Purpose
Patients accessing Physiotherapy in Blackburn demonstrate multiple co-morbidities, physical and biopsychosocial issues. This unique, cost-effective, collaborative service redesign addresses the specific co-existing health issues and behaviours associated with MSK conditions in Blackburn and offers a cost-effective, high quality solution to empower and support the MSK population to better manage their own health and well-being in alignment with Public Health England priorities.
o link between mental and physical wellbeing.
o Awareness of available management options.
Approach
A patient focus group and mapping exercise identified a need for a more supported and seamless transition of care from Physiotherapy to community agencies to better manage the wider aspects of health encountered in an MSK setting. Utilising existing resources, a monthly multi-disciplinary advice and sign-posting session was devised to streamline transition into local community-based physical and mental well-being services. Each Physiotherapy-led session consisted of an overview of available support. A patient representative provided detailed narrative of their own experience of these services.
Session aims were to:
- Inform patients of the links between activity, pain, physical and mental health.
- Increase engagement and seamless access to external support services.
- Achieve long-term health gains.
Impact was evaluated by:
- Attendance rates at each session.
- Referral/uptake of the Well-being and Mindsmatter Services by patients who had self-referred after attending sessions.
- Qualitative patient feedbackwas collected via questionnaire completion; content analysis was undertaken, and themes generated were used to refine the initiative via PDSA cycles.
Outcomes
Over a 12-month period:
- 91% of patients opted into one/both of the management options.
- 82% self-referred to the Wellbeing service, (56% of this cohort attended)
- 32% self-referred to Mindsmatter, (81% of this cohort attended)
Patient feedback showed:
- 91% found the session useful
- 100% intended to make lifestyle changes
- Key themes:
o motivational power of patient representative insight.
o link between mental and physical wellbeing.
o Awareness of available management options.
Physiotherapists are pivotal in the public health arena. This innovative, cost-neutral collaborative approach effectively addresses the complex and broad local and national public health priorities by promoting holistic self-care and behaviour change. Positive patient feedback supports the need to address the biopsychosocial aspect of all MSK conditions; the high uptake to community services demonstrates the value added by integrating these services within traditional management of MSK conditions to promote behaviour change. Further expansion plans to address local population needs are imminent with plans to broaden and incorporate further social prescribing links as well as improving accessibility for those non-English speaking patients with the implementation of an Urdu equivalent.
Implications
Expanding delivery across East Lancashire, this consistent population-based approach has potential to influence the health and wellbeing of a large population whilst offering financial efficiencies to the NHS. Physical and mental wellbeing schemes such as those involved in this pilot, widely exist and are accessible across the UK, adding to this project's sustainability, transferability and scalability on a larger platform. The positive impact of cross-agency partnerships has extended the scope of Physiotherapy, potentially generating greater influence with stakeholders when shaping future commissioning of services that promote self-care and reduce health inequalities.
Top three learning points
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Funding acknowledgements
No funding was received with exception of support from Cumbria and Lancashire CAHPR Research Mentorship Bursary to perform a service evaluation.
Additional notes
This work was presented at Physiotherapy UK 2019 and published in:
- International Journal of therapy and Rehabilitation 26(11) Nov 2019
- RSPH database
- AHP Resource hub 2020
Please see the attached Innovations poster below.
For further information about this work please contact Karen Oliver.