Improving Access with Physio First, West Wakefield

Case study summary

Experience shows that 70% of presentations can be fully dealt with in a single 15 minute appointment. This has reduced pressure on GP appointments and provided better care for patients, with a significant reduction in the wait for expert advice. Patient satisfaction has been very high, with 100% rating their experience as ‘good’ or ‘very good’.

 

Patients contacting the practice with a new musculoskeletal problem are offered an appointment directly with the physiotherapist, often on the same day, without needing to consult a GP.

As part of the GP Access Fund, six practices in West Wakefield found that around 20% of GP appointments were for musculoskeletal complaints. To release GP time, they arranged physiotherapy sessions at one of the health centres, bookable directly using the GP clinical system.

Receptionists, working as care navigators, ascertain the patient’s need when they first contact the practice. Patients presenting with a new musculoskeletal problem from a pre-determined list are offered an appointment with the physiotherapist rather than a GP. This is also offered as part of the online consultation system being used by the practices.

The physiotherapist has 15 minute appointments with patients. They have full access to the GP record, making it easier for them to make a safe and accurate assessment, and allowing them to record the consultation in the notes. The appointment provides an assessment of the problem and advice on exercises and self-management. Where appropriate, the physiotherapist makes an onward referral for continuing therapy. They may also request a prescription via reception or refer back to the GP. Receptionists ensure this is handled in the most appropriate way.

Impact

Experience shows that 70% of presentations can be fully dealt with in a single 15 minute appointment. This has reduced pressure on GP appointments and provided better care for patients, with a significant reduction in the wait for expert advice. Patient satisfaction has been very high, with 100% rating their experience as ‘good’ or ‘very good’. Practices themselves are pleased, too, and the scheme expanded rapidly from one to all six practices in the first few months.

Implementation tips

  • Ensure the service is provided by appropriately experienced physiotherapists, confident in making rapid assessments of musculoskeletal problems in primary care. This usually also means using senior staff.
  • Training for receptionists helps them to make appropriate judgements about signposting patients to a service like this. In West Wakefield, training increased use of the physiotherapy service by 40%.

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