Sheffield MSK service plans to expand ‘virtual’ physiotherapy

Sheffield’s integrated musculoskeletal service has introduced a web-based platform, which is helping physiotherapists to collect patient reported outcome measures (PROMS) and provide exercise videos, a King’s Fund digital conference heard.

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Virtual physiotherapy clinics are part of Sheffield MSK service’s plan

James Maxwell, consultant rheumatologist and clinical lead at Sheffield Teaching Hospitals NHS Trust, told the event on 10 July that the platform, MyPathway, was implemented under the guidance of a musculoskeletal steering group.

‘Each of the service areas in MSK had a lead and we had a physiotherapist as part of that,’ Dr Maxwell told Frontline at the event.

He said MyPathway links patients to their musculoskeletal care via their mobile phones, tablets and PCs. It is integrated into the service’s IT system and displays the booking of musculoskeletal appointments to patients.

It can ask patients to complete PROMS and PREMS (patient reported experience measures) at various points in their care.

‘If a patient is having a hip replacement in a weeks’ time, we can ask them the right stuff and then ask them different stuff in three months and 12 months down the line,’ Dr Maxwell said.

‘This means we get a really good picture of the patient’s outcome measures as they go through their care journey.

‘It can also provide patients with videos of their physiotherapy exercises, and other information.’

Virtual video clinics

As part of MyPathway, the service is starting to offer virtual clinics. So far, it has replaced 80 per cent of face-to-face follow up appointments, Dr Maxwell said.

‘We started in orthopaedics and my area, rheumatology, has obvious scope for that,’ he said. ‘Although we’ve not yet embarked on virtual clinical physiotherapy, but it is very much part of our plan.’

‘I think in terms of physio, we have support through some of the videos for exercises and the ability to direct specific resources to patients based on their PROMS answers.

‘If patients are not doing particularly well, we might be able to direct something differently. It is not yet quite a virtual clinic, but it is heading in that direction.’

Cost savings

Sheffield’s integrated musculoskeletal service was developed as part of a transformation, driven by the city’s clinical commissioning group. It receives 47,000 new patient referrals each year and has more than 350 clinicians.

The service includes a large community physiotherapy arm, podiatry, all elective orthopaedic services provided by both the acute trust and five independent providers, a large tertiary rheumatology service and a chronic pain service.

Dr Maxwell said the trust introduced MyPathway in April 2017 because ‘we needed to measure and report outcomes from all aspects of the service and we knew we needed to have an IT-based solution.’

He told the event that, since then, between 45 and 50 per cent of patients have been using it. It had achieved cost savings, including £80,000 on administration and £90,000 on paper and postage.

‘We are hoping to roll this out to lots of other clinical areas within our trust outside of MSK,’ Dr Maxwell said.

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by Gill Hitchcock

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