It’s estimated that 1 in 5 GP appointments are for musculoskeletal (MSK) related conditions such as joint aches and pains, muscular injuries, sciatica and osteoarthritis. Which is why the County Durham and Darlington NHS Foundation Trust launched a physiotherapy service that bases physiotherapists, with advanced skills, in GP surgeries across County Durham.
Known as ‘First Contact Physiotherapists’, they make the initial assessment and, in many cases then diagnose and recommend appropriate treatment or refer patients for further investigation.
In the year since the service was launched, over 6,900 patients with new joint or muscle related conditions have used it.
Advanced practitioner physiotherapists offer expert knowledge, specifically within musculoskeletal conditions. Whereas a GP might see someone with a muscle or joint problem and then signpost them to physiotherapy, the service gives expert assessment from the first contact with a patient, including advice on initial management and starting an exercise and activity plan.
The initial patient consultation is usually over the phone which can then be followed up with a more in depth, face to face consultation if needed, usually all with 48 hours.
It’s a fast service with a same day call back which allows us the service to assess and diagnose newly identified musculoskeletal problems quickly and accurately. This means support can be offered much quicker than a standard referral to physiotherapy.
The key elements of the service are assessment, investigation and then direction towards the best management for each individual patient. Often, at least initially, we offer advice because most of the injuries that we see happened under six weeks ago. By helping patients to self-manage their condition it is often possible to prevent the onset on longer term, chronic problems or further complications. The majority of patients seen so far were managed with advice including medication and exercise. Around 75% of patients required no onward referral to other clinical services, only 14% required a course of physiotherapy and just 5% were referred back to their GP.