Growing accident and emergency waiting times, packed GP surgeries and delayed discharges are three of the most pressing challenges for the NHS.
Yet innovative solutions are available, and physiotherapists are key to its success.
We must move beyond traditional mind-sets and look at the alternative – a multi-disciplinary approach where physiotherapists and other allied health professionals play an integral role on the front line, giving patients faster access to the most appropriate treatment for their needs.
Let’s start with A&E.
People with musculoskeletal (MSK) conditions accounted for about a fifth of the 18.3m who attended casualty in 2012-13 and physiotherapists are the experts in MSK, so having more available in A&E not only gives patients immediate access to expert advice but it also frees up doctors to see other patients who need their expertise.
For example, Salford Royal NHS Foundation Trust introduced an advanced physiotherapy practitioner to its A&E department in 2010 to treat people with musculoskeletal injuries.
The role includes ordering and interpreting X-rays and blood tests and onward referral for further physiotherapy if needed.
Patients using this service are provided with immediate access to expert physiotherapy advice, which led to a reduction in treatment and waiting times, and savings of £32 per patient by reducing the need for more expensive medical staff. Patient flow through A&E has also improved.
By incorporating physiotherapists in A&E, we can prevent some patients from being admitted to hospital in the first place.
And for those who need further treatment, we can ensure they are discharged as soon as they are well enough to go home.
The integration of health and social care services has seen this work effectively in many areas.
The Bradford Enablement Support Team (BEST Plus) is helping older people remain in their homes with support from a range of health care professionals.
To give an example, a patient who suffered a stroke, a fall and a broken hip, saw the therapy team – which included physiotherapists and occupational therapists – for recovery of mobility and balance.
He was discharged from a community hospital with four care visits daily, where sessions focused on his mobility and strength and after six weeks, he had regained enough independence to return to his usual active and social life without any support.
But we also need to do things differently to speed up access to physiotherapy for patients using primary care.
It is estimated that 20 per cent of people presenting for GP appointments have an MSK pain condition and many will have been referred on to physiotherapy.
We have the ability to assess and diagnose problems, independently prescribe medicine and empower patients with the right health advice to manage their condition at home so it makes sense for us to be the first point of contact.
Allowing patients to self-refer to physiotherapy can not only free up unnecessary GP appointments, but give patients faster access to the right care, which can reduce sickness absences and help prevent illnesses from becoming long-term conditions.
For instance, when it was introduced at Torbay and South Devon Health and Care NHS Trust, waiting times went from up to 10 weeks to inside three days for 90 per cent of patients.
The potential savings are enormous and simply cannot be overlooked at a time of such budgetary restraint in the NHS.
Indeed, all of these solutions have the potential to save money, ease pressures and improve patient outcomes and it is important that they are made available across the country to help the NHS confront the challenges of the future.
By Sue Rees, Chair of Council at the Chartered Society of Physiotherapy (CSP)