Physio Near Me: Are virtual outpatient musculoskeletal (MSK) physiotherapy appointments an effective way to assess and manage patients?

Purpose

This project is designed to pioneer rapid growth in digital innovation and practice, ensuring it is at the forefront of service transformation at Ashford and St. Peter’s NHS Foundation Trust (ASPH). A key benefit to patients is the removal of travel time to and from appointments. At a time of increasing demand for appointments and a drive to decrease outpatient appointments in the acute setting, virtual appointments could play a key role in reducing footfall in a busy NHS foundation trust, potentially reducing infection risks and the trusts carbon footprint A virtual clinic may also provide shorter waiting times. Our aim was to complete a pilot study, across a 3 month period, to assess if virtual video MSK physiotherapy appointments could: increase patient self-management rates; provide direct to gym referrals; attain high patient satisfaction combined with reduced travel to an acute NHS foundation trust.

682.4 patient travel miles saved
this equates to a CO2 emission saving of 137.5kg

Approach

Attend Anywhere software was sourced and implemented at ASPH to deliver the virtual clinics. Two Clinical Specialists were asked to complete two clinics per week from their own home with remote access to Trust systems. These clinics had 6 new patient appointment slots, one hour in length. The inclusion criteria were all MSK patients except for post-operative. Equipment required included a laptop, microphone and webcam. Initial assessment was designed to facilitate shared decision making following assessment on to which management plan the patient would like to undertake. Clinics were populated by administration staff, with waiting list patients being emailed a link to sign in alongside an information leaflet. Patient satisfaction data was collected in the form of a Survey Monkey that automatically presented following the conclusion of the call.

Outcomes

Results: 72 patients were seen in the Physio Near Me virtual clinic across the 3 month period. Following assessment in the clinic, 90.6% of patients required no hospital follow up. This comprised of self-management (47.5%), direct to community gym referrals and open access appointments (26.2%) with 13.1% patients opting for an Attend Anywhere follow up. This far exceeds the national benchmark for First Contact Physiotherapy (FCP) which is 60%. A prospective 682.4 patient travel miles were saved. At the UK average of 50.5mpg, this equates to a CO2 emission saving of 137.5kg – a single person’s flight from London to Barcelona. Survey data collected from patients highlighted the clinics ease of use and time saving benefits. Our DNA rate was 14.8% and we aim to improve this by allowing patients to self-select Attend Anywhere from their initial physiotherapy referral letter.

Conclusion(s): This pilot study appears to suggest that virtual MSK physiotherapy clinics have the potential to reduce footfall into an acute hospital alongside increased early self-management rates and patient satisfaction.

Cost and savings

Not applicable

Implications

Future work should focus on increasing the scale and capacity of the clinic whilst not compromising the quality of care offered, savings on time efficiencies and further explore potential environmental savings. Further engagement with stakeholders, including GP’s and consultants, should also be explored alongside a virtual FCP service.

Top three learning points

No further data

Funding acknowledgements

Not applicable