London first contact physiotherapy pilot saves 155 GP appointments

A pilot first contact physiotherapy service at a GP surgery in Lambeth, south London, is set to continue if funding is found.


At the event, Andrew Nwosu, regional lead for AHPs; Rashida Pickford, consultant physiotherapist at Guys and St Thomas' NHS Trust; Stuart Paterson, CSP Council member; Sarah Friel, advanced physiotherapy practitioner at Guys and St Thomas' NHS Trust; Lisa Horne, MSK-CATS team lead and advanced MSK physiotherapy practitioner at Halton Hospital

More than 40 CSP members at a meeting of the CSP London Regional Network on 4 June, heard that the extended scope practitioner providing the service was able to discharge 53 per cent of patients after one appointment.

These people received advice and were able to self-manage their conditions. The six-month pilot, from April to October 2017, saw patients with a range of musculoskeletal (MSK) conditions, but predominantly low back pain. Overall, it saved 155 GP appointments.

The referral rate to secondary care was low. Only six per cent needed a hospital appointment and only eight per cent required further investigations.

Talking about the pilot, consultant physiotherapist Rachida Pickford told delegates: ‘The one thing we really had to work hard at with commissioners was argument for first contact physiotherapy, because there are always arguments against.

‘They [GPs] always want to talk about multi-morbidity and the fact that these account for 70 per cent of their consultations. They asked how were we going to manage if we need to refer patients back to a GP as well.’

Ruth ten Hove, the CSP’s head of research and development told the event about the drivers behind first contact physiotherapy: ‘The Five Year Forward View really highlights the need to reduce reliance in elective care services.

‘There is also huge variation in referrals from general practice to secondary care, so there is a need to address that at local level.

‘And there is a strong desire in the GP Forward View to create a much broader multi-disciplinary team in general practice, of which a first contact practitioner programme is part.’

Carole McCarthy, chair of the London Regional Network, opened the event. Speaking afterwards, she said: ‘Early engagement of all stakeholders and perseverance are two of the key requirements for success in establishing first contact MSK practitioner services.’

A selection of presentations from the event providing service examples

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