

Swann D (1993)  In Memoriam Nathalie Barr.  The British Journal of Hand Therapy May 1993 Vol No 6

Jones MS (1960)  An Approach to Occupational Therapy.  Butterworth
Wynn Parry CB (1958)  Rehabilitation of the Hand.  1st Edition Butterworth

Leveridge AC (1997)  A History of BAHT Part 1.  British Journal of Hand Therapy  Vol 2 No7

Leveridge AC  (1998)  A History of BAHT Part 2.  British Journal of Hand Therapy Vol 3 No 1