Audit reveals major expansion of physiotherapy role in general practice

Freedom of information requests revealed four in ten clinical commissioning groups in England (41 per cent) said they were running at least a pilot scheme where physiotherapists see patients as their first point of contact.

The Chartered Society of Physiotherapy (CSP), which carried out the FoI audit, believes this model frees up appointments by removing what can constitute between 20 and 30 per cent of a GP’s caseload.

Gaining faster access to a specialist assessment improves the chances of recovery and modelling by the CSP shows the average GP surgery can save £1,000 a week by offering this to patients.

The approach was backed this week in the Government’s Green Paper on a work and health, which included a service in West Cheshire where patients attending any of the area’s 36 GP surgeries can see a physiotherapist instead.

Also supporting it is the Royal College of GPs and the British Medical Association, who today launch joint guidance with the CSP on how to implement such roles.

The guidance is aimed at GPs, physiotherapists and commissioners and covers issues such as funding, insurance and staffing profiles.

Prof Karen Middleton, chief executive of the CSP, said:

‘It makes no sense for patients to be made to see a GP to get a referral when a physiotherapist can assess them just as effectively in the first instance.

‘Seeing a physiotherapist instead means their rehabilitation can start immediately if needed and allows GPs to spend more time with patients who need a medical diagnosis.

‘That is a win for patients and a win for the NHS so it is very encouraging to see so many schemes running across the country.’

The guidance offers solutions to different scenarios in primary care with a range of practical ways to introduce a physiotherapist role in a GP surgery.

Dr Krishna Kasaraneni, BMA GP committee policy lead for education, training and workforce said:

‘Physiotherapists have the clinical expertise to assess, diagnose and treat patients with a range of conditions.

‘Musculoskeletal conditions alone are estimated to account for up to a thirdof GP consultations, so there is a clear opportunity for physiotherapy services to support GPs.

‘At a time of unprecedented patient demand and rising GP workload, this has the potential to reduce pressure and free up capacity in general practice, as well as improve patient access to skilled musculoskeletal services.’

Professor Maureen Baker, Chair of the Royal College of GPs, said:

‘GPs and our teams are currently under considerable resource and workforce pressures, so we are extremely grateful for any initiative that aims to ease these pressures, and make it easier for our patients to access appropriate care and services in the community.

‘Broadening the skill-mix in general practice is a key element in NHS England’s General Practice Forward View as a means of giving GPs more time to spend with patients and put our profession back on a sustainable footing.

‘We have already championed a successful scheme to place pharmacists in GP surgeries, and we are open to similar initiatives with other healthcare professionals, such as physiotherapists, in the best interests of patient care.

‘Ultimately we need the pledges in the GP Forward View to invest more in general practice and build the GP workforce to be implemented as a matter of urgency.’

The FoI request was responded to by 174 of England’s 209 CCGs.

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