The people’s champion

OBE holder Bhanu Ramaswamy, rehabilitation expert for people with Parkinson’s, admits her sweet tooth is behind her choice of specialism. As a child she trailed after her doctor father on ward rounds, and sit with his elderly patients to sneak their snacks.

Born to Indian parents who came to Britain in the 1950s, she mainly grew up in Wales, missing out on the comforts of an extended family of elders. ‘So it was just lovely for me to see the older people,’ she says.

‘And of course, being a greedy little souse I used to sit by them; they’d chat and I’d eat their chocolates,’ the independent physiotherapy consultant admits.

When we speak on her day off, she fizzes with an energy barely contained by her small frame (’I am the internationally negotiated correct height of five foot two and three-quarters’), and a breathless desire to improve both the profession and herself.

She has come fresh from a consultation squeezed in between piano lessons and catching up with admin. ‘I’m a workaholic,’ she admits with her wry, self-deprecating humour, citing her heritage as the root cause. ‘With mum and dad coming across from the south of India to find a better life for the coming generations, expectations to do better thus proving your worth, and that work ethic were instilled in me from the moment I was born.

‘My physiotherapist husband, Mick Heys, is as bad, and hardly seeing one another is how remain happily married!’

When she was awarded her OBE in 2016, her nominator described her as passionate and driven. She has a slightly different take.

I’m gobby, I don’t take nonsense and I’m one of these people who, when they see a gap, does something about it. I want positive results and I can’t abide lingering.

Those positive results have brought seismic changes in the physiotherapy field when it comes to treating Parkinson’s. 

Inspired by seeing her occupational therapy assistant mum receive treatment for a back injury, she qualified in 1988. There followed a spell in the US where she was stimulated by a more holistic approach to treatment, a seed that bore fruit in 1999 when she spotted a gap in community rehabilitation. 

‘I’d seen people who were older or had a long-term condition come in as an acute admission, get outpatient rehab and classes for maybe 10 weeks,’ she says.

‘They were just getting into that habit of exercising regularly when they were discharged – with nothing out there in the community to help continue that support.’

So, with colleague Richard Webber, Ramaswamy set up a weekly exercise class for the local Parkinson’s charity in an old school in Sheffield. As the building had served as a set for a certain Robert Carlyle hit film, her first cohort of participants dubbed the class 'The Full Monty'.

Untapped arenas

The classes were an instant smash – with word of mouth leading to a clamour for more classes. ‘When other interest crept in I realised that out in the community there were loads of untapped arenas to take forward physio and interventions outside the NHS. It went from strength to strength, and over a decade, we set up five weekly exercise classes in Sheffield, and I supported the start of other classes for people with Parkinson’s around the country.’

Though two decades have seen many improvements and innovations in community rehab, she still worries about its future, particularly after service suspensions during the pandemic. ‘Prior to Covid-19, NHS services were being squeezed through constant service changes and mergers. 

I do get angry when service managers say, “This is all we can offer at this time,” – it’s not good enough. The pandemic has given an excuse to almost decimate the service that people need, but where else can they get it?’

Quality of resources

It was an equally intense response to the quality of resources for treating Parkinson’s that led to her current specialism. 

She had joined the CSP’s professional network for physios working with older people, AGILE, and ‘got roped into’ helping to run a course on Parkinson’s for members in 1999.

‘It became obvious that we just didn’t know enough,’ she says. ‘So I set about changing that.’ Ramaswamy participated in shaping the first national guidelines for dealing with Parkinson’s, then ran study days across the UK to help members translate them into clinical practice. She’s had a hand in the development and updating of Parkinson’s guidelines in the UK and Europe ever since, and also created quick reference cards for treatments that came out in 2009.

‘My opportunities through the NHS were amazing,’ the 55-year-old admits. Though she shies away from describing herself as a leader. ‘It was difficult to see myself as leader once I’d left the NHS where progressive roles position you to better influence others,’ she admits. ’I see myself more as a champion for people with Parkinson’s and older people – advocating, co-designing, co-producing – I champion the cause of the person.’

When pinpointing the reasons behind her success, which has seen her become a Fellow of the CSP and an Honorary Visiting Fellow at Sheffield Hallam University, she is careful to distinguish between drive and personal ambition. ‘My peers or mentors were always driven to accomplish higher standards for the profession and people our services were for, as opposed to having personal ambitions to do well.

‘Surrounding myself with those people helped me tap into a desire to create higher standards, to be part of collaborations to produce something more meaningful to the professional and patients.’

Olympic torch bearer 

So it is no surprise that her proudest moment was not getting her OBE, but carrying the 2012 Olympic torch through Sheffield after being nominated by class participants. 

It was particularly meaningful, she explains, as it followed her departure from the NHS, which had prompted a feeling of losing herself. ‘Once you leave a massive organisation you’re treated like a nobody. You lose your connections, and even yourself.’ She’d spent three years ‘trying to find something good’ when a Parkinson’s group in Sheffield secured funding to build on the weekly exercise classes. 

‘They gave me the leeway to see how the research on Parkinson’s could translate into practice. So I coordinated boxing training, spin cycling and education. Class members based in Sheffield helped me find venues because they could see I was doing it for their wellbeing, and they opened my eyes to what worked for them and what didn’t.’

Many friends from the Parkinson’s group turned out to watch her part of the torch relay, as did Ramaswamy’s mum on her first outing post two knee replacements. 

‘I saw so many of my family and friends there clapping as I ran past, I tried not to drop the torch with excitement – it was such a wonderful experience.

‘To be recognised by peers is amazing, but because I am driven by a social conscience, a nomination about people and from them, was a big moment.’

And it is that conscience that prompts her to repeat her advice to all physiotherapists on treating people with Parkinson’s.

‘As physios we’re often very chatty – we don’t think twice about giving two or three instructions at one go or expecting someone to remember an exercise, but what we find with people with Parkinson’s is that they may  take it in more slowly. 

‘We have the capacity and capability to set up email reminders or digital exercise prompts so make sure someone has the information to go over in their own time when they’re home.’

While she’s handing out advice, I ask if there’s a gem she’d pass on to younger generations. ‘There is no point in being involved in trying to make changes that just aren’t able to happen. For example, if you’re in a meeting that keeps repeating its agenda, acknowledge this and push to move the agenda on, or withdraw. My younger self, Mrs Hopeful, may have felt there’s always a possibility for change but now I recognise where my energy is best spent.’

And just where does she get all that energy? Maybe some of it is down to the old sugar rush? Her eyes light up. ‘I still like chocolate - I have a dominant “chocolate-craving” gene. My friends often buy me fancy chocolates, but I’m really a Mars bar freak.’