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More physiotherapy in A&E could relieve pressure

The latest 'Physiotherapy Works' briefing from the Chartered Society of Physiotherapists (CSP) highlights the valuable role their members can play in A&E departments.

Winter pressures on A&E departments are exacerbated by the large number of people, particularly the elderly, presenting with musculoskeletal (MSK) injuries. Therefore, having a physiotherapist on hand to help with assessment, diagnosis and management seems to make sense. As the CSP briefing puts it,  "Physiotherapists in accident & emergency use expert knowledge and skills to improve patient care and flow, preventing unnecessary admissions, restoring function and enabling independent living."

As a recruitment company that works with locum physiotherapists across the UK, we thought we'd help spread the word. One of the key aims of the CSP's briefing is to raise the profession's profile with commissioners, GPs and managers. "If you're going to a meeting with managers, you should have some copies ready to hand out – like a department calling card." said CSP professional adviser Eve Jenner.

About 20% of the 18 million or so people who attend an A&E department each year have MSK injuries, at a cost to the NHS of around £440 million. Using the skills of physiotherapists is not just about relieving pressure on already stretched doctors and nurses. It's also about cutting waiting times and admissions, as well as reducing length of stay and helping to alleviate bed shortages.

If you're a physiotherapist with experience of working in A&E, you may be surprised that this issue hasn't been given greater prominence sooner. As long ago as 1996, a study published in the Journal of Accident and Emergency Medicine concluded that "an A&E based physiotherapy service results in a greater referral rate and shortened time between referral and first treatment".

The experience in other countries seems to endorse this. According to a briefing by the Canadian Physiotherapy Association, two research papers (published in 2010 and 2011) found that physiotherapy assessment and management "decreases length of stay in the Emergency Department and wait times without any increase in adverse events". In her blog on the website for Australia's Peninsula Health, physiotherapist Jacqui talks about her work in A&E, describing it as a "really satisfying role to hold" and a "great example of where physiotherapy as a career can lead you".

That's not to say there are no UK hospitals making good use of physiotherapists in emergency departments. For example, Burton Hospitals NHS Trust has an Emergency Department Physiotherapy Clinic and Salford Royal has created an advanced physiotherapy practitioner post in A&E. "Where physiotherapists are already working in that setting, they are making a real difference," commented CSP Chief Executive Professor Karen Middleton. "The evidence is clear... physiotherapists should be available in every A&E."

Are you a physiotherapist or hospital manager with views on the issues raised in this article? Leave your comments below.

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