NHS Chief Executive highlights NIHR CLAHRC EM study

Simon Stevens, Chief Executive of NHS England, briefly referenced the scheme as an example of ways to increase capacity in primary care and reduce the burdens on general practitioners. 

He was speaking on the BBC Radio Today Programme about plans announced on January 31 to fund 20,000 staff, including pharmacists, physios, paramedics, physician associates and social prescribing support workers, to help GP practices work together as part of a local primary care network.

He said: “We want more GP appointments because we are going to have more GPs, but as well as that we want patients to be able to directly see a physiotherapist or a pharmacist rather than having to go through a GP in the first place.”

The initial pilot scheme was funded by Nottingham City Clinical Commissioning Group (CCG) in 2013. It has now been endorsed by NHS England. At least one pilot scheme is being rolled out to each of the 44 Sustainability and Transformation Partnerships (STPs) across England. STPs were introduced in 2016 following a collaboration between the NHS and the 44 councils across the country to improve health and care.

Rob Goodwin, PhD candidate and Clinical Lead Physiotherapist, who works for community health service Nottingham CityCare Partnership,undertook an evaluation of the initial pilot scheme and has gone on to research first point of contact physiotherapy within his PHD which is funded by his employers and NIHR CLAHRC East Midlands. 

Rob evaluated physiotherapy as a first point of contact in two Nottingham GP practices. This demonstrate that patients got better with physiotherapy and they welcomed the service. The service also helped reduce the ‘burden’ on GPs and administration staff and made considerable financial savings.

Further to this, Rob and colleagues, undertook a qualitative evaluation using Individual interviews and focus groups with physiotherapists, administration and or reception staff and GPs. 

Three key themes were identified as a result of the research; the management of patient expectation, the impact of the service on working practice, including the re-distribution of work at GP surgeries, and addressing beliefs regarding the nature and benefits of physiotherapeutic musculoskeletal expertise. Fears regarding the ability of a physiotherapist to work independently were unfounded.

Rob Goodwin said: “The 12-month pilot scheme was the first step in transforming health, care and wellbeing among patients, who traditionally experience a long wait to see their GP for musculoskeletal complaints. Not only will it improve their experience but also help to relieve the burden on GPs.”

The work in Nottingham was pioneering and contributed significantly, as a case study, influencing the recent NHS England initiative.