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Nottinghamshire physiotherapy first point of contact scheme goes nationwide

An initiative piloted in Nottinghamshire to introduce a physiotherapy as a first point of contact service for people with musculoskeletal complaints is to be rolled out across the country.

The initial pilot scheme funded by Nottingham City Clinical Commissioning Group (CCG) in 2013 has now been endorsed by NHS England. At least one pilot scheme will now be rolled out to each of the 44 Sustainability and Transformation Partnerships (STPs) across England. STPs were introduced in 2016 following a collaboration between the NHS and the 44 councils across the country to improve health and care.

Rob Goodwin candidate and Clinical Lead Physiotherapist, who works for community health service Nottingham CityCare Partnership, undertook an evaluation of the initial pilot scheme and has gone on to research first point of contact physiotherapy within his PHD which is funded by his employers and NIHR CLAHRC East Midlands. 

Rob evaluated physiotherapy as a first point of contact in two Nottingham GP practices. This demonstrate that patients got better with physiotherapy and they welcomed the service. The service also helped  reduce the ‘burden’ on GPs and administration staff and made considerable financial savings.

Further to this, Rob and colleagues, undertook a qualitative evaluation using Individual interviews and focus groups with physiotherapists, administration and or reception staff and GPs.

Three key themes were identified as a result of the research; the management of patient expectation, the impact of the service on working practice, including the re-distribution of work at GP surgeries, and addressing beliefs regarding the nature and benefits of physiotherapeutic musculoskeletal expertise. Fears regarding the ability of a  physiotherapist to work independently were unfounded.

Rob Goodwin said: “The 12 month pilot sheme was the first step in transforming health, care and wellbeing among patients, who traditionally experience a long wait to see their GP for musculoskeletal complaints. Not only will it improve their experience but also help to relieve the burden on GPs’’.

The work in Nottingham was pioneering and contributed significantly, as a case study, influencing the recent NHS England initiative. 

Rob added: “I am delighted the work I implemented in Nottingham city has been taken on board and will now be rolled out across the country.”

Professor Kamlesh Khunti is the Director of NIHR CLAHRC East Midlands and is also Professor of Primary Care Diabetes and Vascular Medicine at the University of Leicester.

He said: “It is very pleasing that an initiative pioneered in Nottingham is having an impact nationally. Health research and pilot schemes like this provide us with the opportunity to learn more about conditions and how best to manage their treatment.”

In parallel to the NHS England pilot of first contact physiotherapy will be a three stage evaluation. Building on the evaluations to date the team in Nottingham will now partner with Keele University in the quarter of a million pound, stage three evaluation. 

Keele University, led by Annette Bishop (Senior Research Fellow) will focus on the impact of FCPs on patients, by capturing patient reported outcome measures (PROMs) and experience measures (PREMs).

The Nottingham group of researchers, will undertake a qualitative evaluation of patient and staff opinions focusing on their perceived impression of the impact of FCPs on general practice.