Physios offer solutions to ease the strain on GPs | Karen Middleton

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Karen Middleton

With a perfect storm engulfing primary care, placing more physiotherapists in GP surgeries could offer a way to turn the tide, writes the head of the Chartered Society of Physiotherapy. 

Barely a week passes when GP pressures aren’t in the headlines.

Only in the last few days a major study, published in The Lancet, identified a 16 per cent rise in general practice workloads – the number of face-to-face GP consultations has gone up by 6 per cent. There is a shortage of locum GPs to provide the volume of appointments patients need. 

Too many people experience delays or difficulties accessing their GP, with a domino-effect for other parts of the NHS – like A&E – and deteriorating health while waiting for treatment. Most agree that the perfect storm engulfing primary care is simply unsustainable and urgent action is required. 

What we need is bold new service solutions to relieve these strains – ones that are ready-made and use the potential of other professionals in the NHS, including physiotherapists. 

Let’s take the important area of musculoskeletal (MSK) conditions, currently accounting for as many as 30 per cent of GP appointments, according to Professor Briggs' report on improving orthopaedic care.  

Increasingly, GPs are inviting physiotherapists – with the skills and experience to assess, diagnose and treat – to work in their surgeries to help manage these cases as the first point of contact. 

In today’s West Cheshire, we can get a glimpse of how the future looks. Patients with common MSK conditions, such as back or neck pain, who ring their local surgery and ask to see their GP are offered an appointment with a physiotherapist. After a successful three-month pilot last year – which freed up over 700 GP appointments – the service is available at all local surgeries, with money from the Prime Minister’s Challenge Fund. 

Similar services, from South Hampshire to the Lake District, are also demonstrating excellent outcomes. 

At the Chartered Society of Physiotherapy (CSP), we want to see this approach available in every community, for three main reasons. 

It’s good for GPs, because it helps relieve some of the acute pressures they are currently experiencing. It offers them more time to spend with the patients they do see, which they say will help them provide better care. Our newly launched Physiotherapy Cost Calculator estimates this could amount to on average five extra minutes for each and every appointment a GP has to spend with patients.

It’s good for patients, because it ensures those with MSK conditions are seen by a specialist physiotherapist straight away, without having to go via their GP. This benefits other patients, who will have better access to GP appointments – we estimate millions could be freed up.

And it’s good for the wider NHS, because it reduces onward referrals and saves money. Figures from our Physiotherapy Cost Calculator show that a typical GP practice could save around £2,500 a week by sending patients with MSK conditions to see a physiotherapist rather than a GP. By treating people sooner, we can reduce the risk of more expensive care being required later. 

The benefits of this way of working has wide ranging support, from the British Medical Association to Arthritis Research UK, and we are committed to building as broad a coalition as possible. 

Over the coming months, the CSP and our members will be making the case to government, local commissioners and GPs. By working together, GPs and physiotherapists can deliver cost-effective, quick and high quality patient pathways for MSK conditions.  

For perhaps too long we have talked about the challenges facing general practice – now is the moment to act. Patients deserve nothing less. 

Professor Karen Middleton is chief executive of the Chartered Society of Physiotherapy. Follow her and the organisation on Twitter @KMiddletonCSP @thecsp

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