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Should physios be at the heart of general practice

The Chartered Society of Physiotherapy, the British Medical Association and the Royal College of General Practitioners all support the idea of expanding the role of physiotherapists in primary care.

As we reported in this blog post, making more use of allied health professionals to support GPs is a defining strategy in the NHS Five Year Forward View. With an estimated 8.8 million working days lost because of musculoskeletal (MSK) injuries each year, physiotherapists have a vital role to play in the new multispecialty models of care.

Research has estimated that in 2012, 5.8 million people attended A&E or walk-in centres because they were unable to get a convenient appointment (or an appointment at all) with their local GP. The National Audit Office estimates that a typical consultation at a GP practice costs the public purse £21, whereas a visit to A&E costs £124.

In researching its 2016 report Understanding Pressures in General Practice, the King's Fund found that the average GP practice contracted 0.2 full-time equivalent allied health professionals, but in the week of the survey they had worked an average of 0.3 full-time equivalents.

Widespread support for physiotherapists in general practice 

In January, the British Medical Association (BMA) told the Chartered Society of Physiotherapy (CSP) that they would like to see the introduction of new roles for physiotherapists in general practice, based on the existing primary care pharmacy model. Giving evidence to the Public Accounts Committee (PAC), the CSP said that 40% of clinical commissioning groups (CCGs) had already piloted the use of general practice physiotherapists and that, as well as the BMA and the Royal College of General Practitioners (RCGP), eight out of 10 doctors themselves had confidence in the model.

High percentage of GP consultations avoidable

In its report on access to general practice, the PAC referred to a National Audit Office finding that 27% of GP consultations were potentially avoidable, including patients who could have been seen by others in the practice. "Healthwatch England told us that the patients they had spoken to did not mind whether they saw a GP, a nurse, a physiotherapist, or another professional when it was the right thing to do," the report went on to say.

Practices in Wales leading the way 

"It makes no sense for patients to be made to see a GP to get a referral when a physiotherapist can assess them just as effectively in the first instance," commented CSP chief executive Karen Middleton, responding to the news in December last year that 40 GP practices in Wales are now offering physiotherapy. "Seeing a physiotherapist instead means their rehabilitation can start immediately if needed and allows GPs to spend more time with patients who need a medical diagnosis. That is a win for patients and a win for the NHS."

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