Physiotherapy in primary care

Social enterprise AHP Suffolk (AHPS) developed projects to reduce physiotherapy wait time, reduce secondary care referrals and provide a 'single point of access' service.

Key components are self-management offerings, an intelligent self-referral system (web or phone) and introduction of rehab classes at scale - all partnering with local service providers, including acute trusts, GPs, leisure centres, and mental health and healthy living providers. These services are provided for NHS patients in East Anglia. This includes a full service for all of Suffolk from referral through treatment to discharge or onward referral.

Online referral

AHPS developed an online (and telephone service) self-referral portal. Patients can self-refer or be directed by their GP via a website to complete a referral form. Or they can call a helpline where the information is recorded for them. The service sends advice and exercises by email or post within 24 hours of the referral. Self-referrals and GP referrals are all triaged to the appropriate service (mostly MSK Physiotherapy).

Self-referral leads to a 20% attrition rate. This saves 0.8 of a follow up appointment when they do go through to face to face physiotherapy. And patients seem to be happy with the advice they’re given. Self-referral also has a significant impact in reducing GP appointments. Over 60% of patients now self-refer without seeing a GP. MSK represents around 25% of GP appointments. So this could realise a substantial saving.

Reduced need for arthroplasty

Different pathways are in place to reduce secondary care referrals. The most successful are the hip and knee pathways. These were developed in collaboration with the CCG due to high rates of arthroplasty in the area. The pathways consist of a series of education and exercise sessions with follow up phone calls. They reduced the need for arthroplasty by 20% in the area.

Consultants now only see the patients they need to see. This reduces system waste and provides a better patient experience.

Partnership working

AHPS continues to grow its base. It works in partnership with a mix of NHS providers/commissioners and social enterprises; examples are ESNEFT (East Suffolk and North Essex NHS Foundation Trust), NCHC (Norfolk Community Health and Care NHS Trust), ACE (Anglian Community Enterprise), ECCH (East Coast Community Health Care), Cambridge and Peterborough CCG, West Norfolk CCG, and West Suffolk CCG. Together they provide self-referral, single point of access, triage, MSK physiotherapy and rehab services.