Physios In GP Practices

Physiotherapists in General Practice Surgeries

The Changing Face of Primary Care

Demands on GP practices are at there highest, without a growth in resources (Health Committee Select – Primary Care, 2016), which have in fact been reduced by about 25% over the past few years (Briggs, 2015). GP training places are going unfulfilled (12% – National Audit Office, 2015) and numbers in 2015 show that 11% of patients seeking a GP appointment failed to get one due to demand exceeding capacity (RCGP, 2015). The National Audit Office estimates that 27% of appointments were avoidable contacts. Of note is that it is estimate 40% of a GPs working week is spent on tasks such as prescriptions, referrals and form filling.

So why is this news?

The British Orthopaedic Association estimate that 1 in 3 GP consultations are musculoskeletal. The Chartered Society of Physiotherapy suggest that 15-30% of the GPs caseload in Musculoskeletal. Which means Physiotherapists could see these patients.

Why?

Physiotherapists are the skilled practitioners in musculoskeletal medicine. They are trained to a high level to assess patients with musculoskeletal pain, rule out anything serious and advise on future treatment and management.

NHS England are keen for a step change in the integration of services and the Health Select Committee have recommended physiotherapists work in General Practice teams, to see musculoskeletal patients and reduce the demand on these teams, but to also improve the patient pathway,

Benefits? 

• Cost saving. An advanced Physiotherapist costs £54.11 per hour. A GP costs 130.71 per hour (CSP Policy Briefing, 2016). The way we are able to model such a service means we can offer a Physiotherapist to a GP practice at £40 per hour.
• More time for GPs. A pilot in North Wales in six months had physiotherapists see 1525 patients of which only 23 needed any input from a GP, and a pilot in Suffolk in six weeks saw 164 patients with only one needing any input from a GP.

GP’s will also not have to do any referral paperwork.

• Improved Patient Pathway. Right care. Right time. Right place. Reduced referrals to secondary care (12% in North Wales) and reduced prescription costs / medication use. A pilot in Nottingham found statistically significant improvements in clinical recovery from going straight to the physiotherapist. A pilot in Suffolk had a 99% Friends and Family score, with 96% of patients ‘strongly agreed or agreed’ that they were seen quickly and the service was easily accessible and 88% ‘strongly agreed or agreed’ that the service offered was ‘perfect’.

Concerns?

• RCGP warns that making self-referrals the standard for Physiotherapy treatment could have the unintended consequence of swamping physiotherapy services
  • Suffolk has had self-referral physiotherapy for 10 years and have not seen this trend
  • Quality, innovation, productivity and prevention (QIPP) process snd NICE both endorse self-referral to physiotherapy
• Red Flags
  • Physios are the expert group concerning MSK issues
  • Highly skilled to spot and act upon red flags
  • Same high safety record as GPs, second only to Orthopaedic Consultants in Musculoskeletal Knowledge (BMC, 2005)
  • CSP’s Primary Care Health Monitor 2016 that 8/10 GPs are already confident in the service

What Do We Offer?

• We will place physiotherapists into GP practices based on agreed needs.
• Physiotherapists will be highly skilled, highly trained and be able to link in with current systems and processes.
• All governance managed through First Point Physio in line with GP practices current guidelines. GP Practices deal direct with us and we take all the hassle away.
• Full auditing of service.
• First Point Physio contactable 7 days a week, day times and evenings.

Get in touch

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