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New Physiotherapists improve agility of patients and Practices

Since the launch of the Primary Care Networks (PCNs), PICS has been successful in building teams of First Contact Physiotherapists for the PCNs we support. Analysis already shows that early intervention by First Contact Physiotherapists (FCPs) and their community-based care approach is benefiting patients with quicker care closer to home, it’s reducing GP workload and wait times for other patients, and it’s reducing hospital admissions and the escalation of conditions into more complex, costly cases.

The teams have grown quickly and are set to further expand in the New Year. PICS is working with Musculoskeletal Hubs to up-skill the FCPs so they will be able to refer directly for scans and x-Rays and provide injection therapy.

What does the role offer?

These new roles significantly contribute to reducing GP work load and patient wait times. They provide Practices and PCNs with Physiotherapy expertise and knowledge, and they increase capacity for patients to be seen quickly and treated locally.

All patients are invited to feedback about the new service, and the Mid-Notts locality has already been able to report 100% positive feedback from over 75 patients. GPs are also reporting great benefit in capacity and speed with which patients can be seen. Dr Tariq Hama, from Hama Practice in Kimberly, Nottinghamshire, says “The service is very easily accessible as we can arrange it via a simple text message. This takes away the laborious time consuming task of making formal referrals which then extends the time taken for the patient to be seen.”

What to the FCPs do?

  • Assess patients face to face or virtually without them seeing the GP first.
  • Significantly add to appointment capacity at the Practice, seeing between 15-25 extra patients per FCP per day.
  • Respond quickly, often with same day appointments, to help reduce waiting lists exacerbated by the COVID- 19 pandemic.
  • Move patients quickly and efficiently into treatments in the Musculoskeletal Hubs.
  • Support Practices on Musculoskeletal (MSK) related conditions and issues, to improve whole-patient care across complex cases.
  • Empower patients to self-care, supported with reassurance about their condition and tailored treatment options.

Mr Flegg’s story:

Asha Gudibandi is First Contact Physiotherapist for Notts West PCN and started with PICS in Autumn 2020. In just six weeks, Asha has had over 400 patient contacts. One of her patients, Mr Peter Flegg, shares his experience of the service.

Peter Flegg

Mr Peter Flegg, 78, from Kimberly, called Hama Surgery on Tuesday 10 November, wanting to see his GP and get help for his shoulder, which was very stiff and painful, and his knee which was swollen and sore. He explains: “Some years back I had a motorbike accident and landed on my shoulder. It’s never really been right since then. Recently, it’s been more painful. Meg, my wife, persuaded me to go and see the doctor so I called in the morning to make an appointment. But instead, they made an appointment with Asha that same day – we got the message in the morning and then went within half an hour to go and see her. I’ve never seen a physiotherapist before.

“I rang to see the doctor thinking I could get painkillers. But Meg and I then met Asha and it went very well and was very informative. She showed us charts and explained about the joints and what’s going on. She also helped me manipulate my arms and knee so I could see what was going on myself. She showed me some exercises and sent me them so I’ve got them on my computer. I’ve been doing the exercises and it helps – I’ve just got to persevere and see how we go. She said we could get in touch with her if we had any problems. She’s very good, she’s very knowledgeable and she’s very helpful.”

Meg Flegg, Peter’s wife added: “Peter has never really been one to do exercises and such, but Asha was so good with him and showed him what to do and he is really trying to do his exercises. The swelling has gone down and now he has more movement in his shoulder than he’s had in a long time.”

FCP Asha Gudibandi, who covers the practices within Eastwood, Hama, Giltbrook and Newthorpe, explains how she made the appointment:

Asha Gudibandi

Mr Flegg was originally booked to see the GP, but I took the initiative to see him face to face as I felt it appropriate to be assessed by myself, enabling the GP to see acute patients, or those with more complex needs.

He presented with 2 joint problems that were unrelated but were addressed at the same time during the 20-30 min consultation. I provided an educational element and exercises which removed the need for Mr Flegg to have more visits to community health care centres. I also created an on-going management plan, which including an option to get medication from the GP to enable him to start the exercises if he decided it were needed, which would also save his time and the GP’s time.

Mr Flegg was happy with the outcome and his understanding of the conditions presented was improved. He was also provided with advice on how to self-refer himself for any further MSK-related concerns, which would save his time and the time of the administrators at the surgery.

Dr Tariq Hama, Mr Flegg’s doctor, says “Asha serves an excellent role as First Contact Physiotherapist. The service is very easily accessible as we can arrange it via a simple text message. This takes away the laborious time consuming task of making formal referrals which then extends the time taken for the patient to be seen.”