Physios to be first contact for common aches and pains in GP practices

Author: Caroline White
Physios to be first contact for common aches and pains in GP practices

Plans announced by NHS England to roll out an enhanced physiotherapist service in GP practices to treat common aches and pains have been given a cautious welcome by the Royal College of GPs, amid concerns that the push to boost the GP headcount will lose some of its momentum.

The proposals come on the back of successful trials in 41 areas of the country, including in Nottingham, West Cheshire, and Gloucestershire, where patients have chosen to be assessed and treated for back pain, arthritis and other muscle, bone, and joint conditions by physiotherapists with enhanced skills based in GP practices, rather than waiting to see a GP to get a hospital referral.

Evaluation of the service found that in some areas they delivered hundreds of thousands of pounds of savings, while patients rated the care they received very highly.

And a new poll of 2,005 UK adults conducted by Opinium on behalf of the Chartered Society of Physiotherapy, shows that nearly three-quarters (73%) of respondents said they would take an appointment with a first contact physiotherapist if they were offered one for a bone, joint or muscle problem, with fewer than one in 10 saying they wouldn’t.

The service will be rolled out as part of the NHS Long-Term Plan, which aims to cur hospital appointments by around a third in a bid to make the NHS more efficient.

It will mean that patients will be able to book convenient appointments directly with physios and other expert health professionals at a local practice, without the need to wait for a referral or to travel to a specialist clinic.

Initial findings from the pilots, supported by NHS England’s Elective Care Transformation Programme, show that up to seven in 10 patients were successfully discharged from care after just one consultation, and one part of the country reduced the number of people requiring long-term physiotherapy care by a fifth. The service also helps people to manage their arthritis.

One practice managed to free up an extra 560 appointments over the course of a year by adopting this approach.

Professor Stephen Powis, NHS medical director, said: “More physios based in community GP surgeries…is a great example of how the NHS Long-Term Plan will increasingly deliver more care options closer to home over the coming years.

“Achieving this improvement and crucially, giving patients more options, will also have an impact on how we currently measure waiting times for care, which is why we are working with clinicians and NHS leaders to design and test new systems, which better reflect modern care and patients’ needs and outcomes.”

Professor Karen Middleton, chief executive of the Chartered Society of Physiotherapy, said: “The most important thing for patients is to see the right person at the right time and placing physiotherapists in GP surgeries allows them to do just that.

“It speeds up access to the expertise they need, while reducing the likelihood of them having to attend further unnecessary appointments or undergoing tests they don’t require.”

More than 100 million hospital appointments take place in England each year- around double the number a decade ago-with referrals for treatment rising by around 4% each year.

Commenting on the proposals, Professor Helen Stokes-Lampard, chair of the Royal College of GPs, said: "General practice is currently facing intense resource and workforce pressures and expanding the practice team to include clinical colleagues like physiotherapists is key to addressing this, and freeing up our time for patients who need our expert generalist skills.

"Physiotherapists are highly-skilled healthcare professionals who are expert at dealing with a multitude of musculoskeletal conditions that cause many patients a great deal of misery. This scheme has shown that having them working in GP practices is beneficial for both patients and general practice, and cost-effective for the NHS, and we welcome the further expansion of this initiative.”

But she cautioned: "However, physiotherapists like any other member of the wider practice team, must not be seen as a substitute for GPs, and we must continue to do everything possible to build the GP workforce by the thousands we desperately need to ensure the long-term sustainability of the NHS and patient care."