Emergency physiotherapy practitioners

Musculoskeletal emergency physiotherapy practitioners (EPPs) work as frontline healthcare providers.

They manage patients who attend emergency departments (ED) with musculoskeletal dysfunction.

Integrating EPPs in ED improves patient outcomes and patient flow. This approach streamlines care without additional radiographic investigation. It reduces costs and improves patient satisfaction.

Queen’s Hospital is part of University Hospitals of Derby and Burton. In 2013, the hospital started an initial pilot. The hospital established a musculoskeletal EPP service in ED.

Since then, three EPPs have worked in ED. All are senior physiotherapists with advanced practice skills in emergency care.

The EPPs assess patients. They diagnose the patients without the need for medical or nursing intervention. They refer patients for investigations to assist diagnosis, such as X-rays and blood tests.

Achievements

Local data shows this approach reduces waiting times for patients with musculoskeletal problems.

• median waiting time for treatment by an EPP was 34.5 minutes - 20 minutes less than national median
• in 2018 after EPP intervention, 2.5% of patients returned to ED following discharge - compared with 8.3% nationally
• more medical and nursing time is available to manage other patients attending ED

Reducing avoidable reattendances in ED by improving care and communication during a first attendance is a key indicator of effective clinical intervention. To represent good practice, unplanned reattendance rates should be below 5 per cent. EPPs in ED at Queen’s Hospital have shown this can be achieved.