Prime movers: CSP members can help GPs cope with ever-rising demands

The National Audit Office (NAO) is a powerful statutory body in Westminster with a remit to scrutinise public spending independently for parliament. It aims to hold government to account and improve public services.

The NAO published a report titled Stocktake of access to general practice in England in November. This confirmed that primary care is facing a rising demand for services while there is a crisis in GP capacity.

The report says there is an urgent need to improve the quality of data relating to how services manage supply and demand issues, given satisfaction rates among patients are falling and that they face problems in gaining access to GPs.

It also highlights how other health professionals are dealing with the rising demand for GP services, and how practices are starting to use other health professionals in various ways.

Increasingly, policymakers and clinical leaders are looking into role substitution. For example, the West Wakefield Health and Wellbeing Project is working on the hypothesis that 50 per cent of local GPs’ workload could be undertaken by other healthcare professionals. Programme director Dr Chris Jones said: ‘I want physiotherapy to form a significant part of this 50 per cent.’

Primary care can flourish when physios support GPs

The CSP has argued that primary care can only flourish if the physiotherapy staff get the go-ahead to work at the top of their professional capability and reduce demands on GPs.

The crisis of GP capacity has renewed interest in the self-referral model of access for physiotherapy. Some GP surgeries are offering patients an appointment with a physiotherapist in the practice instead of a GP – to do the initial assessment and triage – so that patients who need advice, exercises and discharge are dealt with straight away by an expert, and waiting lists for physiotherapy services are shorter.

In order to persuade GPs, trusts and commissioners it is essential that we use the strong evidence we have, and that we continue to build on this.

Data on the impact on patient satisfaction, on patient demand (such as repeat appointments), on GP capacity, on patients’ lives (such as being fit for work, ability to self-manage), on numbers of X-rays and scans ordered and consultant referrals, on patient safety (such as picking up red flags), levels of prescribing and the impact of having prescribing physios. These are all essential parts of the evidence the profession needs to bring to the table.

While the current context provides some real opportunities for physiotherapy, it also brings significant threats.

We only need to look at Mid Essex where commissioners, in an effort to save money, are consulting on whether to drastically limit access to musculoskeletal physiotherapy services or cut them completely to see this.

Evidence showing the impact of physiotherapy services in primary care is critical in persuading local providers and funders of the need for services as the system develops.

The CSP must influence policymakers on a national stage, convincing them of the need to expand physiotherapy and to continue producing resources that members can use to make their case locally. 

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