We are all aware of the difficulties meeting the demand for GP appointments that prevails across the country. Many initiatives are being trialled to improve the situation. Since around 25% of GP consultations relate to musculoskeletal (MSK) conditions, finding alternative ways of helping this specific patient group could potentially free up scarce GP time and allow patients prompt access to specialist MSK expertise. A successful pilot study in South Lakeland has utilised an experienced MSK physiotherapist, operating in an Advanced Practice role, and has demonstrated very high patient satisfaction, with a very high percentage of patients being successfully managed without referral back to the GP, releasing appointments for more complex medical cases. Examples of similar services are beginning to develop in other regions.
From May 2017, Advanced Practice Physiotherapy (APP) clinics will be available at Windrush Medical Practice. Initially, clinics will run Monday AM and PM, Wednesday AM and Thursday AM. We envisage expanding the service to 8 clinics per week as it develops.
The APP clinics are there to manage a full range of MSK problems, both spinal and peripheral. Experience suggests we will see a lot of back pain and sciatica, neck pain, knee and hip pain, and shoulder problems.
Where needed, appropriate pain relief and/or investigations can be arranged. It may be that referral for management under the local physiotherapy or podiatry service is appropriate, or that the problem needs onwards referral to a hospital specialist. All can be managed within the APP clinics. It is anticipated that with prompt access to appropriate advice, many patients will successfully self-manage their problem before it becomes chronic and harder to resolve.
Windrush patients may elect to access the service when they arrange an appointment, or it may be suggested to them once the telephone receptionist has established the nature of the problem. Equally, it may be that the GP suggests an APP appointment to clarify optimal management.
The service will be staffed by experienced Chartered Physiotherapists. My own experience is of 19 years within the NHS working with MSK patients. For a substantial proportion of this time, working as an Extended Scope Practitioner in Spinal Neurosurgery, and more recently, as Team Lead in a large primary-care physiotherapy service in Oxford. We are currently recruiting further clinicians.
From a personal viewpoint, I have long advocated that services could be configured in this way, to ensure prompt provision of high quality care to MSK patients. I’m delighted to be involved in this initiative and determined to see it develop and progress
Chris Braund, MCSP
Advanced Practice Physiotherapist