Our #physiotalk chat on Monday 21st July at 8pm (BST) will be co-hosted by Peter Gettings (@Peter_Gettings) who is a physiotherapist specialising in musculoskeletal (MSK) & rheumatology physiotherapy and also currently training as an MSK Sonographer – thank you Peter! As usual during this #physiotalk chat we hope to cover the topic in a way that makes it interesting for those who specialise in the area and also those who don’t!
This is the first physiotalk that I have been involved with from this side of the screen. When I offered to host an MSK chat I was acutely aware of the huge variety of areas that MSK covers and all of the usual points of debate that are cycled through on twitter on a fairly regular basis. The trouble with these topics is that people often have strong opinions and are not afraid to voice them, this means that many people will follow the debates and whilst still learning from them are reticent to contribute.
The idea for this talk, “Working smarter in MSK”, came from my own experiences within our NHS trust, dating back several years, when the local commissioners proposed cuts to our physiotherapy service. Their plan was to ration physiotherapy for any condition older than eight weeks to one visit per patient. Our service lead came up with a proposal that would see us stop providing equipment such as tennis elbow clasps, heel raises and maternity belts etc as well as an overall reduction in appointments for patients. This meant that instead of a single assessment appointment our patients were able to receive a maximum of five appointments. This was initially quite a challenge for us to change our ways of working and it forced us to evaluate our practices in order to deliver the most appropriate treatment for our patients in the most efficient manner.
We are keen not to lose our autonomy as professionals and send everyone to a group session just because it is more cost effective but in that environment it is possible to deliver much more information and promote wider discussion within the group. Some of the areas that we have addressed are listed below:
- Implemented a modified version of the Keele STarT Back pathway – we paper triage people with non-specific LBP directly into an advice and education session after which they are given the option to attend one of our exercise classes. Prior to their attendance at the talk they complete the questionnaire and if they are identified as high risk they are offered 1:1 assessment.
- We are in the process of editing this education session as a take home DVD for our patients.
- We run an OA advice and exercise group based on the NICE guidelines
- We are currently writing a similar advice/education session for our whiplash patients
- We have introduced pilates and tai chi classes for patients.
The idea behind this tweet chat was to provide a discussion forum to see how others are managing to cope with service changes, and also to discuss how to try and influence the changes and to deliver a successful service in the current climate within NHS services in the UK.
- Transforming Outpatient Services Change Package – Getting patients on the right pathway through transforming Community Allied Health Professional (AHP) MSK services
- NHS Improvement quality and service improvement tools
- Lean thinking
- Self referral
- An MSK who to follow for twitter
- How to tweet chat
- Keeping up with tweet chats: using TweetDeck
- Professionalism and twitter
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