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Primary development

It was great to see coverage of different examples of services providing musculoskeletal care at first point of contact in Frontline (page 28, 16 September)
I feel this is a priority area for the NHS at a time when recruiting medical staff is such a significant challenge. Localities across the UK are trying to reduce the burden on GPs and to provide a high-quality service for patients. The services described show an alternative which physiotherapists can provide. 
I have been pleased to be involved in the CSP primary care reference group and hear the progress that the likes of Amanda Hensman-Crook are making in Windermere, Cumbria, while planning, with colleagues, the initiation of a pilot for a similar service in Darlington. 
I look forward to working with colleagues within the reference group as we look to develop CSP policy for this area and, more importantly, improve the quality of care our patients receive with physiotherapy at the forefront of these services.
  • Robert Goddard, head of adult physiotherapy and interim head of adult Occupational Therapy, County Durham and Darlington NHS Trust.
To take part in a discussion of these issues log on to the CSP website as a member and visit the Primary Care iCSP network.  

Prudent move

I am writing in response to the CSP changing its mechanism for travel claims for members attending CSP meetings. 
I must applaud the CSP’s prudence in actively promoting members seeking the lowest travel fares and showing such responsibility in extracting optimal value from our subscriptions. This is refreshing role modelling. 
  • Beverley Harden

Inspiring success

I have 21 years’ experience in respiratory, neurology and palliative care. I have followed Karen Middleton’s In person columns in Frontline. These have been inspirational and affirming. 
They gave me the confidence to promote my work for the first time and the confidence to share the achievements I gained in running a new service. This service changed practice and made a difference to patients with motor neurone disease and their families in Gloucestershire and Wiltshire.
It was clear from the beginning of the project that it was going to be a steep challenge to collect enough evidence to persuade the clinical commissioning group to commission this service as an ongoing concern. 
However, with the support of a steering group, I was able to set up a robust coordinated service.
This included creating respiratory pathways, setting up training packages, linking in with the acute sector, tertiary services, social services and voluntary sector, and, above all, bringing expertise and knowledge in the management of motor neurone disease to patients and their families at home.
I have been awarded three ‘Extra mile recognition’ certificates by the Motor Neurone Disease Association UK for my work with patients and their families in the two community settings.
  • Anita Sinclair, community clinical lead, neurology and respiratory, Great Western Hospitals NHS Foundation Trust
Frontline and various

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