PHYSIO WORKS JAY COOKSON MSc MMACP MCSP PGD MANIP (ther) CMP AP Physiotherapist Neuro Surgical Team Southampton Chair committee for education & approval PGA lecturer Email jay.cookson@uhs.nhs.uk Twitter @jtjcookson

AP The role utilises extensive skills Progresses skill base Not a new concept WHERE DOES IT STOP?

WHAT DOES THE EVIDENCE SHOW Patient satisfaction high: 96% of patients rated care as excellent or very good 97% of GPs report improvement to MSK care Cost effective: potential saving of £220,000 per annum (1) Improved overall outcomes Potential further savings to NHS due to more appropriate care pathways

PHYSIOS ARE BEST! Evidence suggests APs investigate more appropriately and accurately than Consultants and GPs (2,3) Does this mean that assessment is more accurate? Treat patients, not scans!

COST COMPARISONS Study in Portsmouth demonstrated APs were over 1/3 cheaper than normal A+E route Through admission avoidance saved the trust over £1,000,000 in a 6 month trial (4)

SOUTHAMPTON PILOT Reduce admission of spinal patients that come through A+E Reduce demand on over utilised on-call service Physio lead – cost savings a/a

PATIENT BENEFITS Specialist assessment within 48 hours Appropriate investigations or management strategies started quickly Reduce chronicity

CONCLUSIONS APs demonstrate high skill levels Excellent patient centred care (5) Saves the NHS money

REFERENCES Connect Physiotherapy. Innovating the MSK pathway – Newcastle West Pilot. 2013. URL: http://www.connectphysiotherapy.co.uk/connect-the-nhs/newcastle-west-pilot/ [Accessed: 18.11.14] Gardiner J, Turner P. (2002) Accuracy of clinical diagnosis of internal derangement of the knee by extended scope physiotherapists and orthopaedic doctors: retrospective audit. Physiotherapy, 88 (3):153-157. 3 Comparison of referrals for lumbar spine magnetic resonance imaging from physiotherapists, primary care and secondary care: how should referral pathways be optimised? V Palmer L Thompson H Anniq Published online 1.5.14 4 The News. Community lounge hailed success to avoid A&E stays. The News. 2013; URL: http://www.portsmouth.co.uk/news/health/local-health/community-lounge-hailed-success-to-avoid-a-e-stays-1-5189911 5 McPherson K, Kersten P, George S, Lattimer V, Breton A, Ellis B, Kaur D, Frampton G. (2006) A systematic review of evidence about extended roles for allied health professionals. Journal of Health Services Research and Policy 11 (4): 240-247. 6 K Middleton Powerpoint presentation Physiotherapy’s Offer 2014