FRONTIER: First Contact Physiotherapy in Primary Care: A Realist Evaluation of effectiveness and costs

Finanțare

National Institute for Health (NIHR) Health Service & Delivery Research (HS&DR) Ref. 16/116/03

Care este întrebarea de cercetare?

To evaluate ‘First Contact Physiotherapy’ in general practice for patients with musculoskeletal disorders (MSKDs), and provide evidence for the adoption of appropriate service delivery models.

Care este problema?

Millions of people in the UK experience pain and reduced quality of life as a result of conditions or injuries that affect the bones, spine, joints and muscles – these are known as musculoskeletal disorders (MSKD).

About one-third of all GP appointments are taken up by patients consulting these problems. This costs the NHS a lot of money and makes it more difficult for all patients to get an appointment with their GP.

One approach gaining popularity is First Contact Physiotherapy (FCP), whereby a highly skilled physiotherapist who is an expert in managing MSKD works within the GP practice and sees patients with MSKD without them having to consult a GP first.

The physiotherapist can assess the patient’s condition and provide immediate advice, and in some cases prescribe drugs, order x-rays and blood tests, or inject joints.

Early information on this new model collected by the applicants suggests that it may free up GP time to see other patients, reduce unnecessary requests for further tests or consultant opinion, improve patient satisfaction and save the NHS money.

Care este scopul cercetării?

There are different ways in which FCP can be provided, but we know little about what works in which circumstances. For example, in some practices, physiotherapists can only assess and provide limited treatment and advice. In others they can also prescribe drugs, inject joints and order other investigations and tests.

These factors affect costs; the amount of GP time saved; satisfaction levels; and the quality of the service patients are offered. We will investigate use of FCP in a variety of GP practices across the UK, to find out what works best in different situations and why.

Cum se va realiza acest lucru?

First, we will conduct a UK-wide survey to establish the extent of FCP practice and use this information to select a sample of GP practices to study in further detail.

We will then review previous work on FCP to identify the factors that may affect how the service works and consult with stakeholders to ensure we fully understand the important issues. We will then use this information to guide how we investigate GP practices implementing FCP.

We will focus on 8 different practices nationwide that use FCP, and investigate how these models work in practice. We will also include 4 GP practices that do not have FCP, for further comparison.

We will interview healthcare staff, patients, receptionists, practice managers and commissioners to understand what works, how and for whom.

We will monitor some patients within each GP surgery to track how their pain and function change over six months and collect information about waiting times and satisfaction with the service they received.

We will compare the type and amount of healthcare resources they use and how quickly they can return to work or their usual activities.

Cine conduce cercetarea?

Prof Nicola Walsh, Professor of Knowledge Mobilisation & Musculoskeletal Health, Faculty of Health and Applied Sciences, University of the West of England.

Informații suplimentare:

Visit the FRONTIER study website

For more information or to get involved in this project, email bnssg.research@nhs.net.

Opiniile exprimate sunt cele ale autorului (autorilor) și nu neapărat cele ale NIHR sau ale Departamentului de Sănătate și Asistență Socială.