Bridging the gap - the development of a rehab specialist support worker role in a community MSK pathway


As part of a service review we wanted to improve the efficiency of the community MSK pathway, focusing on the way patients moved from physiotherapy services to the exercise and leisure sector Working with a CSP officer for advice and guidance we scoped a higher level support worker role into which we sought to employ a Band 4 with appropriate training and experience in the exercise sector. Over a 6 month pilot period we sought to achieve the following aims and objectives: • Reduce waiting times to community MSK physiotherapy • Deliver a more cost effective staffing model for physiotherapy led exercise classes • Build and develop links to community exercise provision • Improve patient confidence and experience of transition into the local leisure and exercise sector


We used Plan, Do, Study, Act methodology and engaged all members of the team to support with the development of a competency framework, working processes, and governance arrangements.


Results: Patient waiting time data was analysed at 3 and 6 months; patient and staff feedback at 6 months At 3 months the average wait for community MSK physiotherapy had reduced by 5 days. At 6 months the average wait had reduced by a further 2 days.Average waiting times therefore reduced by 7 days over the 6 moth pilot period. Staffing costs for delivery of group exercise interventions reduced by 50% by using the rehab specialist vs registered staff. Three community exercise schemes were developed and led by the rehab support worker including an ESCAPE pain programme. Links with local gyms were developed and patients were actively supported to attend joint sessions with the rehab specialist and gym staff. Patients reported the model was ideal for them to feel confident to exercise independently and in gym settings. Staff reported that the skill sharing approach to staff training with the rehab specialist had enhanced their own knowledge especially in relation to strength and conditioning training.

Conclusion(s): Building and nurturing collaboration with exercise professionals in order to successfully move patients from healthcare to community exercise and leisure settings is crucial for the future physiotherapy workforce. This is to enable the profession to work smarter, meet increasing demand and improve patient outcomes through empowered self-management. Our pilot demonstrated that a rehab specialist role with a focus on exercise prescription was a safe and effective approach to achieve our service improvement aims.

Cost and savings

No further information. 


We propose that the development of rehab specialist roles such as the one presented here is one way that the profession might enhance collaborative relationships with local exercise professionals, manage demand on already stretched services and reduce costs in running classes.

Top three learning points

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Funding acknowledgements

No funding was received for this project