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Putting primary care physiotherapy into practice

Tagged In:  Physiotherapy

Primary care physiotherapists can not only reduce GPs' workloads and save practices money, they can also provide other important benefits.

In the previous blog post we looked at how the physiotherapy self-referral model is helping reduce pressure on GP practices and save the NHS money. However, the benefits don't stop there. Developing an expanded role for physiotherapists in primary care and enabling them to be the first point of contact for those with musculoskeletal (MSK) problems has other positives for both patients and health professionals.

"For patients, this approach removes the need for repeat visits in order to get a referral, speeds up access to specialist care and empowers them to self-manage their condition," wrote Chartered Society of Physiotherapy (CSP) Chief Executive, Professor Karen Middleton, in a recent article for Practice Business.

The British Medical Association (BMA) also supports the primary care physiotherapy model, saying that the presence of a physiotherapist in a practice can provide the practice management team with more options as to how they provide care to their patient list.
As for GPs, CSP modelling has shown that having a physiotherapist in the practice to deal directly with MSK issues means they can spend an extra five minutes with each of their other patients. General practice physiotherapists are regulated practitioners who work independently and have their own professional liability cover. Many are able to prescribe medicines, order investigations, administer injection therapy and plan complex case management.

According to the CSP, an advanced practice physiotherapist costs around £54 per hour, while a GP costs around £130 per hour.

There are also wider benefits, including lower levels of testing and prescribing, fewer secondary care referrals and shorter waiting times for those who are referred for other diagnostics or treatment.

Two shining examples of the primary care physiotherapy model were discussed at the recent CSP Conference in Scotland. At NHS Forth Valley, the employment of two full-time practice physiotherapists has made a dramatic impact. They directly see all MSK patients and only 1% of those patients has required a review by a GP. In Edinburgh, two community advanced physiotherapy practitioners from the NHS Lothian Physiotherapy@Home unit have been placed in the Boroughloch Medical Practice. Benefits have included an increased level of patient self-management.

In association with the BMA and the Royal College of General Practitioners (RCGP), the CSP has issued new guidance on implementing the primary care physiotherapy model. It provides practical help for GPs and commissioners, setting out the benefits, funding options and practical considerations for implementing and evaluating general practice physiotherapy roles.

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