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a physio imageSeptember 6 2017

Guidance encouraging greater uptake of physiotherapy for musculoskeletal (MSK) conditions has been released to help ease workload on general practice. 

 The Chartered Society of Physiotherapist has teamed up with the RCGP Cymru Wales and BMA Cymru Wales to issue the guidance, which is also being promoted through a CPS policy document, ‘Think physio for primary care’.

MSK conditions are thought to account for one in five GP appointments. “Physiotherapists providing a first point of contact service means that patients presenting with a musculoskeletal problem for a GP appointment are offered an appointment with a physiotherapist instead,” says the guidance.

“Physiotherapists working in general practice are able to address the needs of a large proportion of the patient population. They have the clinical expertise and autonomy to assess, diagnose and treat patients with a range of conditions, including MSK, neurological and respiratory conditions.”

Under the proposed new pathway, a patient contacting the GP surgery with an MSK condition could be offered an appointment directly with a general practice physiotherapist. The patient could then receive advice, analgesia and a 4-week exercise prescription as well as being referred for imaging and being given the results, with a possibility of a surgical referral, all with a total waiting time for the patient of six weeks. Under the current system, the process can take as long as 22 weeks.

Funding for existing primary care physiotherapists has been pump primed, however, the document proposes that “physiotherapists are able autonomously to manage a significant proportion of GP MSK appointments. GP practices therefore may consider funding their own physiotherapy services.” It suggested this can be done in the following ways:

  1. Contracting - where the physiotherapist/s are paid at an hourly rate for their services;
  2. Directly employing a physiotherapist and paying them a salary; or
  3. Inviting a physiotherapist to join the practice as a partner.

Highlighting the policy launch, NHS Wales GP One said: “The majority of GPs MSK caseload can be dealt with effectively by a physiotherapist without any need to see the GP.

“GPs and policy makers are recognising that physiotherapy can help meet patient needs in new and sustainable ways. Change is happening in Wales with GPs starting to bring in experienced physiotherapists to work alongside them as the first point of contact for their MSK patients.”

Links:
NHS Wales GP One announcement          
CSP. ‘Think Physio for Primary Care Policy briefing Wales 2017.                 
CSP/RCGP/BMA. ‘General Practice Physiotherapy posts – A guide for implementation and evaluation in Wales. July 2017 Version 2.’                 

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