A two year study carried out at two GP practices in Forth Valley, where physiotherapists are a first line of contact for musculoskeletal conditions rather than a GP, has declared the service a success and revealed a significant drop in referrals to orthopaedics.
The survey, which was carried out at Kersiebank and Bannockburn Medical Practices, shows almost 8,500 patient contacts were made with more than 87% being managed within primary care. At one practice the number of referrals to orthopaedic services was down 37%, while at the other the reduction was 67%.
The service was launched in November 2015 in response to a shortage of GPs. Both health centres are managed by NHS Forth Valley and patients were asked for feedback about the outcome of appointments. A patient experience questionnaire was also conducted.
Catherine McRitchie, NHS Forth Valley Lead Advanced Physiotherapy Practitioner, said:“The results suggest that patients with musculoskeletal conditions may be assessed and managed independently and effectively by physiotherapists instead of GPs. This has the potential to significantly reduce workload for GPs and patients reported positive views regarding the service.”
Other practices throughout the area are now adopting a similar multi-disciplinary approach in line with the recommendations of the new GP contract. This is being supported by NHS Forth Valley’s Primary Care Improvement Plan which aims to recruit more than 200 additional staff over the next three years to support GP practices across Forth Valley. These include physiotherapists, mental health nurses, pharmacists and Advanced Nurse Practitioners.
An article published in the British Journal of General Practice says physiotherapists could be part of the answer to the GP recruitment problems and it presents a unique opportunity for them to demonstrate their value in managing musculoskeletal conditions instead of a doctor.
Sara Conroy professional lead for the Chartered Society of Physiotherapists (CSP) in Scotland said: “The research in Forth Valley provides a great example of how physiotherapists working in GP practices can provide enormous benefits. Forth Valley was one of the first Health Boards to do this, but in Scotland we now have this in most health boards. The paper points to evidence that advance practice physiotherapists working in primary care as a first point of contact can deal with up to 30 per cent of a GP’s caseload.”
Meanwhile, the CSP is looking forward to first contact physiotherapy services being fully implemented across the UK.
Ms Conroy added: “There are other areas where physiotherapy skills could help take pressure off GPs. Frailty management and respiratory care are just two examples.”
Physiotherapists Catherine McRitchie, Fiona Downie and Wendy Monteith who have moved into GP practices in Bannockburn and Grangemouth.
