Parkinson’s audit reveals rise in early referrals for physiotherapy, but calls for service improvements

More people with Parkinson's are receiving a physiotherapy referral within two years of their diagnosis, but not enough services are using appropriate (or any) outcome measures.

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The audit reports a rise in services specialising in the treatment of Parkinson’s

This is according to the 2017 UK Parkinson’s Audit, published today.

The audit is the largest dataset ever collected about the quality of care provided to people with Parkinson’s across the UK.

It was organised by the UK Parkinson’s Excellence Network, a collaboration between health and social care professionals and the charity Parkinson’s UK.

Fiona Lindop, a specialist physiotherapist at Derby Hospitals NHS Trust, is part of the audit’s steering group and governance board and recently became the first therapy lead for UK Parkinson’s Excellence Network.

She told Frontline: ‘More people are been referred to physiotherapy earlier, which is great. However, only 16.8 per cent were been referred in the diagnosis phase.

‘And we really want to capture people in the diagnosis phase, so we can encourage them in terms of exercise and maintaining their mobility and independence right from the start.

‘They might not need physiotherapy on a regular basis at that point, but they do need an assessment and intervention advice.

‘Also, the audit shows that 85.2 per cent of physios reported using outcome measures, which is slightly more than last year. But this is a major area of concern as it means 14.8 per cent of physiotherapists are not using any outcome measures.

‘And among those using outcome measures some are not inappropriate. So we need to encourage a better use of validated, appropriate outcome measures so that patients can have better care and so can properly evaluate what we are offering.’

Improvements since 2015

In total, 95 physiotherapy services took part in the audit and collectively they reported on 1,514 people with Parkinson’s.

Using standardised assessments, and with reference to evidence-based guidelines, the audit examined whether physiotherapists are currently providing quality services for people with Parkinson’s.

It found there has been many service improvements since the previous audit took place in 2015. These include:

  • An increase in the number of people with Parkinson's referred to physiotherapy within two years of diagnosis (52 per cent compared with 49.3 per cent in 2015)
  • An increase in the number of services specialising in the treatment of Parkinson’s (64.2 per cent against 57.8 per cent in 2015)
  • 89.5 per cent of physiotherapists have been able to access Parkinson's-related continuing professional development in the past 2 years

However, the audit also found many areas requiring improvement, including that 14.8 per cent of physiotherapists reported they were not using any outcome measures.

In addition, there were 21 cases (3.2 per cent) of unregistered therapy support carrying out initial assessments.

A need for more integrated working

As well as physiotherapy, the audit examined the provision of physiotherapy care across a range of clinical services, including occupational therapy and speech and language therapy.

A common theme across all areas of Parkinson’s care was the need for more specialised multidisciplinary working.

The audit found that physiotherapists who were part of a fully integrated clinic model saw only 13.7 per cent of Parkinson’s patients. However, 56.8 per cent of services did offer assessment as part of a multidisciplinary team.

It also highlighted standardised practises, communication and information sharing, medicines management and anticipatory care planning as areas that need improvements across all specialisms in Parkinson’s care.

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by Robert Millett

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