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Bangalore, Karnataka, India
Physiotherapist and Research Scholar, ESIC Model Hospital & PG Research Institute- ESICPGIMSR (Under Govt of India),Rajaji Nagar, Bangalore and General Secretary of Bangalore Physiotherapist Network (BPN) 2017-2020

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11 Nov 2015

Direct Access in Physiotherapy

Patients 'should have direct access to physiotherapy': Patients should be able to see a physiotherapist in their GP's surgery, an expert has said.

Patients should be able to see a physiotherapist in their GP's surgery, an expert has said.
Professor Karen Middleton, chief executive of the Chartered Society of Physiotherapy, said patients should have direct access to an NHS physio rather than needing a referral from their GP.

This would free up GPs to concentrate on other cases, some of which are more serious.
In a Scrubbing Up column for the BBC website, she said: "If you ring your local surgery, you can probably get an appointment with the GP or a nurse.

"But if you have a common problem such as back or neck pain, should you also be able to see a physiotherapist?

"We think so - as do increasing numbers of GPs, who are bringing in physiotherapists to work alongside them in their practices.

"These aren't physios the GP refers to - the physio is a patient's first point of contact who they see instead of the GP.

"Up to 30% of a GP's caseload can be musculoskeletal (MSK) problems, and physios are the experts in these conditions - so it makes complete sense for them to see those patients."
She said the benefits for patients are numerous - speeding up access to an expert, cutting the number of appointments they need and potentially avoiding surgery.

She said: "The longer someone waits for treatment, they greater the likelihood is that their relatively minor condition becomes chronic.

"So why not see the physio in the first instance?

"A physio can assess and diagnose a patient at that first appointment so that their rehabilitation begins immediately.

"In many cases, they will just need advice on what to do and the problem will go away.

"This then frees up places on the waiting list for people who genuinely need further treatment."

She said the new system would also save the NHS money.

"You'd also need to be living on Mars - or perhaps just outside the UK - to not know of the urgent and enormous problems the NHS faces financially.

"Our modelling shows that if even a fifth of the patients seeing their GP for an MSK problem saw a physio instead, it would save at least £525m a year for the NHS.
"That's a conservative estimate, by the way, as it looks only at the savings from that initial appointment.

"Additional savings would come from reduced follow-up appointments, fewer tests such as X-rays and scans and lower numbers of referrals on to secondary care in hospitals."

Ms Middleton said there was a need to dispel myths, such as it is not safe to skip the GP stage.

"Physios are trained to identify what we call red flags - evidence of serious illness - and would always send those patients on to the most appropriate medical professional," she said.

"Research has shown virtually no red flags are missed by Physios."



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