As the number of older people increases, physiotherapy services are having to adapt to manage demand.
Sarah Morton, head of adult physiotherapy at Gloucestershire Care Services (GCS) talked about the healthcare picture in Gloucester. It has 76 general practices and 16 GP clusters. GCS’s musculoskeletal advanced physiotherapy practitioner team currently operates in two clusters, Gloucester City and Aspen.
‘The GP clusters each have funding to employ and develop GP-based physiotherapy services,’ said Ms Morton. ‘We are co-located with general practices and record on their system. It also enables the practices to learn from APP decision making.’
In North Wales, the primary care physiotherapy service covers a large geographical area, encompassing 105 general practices and 13 GP clusters. The team’s 21 physiotherapists work directly within practices and see patients with musculoskeletal issues as a first point of contact. They have advanced skills such as non-medical independent prescribing and injection therapy.
‘The advanced skills we have can help to relieve general practices of patient contact,” explained Stormont Murray, advanced physiotherapy practitioner in primary care at Betsi Cadwaladr University Health Board. ‘This has resulted in 30 per cent more GP availability.’ Patients are seen within clinics at each surgery with 20 minute appointment slots. ‘Patients are getting faster access to MSK expertise and it is increasing GP capacity. Patient motivation is higher in primary care and so much can be achieved in a 20 minute appointment. It’s the most satisfying area I have ever worked in.’
In Wandsworth, a team of 27 health professionals including 12 physiotherapists, a pharmacist and five exercise facilitators provide the integrated falls and bone health service. Catherine van’t Riet, clinical team leader for the service at St George’s University Hospitals NHS Trust, discussed how patients are referred into the service. GP and orthopaedic unit referrals are common.
Additionally, the team is proactive in identifying patients that would benefit from the service. ‘Our proactive, preventative approach includes case finding by looking at DEXA scan results and falls risk,’ she explained. Feedback from the service’s ‘bone boost’ participants included comments that they felt stronger and the weakness in their joints had improved.
Ms van’t Riet also gave examples of their community initiatives including a gardening project that had a 100 per cent attendance and working with Fulham FC to provide a walking football programme. ‘The service is integrated around the person to bridge any gaps,’ she said.
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