AHPs SO WHAT……#1

AHPScot are pleased to introduce a new monthly feature…AHPs SO WHAT?

This feature aims to showcase areas where AHPs have made a sustainable difference in health and social care. If you have any work to share, no matter how small or how large please get in touch with us at Contact:  Debbie.Provan@nhs.net or Fraser.Ferguson@gov.scot If you don’t tell us we can’t share and spread it.

Feel free to download these initiatives to share locally. Click here for a PDF version of today’s post.

 


AHP’s SO WHAT……Adding Physiotherapists to NHS 24 Unscheduled Care Service

Situation

Screen Shot 2018-05-11 at 14.13.01NHS 24 have been providing safe patient triage in unscheduled care for over  10 years. All patients are triaged and are sent to an option of outcomes, which are available throughout NHSScotland.     These Out of Hours Service (OOHS) options are:

  • 999
  • Emergency Department
  • Primary Care Emergency Centre (PCEC)
  • GP Home Visit
  • GP Call back 

    and Self Care, which is not part of OOHS

Observation

Only 11.6% of patients with back pain were discharged at the time of triage. This sat outside the evidence base which indicated that most MSK presentations did not require urgent medical attention and with self-care advice would be able to get better on their own. Over medicalising MSK patients, especially in the acute phase, can lead to longer term issues with a return to normal function and activity levels.

What could AHPs do?

Screen Shot 2018-05-11 at 14.13.14Aside from GPs, Physiotherapists are the single largest professional group who manage MSK problems in the NHS in Scotland. So it made sense that this specialist skillset would be better placed to provide enhanced triage and self-care to this group of patients. Not only improving the current patient journey but freeing up nurses to deal with more medical related patients.

 How did they do it?

Screen Shot 2018-05-11 at 14.13.22Using already existing NHS 24 technology infrastructure, NHS 24 initially received short term funding form the Local Unscheduled Care Action Plan (LUCAP) to pilot this. It’s success led to substantive funding to embed this service within NHS 24 systems.

 

Assessment

 Screen Shot 2018-05-11 at 14.13.27Based on data on 12,694 patients triaged by physiotherapists at NHS 24 between May 14 and Oct 17, the physiotherapy led model to MSK triage brought about a major realignment of services used. 999 and ED  outcomes reduced from 13.1% and 4.7% to 10% and 2.7% respectively. 

Screen Shot 2018-05-11 at 14.13.32 Self-care outcome increased from 11.6% to 75.5%. 

When these outcomes are costed a physiotherapy led triage model equates to a £53.20 saving per call over the traditional triage model.

 

Taking it forward

In USC OOH services why should this just be limited to MSK and Physiotherapy. The model could be safely expanded to include more presentations such as COPD, Falls and be expanded to other AHPs too.

 Screen Shot 2018-05-11 at 14.13.47

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