1
|
Thomas R, Berry A, Cramp F, Walsh N. Patient perspectives of general practice consultation for musculoskeletal disorders: A qualitative study. Musculoskeletal Care 2024; 22:e1904. [PMID: 38837521 DOI: 10.1002/msc.1904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2024] [Accepted: 05/28/2024] [Indexed: 06/07/2024]
Abstract
BACKGROUND Musculoskeletal disorders (MSKDs) are a significant reason for general practice consultations in the United Kingdom. Current models of care include consultation with a General Practitioner (GP) or a First Contact Physiotherapy Practitioner (FCPP). Evidence suggests that FCPP led care is safe, yet it is unknown whether patients share this belief. PURPOSE To explore patients' perspectives of general practice consultation for MSKDs, including views on safety, satisfaction and recommendations for future practice. METHODS A secondary data analysis utilising qualitative data from the Patient Reported Experiences and Outcomes of Safety in Primary Care (PREOS-PC) questionnaire completed by 426 general practice patients who consulted with a MSKD between December 2019 and October 2022. Responses to the question 'What changes, if any, would you suggest to your GP surgery to make sure that health care is provided safely?' were analysed using content analysis. RESULTS 606 responses across three timepoints were analysed. Two themes and six subthemes were identified; views on safety and satisfaction (inherent trust in the system, provision of face-to-face appointments, prompt access to care, person-centred care) and recommendations for future practice (appointment system: prompt access to face-to-face appointments, delivery of care: co-ordinated and collaborative person-centred care). CONCLUSIONS Patients commented that FCPP consultations provided quick and accurate diagnoses and targeted advice. Recommendations for future practice included prompt access to face-to-face appointments, phone calls to be answered more quickly, improved communication for test results and follow ups, patients to feel listened to with a more individualised approach, and better continuity of care.
Collapse
Affiliation(s)
- Rachel Thomas
- School of Health and Social Wellbeing, University of the West of England, Bristol, UK
| | - Alice Berry
- School of Health and Social Wellbeing, University of the West of England, Bristol, UK
| | - Fiona Cramp
- School of Health and Social Wellbeing, University of the West of England, Bristol, UK
| | - Nicola Walsh
- School of Health and Social Wellbeing, University of the West of England, Bristol, UK
| |
Collapse
|
2
|
Phua R, Mandrusiak A, Singh L, Martin R, Forbes R. Identifying and navigating suspected serious pathologies: New-graduate physiotherapists' perspectives and developmental needs. Musculoskelet Sci Pract 2024; 71:102944. [PMID: 38520877 DOI: 10.1016/j.msksp.2024.102944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Revised: 02/28/2024] [Accepted: 03/17/2024] [Indexed: 03/25/2024]
Abstract
BACKGROUND Physiotherapists in Australia play a vital first-contact role in identifying suspected serious pathologies and navigating their management pathways. Current literature highlights challenges faced by physiotherapists including implications of ineffective identification and management of suspected serious pathologies, yet the perspectives of new-graduate physiotherapists related to this area of practice remain unknown. OBJECTIVE The aim of this study was to explore new-graduate physiotherapists' perspectives and developmental needs related to identifying suspected serious pathologies and navigating their management pathways in patients with musculoskeletal complaints. DESIGN and Method: A qualitative study using a reflexive thematic analytical approach was undertaken. Eighteen semi-structured interviews were conducted. Thematic analysis was utilized on the interview data. RESULTS Four key themes were generated: (1) Physiotherapists as advocates; (2) Navigating uncertainties and complexities; (3) Safe and accessible workplace support builds confidence; and (4) Importance of direct learning opportunities. CONCLUSION New-graduate physiotherapists recognize their imperative role as first-contact practitioners in identifying and navigating suspected serious pathologies yet also experience significant uncertainties. The findings highlight key developmental needs, including supportive workplaces, established referral frameworks and direct learning opportunities during pre-professional training.
Collapse
Affiliation(s)
- Rachel Phua
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia.
| | - Allison Mandrusiak
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia.
| | - Lakhvir Singh
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia.
| | - Romany Martin
- School of Health Sciences, The University of Tasmania, Launceston, Australia.
| | - Roma Forbes
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia.
| |
Collapse
|
3
|
Jones B, Anchors Z, Voss S, Walsh N. Challenges and enablers to implementation of the Additional Roles Reimbursement Scheme in primary care: a qualitative study. Br J Gen Pract 2024; 74:e315-e322. [PMID: 38228358 PMCID: PMC11044017 DOI: 10.3399/bjgp.2023.0433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 01/03/2024] [Indexed: 01/18/2024] Open
Abstract
BACKGROUND The Additional Roles Reimbursement Scheme (ARRS) was set up to recruit 26 000 additional staff into general practice by 2024, with the aim of increasing patient access to appointments. Despite the potential benefits of integrating ARRS practitioners into primary care, their implementation has not always been straightforward. AIM To explore the challenges and enablers to implementation of the ARRS including its impact on primary and secondary care systems. DESIGN AND SETTING Qualitative interview study with ARRS healthcare professionals and key professional stakeholders involved in staff education or scheme implementation across three integrated care systems in England. METHOD Participants (n = 37) were interviewed using semi-structured individual or paired interviews. Interviews were audio-recorded and transcribed. Data were analysed using framework analysis until data saturation occurred. RESULTS Using framework analysis, 10 categories were identified. Three were categorised as successes: staff valued but their impact unclear; multiple and certain roles maximise impact; and training hub support. Seven were categorised as challenges: scheme inflexibility; creating a sustainable workforce with career progression; managing scope and expectations; navigating supervision and roadmap progression; infrastructure and integration challenges; ARRS roles impact on wider systems; and tensions and perspectives of existing staff. CONCLUSION Most ARRS staff felt valued, but the scheme broadened expertise available in primary care rather than reducing GP burden, which was originally anticipated. Some PCNs, especially those in areas of high deprivation, found it difficult to meet the population's needs as a result of the scheme's inflexibility, potentially leading to greater health inequalities in primary care. Recommendations are proposed to optimise the effective implementation of the primary care workforce model. Further research is required to explore administrative role solutions, further understand the impact of health inequalities, and investigate the wellbeing of ARRS staff.
Collapse
Affiliation(s)
- Bethan Jones
- Centre for Health and Clinical Research, University of the West of England Bristol, Bristol
| | - Zoe Anchors
- Centre for Health and Clinical Research, University of the West of England Bristol, Bristol
| | - Sarah Voss
- Centre for Health and Clinical Research, University of the West of England Bristol, Bristol
| | - Nicola Walsh
- Centre for Health and Clinical Research, University of the West of England Bristol; National Institute for Health and Care Research Applied Research Collaboration West, Bristol
| |
Collapse
|
4
|
Williams JT, Lister H, Fakouri B, Panchmatia JR. The National Suspected Cauda Equina Syndrome Pathway: implications for physiotherapists. Physiotherapy 2024; 122:68-69. [PMID: 38244418 DOI: 10.1016/j.physio.2023.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 09/22/2023] [Accepted: 10/16/2023] [Indexed: 01/22/2024]
Affiliation(s)
- John T Williams
- Guy's Hospital, Great Maze Pond, London SE1 9RT, United Kingdom.
| | - Helen Lister
- Guy's Hospital, Great Maze Pond, London SE1 9RT, United Kingdom
| | - Bahram Fakouri
- Guy's Hospital, Great Maze Pond, London SE1 9RT, United Kingdom
| | | |
Collapse
|
5
|
Lamb K, Comer C, Walsh N, McHugh G. Patient access to first contact practitioner physiotherapists in the UK: A national survey. Musculoskeletal Care 2023; 21:1554-1562. [PMID: 37837408 DOI: 10.1002/msc.1834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 10/09/2023] [Indexed: 10/16/2023]
Abstract
BACKGROUND First Contact Practice Physiotherapists (FCPPs) offer expert care for patients with musculoskeletal (MSK) conditions in Primary Care, usually within GP practices. This is a rapidly expanding area of practice endorsed by NHS England, the Chartered Society of Physiotherapy (CSP) and the British Medical Association (BMA). Efficient and appropriate access is important for optimising FCPP practice, but there is little published information about how patients currently access FCPP appointments. OBJECTIVE To investigate how patients access FCPP appointments in General Practice. DESIGN Cross-sectional online survey of FCPPs in the UK. METHODS FCPPs were surveyed about patient access to appointments. The survey instrument was designed using Jisc Online Surveys, piloted, and then distributed via social media and professional groups to FCPPs nationwide. Descriptive statistics were used to analyse demographic and multiple-choice questions, and free text responses were analysed using quantitative content analysis. RESULTS 193 participants completed the survey. Booking via GP Reception (n = 179) was reported as the most common route into an FCPP appointment, closely followed by booking after seeing another clinician for the problem (n = 172). CONCLUSION This research has provided clarity regarding how patients access the rapidly growing speciality of FCPP within GP practices in the UK. The role of GP Reception staff in facilitating access to FCPPs, the application of triage and the use of digital or online systems were highlighted as important elements for enabling efficient access to FCPPs by patients with MSK conditions.
Collapse
Affiliation(s)
- Kirsten Lamb
- Leeds Community Health Care NHS Trust, Leeds, UK
| | | | - Nicola Walsh
- Centre for Health and Clinical Research, University of the West of England, Bristol, UK
| | - Gretl McHugh
- School of Healthcare, University of Leeds, Leeds, UK
| |
Collapse
|
6
|
Parchment A, Lawrence W, Rahman E, Townsend N, Wainwright E, Wainwright D. 'Making every contact count' with patients with musculoskeletal conditions: a qualitative exploration of acceptability to physiotherapists. BMC Health Serv Res 2023; 23:1125. [PMID: 37858090 PMCID: PMC10588214 DOI: 10.1186/s12913-023-10126-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 10/06/2023] [Indexed: 10/21/2023] Open
Abstract
AIM To qualitatively explore physiotherapists' experiences and acceptability of implementing 'Making Every Contact Count Healthy Conversation Skills' (MECC HCS) in routine practice with patients with musculoskeletal (MSK) conditions. METHODS This article reports the second phase of a mixed method, sequential explanatory study. Physiotherapists trained in and delivering MECC HCS in their practice were invited to take part in semi-structured interviews. We hoped to develop a rich, in-depth understanding of their use and perceptions of the brief intervention and to contextualise findings from the first phase of the study. Qualitative data were analysed using Reflexive Thematic Analysis. RESULTS Physiotherapists valued MECC HCS as being integral to their practice, promoting a person-centred approach to supporting behaviour change and enhancing self-management in patients with MSK conditions and pain. It was believed that this brief intervention could reduce workload pressure for physiotherapists and have significant wider benefits for health services. Time limitations associated with appointments did, however, pose as a challenge to MECC HCS delivery, and it was felt that more organisational-level support was needed to sustain it. CONCLUSIONS These findings support our quantitative data, collected in the first phase of this study. MECC HCS is a highly acceptable brief intervention that can be delivered in physiotherapy care to support behaviour change in patients with MSK conditions. Future roll-out may be optimised within organisations by providing regular refresher training and adopting a MECC champion.
Collapse
Affiliation(s)
- Amelia Parchment
- Department for Health, University of Bath, Bath, BA2 7AY, England, UK.
- NIHR Applied Research Collaboration- Greater Manchester, University of Manchester, Manchester, M13 9PL, England.
| | - Wendy Lawrence
- Primary Care, Population Science and Medical Education, Faculty of Medicine, University of Southampton, Southampton, SO16 6YD, England, UK
| | - Em Rahman
- Public Health Workforce Development, Southern House, Health Education England, Winchester, SO21 2RU, England, UK
| | - Nick Townsend
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, Bristol, BS8 1TZ, England, UK
| | - Elaine Wainwright
- Aberdeen Centre for Arthritis and Musculoskeletal Health (Epidemiology Group), School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, AB25 2ZD, UK
| | - David Wainwright
- Department for Health, University of Bath, Bath, BA2 7AY, England, UK
| |
Collapse
|
7
|
ShahAli S, Shahabi S, Etemadi M, Hedayati M, Anne BC, Mojgani P, Behzadifar M, Lankarani KB. Barriers and facilitators of integrating physiotherapy into primary health care settings: A systematic scoping review of qualitative research. Heliyon 2023; 9:e20736. [PMID: 37860510 PMCID: PMC10582494 DOI: 10.1016/j.heliyon.2023.e20736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 10/02/2023] [Accepted: 10/05/2023] [Indexed: 10/21/2023] Open
Abstract
Purpose This scoping review investigated the barriers and facilitators to integrating physiotherapy into primary health care (PHC). Materials and methods PubMed, Scopus, Web of Science, Embase, ProQuest, and REHABDATA were searched. Two independent reviewers were involved in screening, selecting, and extracting data. Data were synthesized using thematic analysis. Results Of the 483 screened documents, 44 qualitative studies, primarily from high-income countries, were included. All of the studies had good methodological quality. Barriers and facilitators of integrating physiotherapy into PHC were extracted within the WHO six building blocks framework. In total, 41 items were identified as barriers to the integration process. The studies included 49 recommendations to facilitate integrating physiotherapy services into PHC. Conclusion Integrating physiotherapy services into PHC faces many barriers. The most commonly suggested potential barriers are poor knowledge of physicians about physiotherapy, ineffective teamwork, physiotherapists' time constraints/workload, a lack of clarity over the role and knowledge of physiotherapists, unawareness of physiotherapy users about these services, and lack of intra- and inter-professional collaborations. The most commonly suggested recommendations to facilitate the integration process include: Clarifying the role of involved professionals, strengthening teamwork, improving intra- and inter-professional collaborations, and providing comprehensive training programs for physiotherapists.
Collapse
Affiliation(s)
- Shabnam ShahAli
- Iranian Center of Excellence in Physiotherapy, Rehabilitation Research Center, Department of Physiotherapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Saeed Shahabi
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Manal Etemadi
- The National Institute for Health and Care Research Applied Research Collaboration West (NIHR ARC West), University Hospitals Bristol and Weston NHS Foundation Trust, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, UK
| | - Maryam Hedayati
- Department of Health Services Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Barth Cornelia Anne
- School of Public Health, Physiotherapy and Sports Science, University College Dublin (UCD), Dublin, Ireland
- Centre for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
| | - Parviz Mojgani
- Iran-Helal Institute of Applied Science and Technology, Tehran, Iran
- Research Center for Emergency and Disaster Resilience, Red Crescent Society of The Islamic Republic of Iran, Tehran, Iran
| | - Masoud Behzadifar
- Social Determinants of Health Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Kamran Bagheri Lankarani
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| |
Collapse
|
8
|
Ingram S, Stenner R, May S. The experiences of uncertainty amongst musculoskeletal physiotherapists in first contact practitioner roles within primary care. Musculoskeletal Care 2023; 21:644-654. [PMID: 36683250 DOI: 10.1002/msc.1735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Revised: 01/09/2023] [Accepted: 01/10/2023] [Indexed: 01/24/2023]
Abstract
AIM The aim of this research was to explore the experiences of uncertainty amongst Musculoskeletal First Contact Practitioners working in primary care. BACKGROUND The Musculoskeletal First Contact Practitioner role involves advanced physiotherapists providing an alternative to the GP by acting as first point of contact for people presenting to primary care with musculoskeletal conditions. Limited research into the role exists but the first-contact aspect, clinical complexity and time pressures are deemed to contribute to uncertainty within the role. METHOD A qualitative research design was undertaken using a hermeneutic interpretative phenomenological approach. Data was collected using semi-structured interviews with subsequent thematic analysis of the data. FINDINGS Eight participants working as Musculoskeletal First Contact Practitioners across England were recruited using purposive sampling. Five themes were identified: (1) Role clarity within primary care, (2) Burden of responsibility, (3) Preparedness for the primary care environment, (4) 'I'm not really sure how long I am going to stay in this role', (5) Mitigating uncertainty. CONCLUSION This study demonstrates the multifaceted phenomenon of uncertainty amongst Musculoskeletal First Contact Practitioners. Uncertainty appeared to be influenced by the primary care environment, preparedness for the role and perceived burden of responsibility. Diagnostic uncertainty was prevalent with concerns of missing serious pathology evident. The impact of uncertainty on wellbeing was linked to possible burnout and retention issues. Consultation approaches, access to support networks and a cultural shift in tolerating uncertainty were reported to mitigate uncertainty. Further research into possible differences in experiences related to employment models appears warranted.
Collapse
Affiliation(s)
- Simon Ingram
- Somerset NHS Foundation Trust, Musgrove Park Hospital, Taunton, Somerset, UK
| | - Rob Stenner
- Somerset NHS Foundation Trust, Musgrove Park Hospital, Taunton, Somerset, UK
| | - Sue May
- School of Health Professions, Peninsula Allied Health Centre, University of Plymouth, Plymouth, Devon, UK
| |
Collapse
|
9
|
Anchors Z, Jones B, Thomas R, Berry A, Walsh N. The impact of remote consultations on the health and wellbeing of first contact physiotherapists in primary care: A mixed methods study. Musculoskeletal Care 2023; 21:655-666. [PMID: 36762885 DOI: 10.1002/msc.1737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 01/17/2023] [Accepted: 01/18/2023] [Indexed: 02/11/2023]
Abstract
BACKGROUND First Contact Physiotherapists (FCPs) were introduced to reduce demands on GPs by providing improving access to expert musculoskeletal care. FCPs experience similar workplace stressors to GPs and there is an emerging concern that remote consultations are causing further impacts to their wellbeing. AIM To explore the impact of remote consultations on FCPs. METHODS A mixed methods sequential explanatory study with FCPs was conducted. An online survey measured the usage and impact of remote consultations. Semi-structured interviews explored the lived experiences of using remote consultations. RESULTS The online survey was completed by 109 FCPs. A key benefit of remote consultations was patient convenience; perceived challenges included IT issues, poor efficacy, FCP anxiety, isolation, and increased workload. FCPs viewed remote consultations as a 'challenge' rather than a 'threat'. Nearly two thirds of the FCPs had not received relevant training, yet over half were interested. Follow-up interviews with 16 FCPs revealed 4 themes: (1) Remote consultations provide logistical benefits to the patient; (2) Compromised efficacy is the key challenge of remote consultations; (3) Challenges for FCPs working in areas of high deprivation; and (4) Remote consultations impact the health, wellbeing and work satisfaction of FCPs. CONCLUSIONS Remote consultations offer a convenient alternative for patients, but may add to FCP stress particularly in areas of high socioeconomic deprivation. Further research is required to understand how remote consultations can be enhanced when communication barriers and lower levels of digital literacy exist. Continued monitoring of job satisfaction and resilience levels is important to ensure FCPs remain in their role.
Collapse
Affiliation(s)
- Zoe Anchors
- School of Health and Social Wellbeing, University of the West of England, Bristol, UK
| | - Bethan Jones
- School of Health and Social Wellbeing, University of the West of England, Bristol, UK
| | - Rachel Thomas
- School of Health and Social Wellbeing, University of the West of England, Bristol, UK
| | - Alice Berry
- School of Health and Social Wellbeing, University of the West of England, Bristol, UK
| | - Nicola Walsh
- School of Health and Social Wellbeing, University of the West of England, Bristol, UK
- NIHR ARC West, Bristol, UK
| |
Collapse
|
10
|
Frost H, Tooman T, Cowie J, Gillespie N, Ackerman P, Krievs E, Dziedzic K. Advanced Practice Physiotherapists and the implementation of the JIGSAW-E model for the management of osteoarthritis in Scottish primary care settings: a qualitative case study. Physiotherapy 2022; 117:81-88. [PMID: 36244276 DOI: 10.1016/j.physio.2022.08.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 07/21/2022] [Accepted: 08/12/2022] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To explore the acceptability, barriers and enablers of NICE guidelines for osteoarthritis in the Scottish primary care setting using the Joint Implementation of Guidelines for Osteoarthritis in Western Europe (JIGSAW-E) model and investigate the role of Advanced Physiotherapy Practitioners (APPs) in providing evidence-based care. DESIGN A qualitative case study comprised of semi-structured interviews followed by a workshop with participants. SETTING 10 Scottish primary care practices. PARTICIPANTS Six general practitioners (GPs) and eight APPs were interviewed. Twenty-three practitioners attended the workshop including 22 physiotherapists and one GP. RESULTS While both GPs and APPs recognised the need to improve and standardise osteoarthritis care delivery, this study found that APPs were better situated to implement the evidence-based model. Barriers to implementation included lack of time for training, limited appointment time for GPs to consult and discuss medication use with patients, limitation of disease specific guidelines for patients with complex multimorbidity, and system-based barriers such as electronic data collection and high staff turnover. The key enabler was practitioners' motivation to provide optimal, standardised quality care for osteoarthritis. To increase acceptance, ownership and usability for both practitioners and patients, the JIGSAW-E model materials required adaptation to the local context. CONCLUSION This study provides evidence that the JIGSAW-E model is acceptable in Scottish primary care. Furthermore, the evolving roles of GPs and APPs within multidisciplinary primary care teams provides a platform to implement the JIGSAW-E model, where APPs are well placed to provide leadership and training in the delivery of evidence-based care for osteoarthritis.
Collapse
Affiliation(s)
- H Frost
- Edinburgh Napier University, The School of Health and Social Care, Scotland, UK; University of Edinburgh, Advanced Care Research Centre (ACRC), Edinburgh, Scotland, UK.
| | - T Tooman
- University of Edinburgh, Advanced Care Research Centre (ACRC), Edinburgh, Scotland, UK; University of Dundee, School of Medicine, Scotland, UK; University of St Andrews, School of Medicine, St Andrews, Scotland, UK.
| | - J Cowie
- Nursing, Midwifery and Allied Health Professions Research Unit, Faculty of Health Sciences & Sport, University of Stirling, Scotland, UK.
| | - N Gillespie
- Edinburgh Napier University, The School of Health and Social Care, Scotland, UK.
| | - P Ackerman
- Department of Physiotherapy, NHS Lothian, St John's Hospital, Livingston, Scotland UK.
| | - E Krievs
- Dalhousie Medical Practice, Bonnyrigg Health Centre, Midlothian, Scotland, UK.
| | - K Dziedzic
- Impact Accelerator Unit, School of Medicine and Health Sciences, Keele University, England, UK.
| |
Collapse
|
11
|
Stanley M, Muftaudeen M, Muonwe C, Umeonwuka CI, Nwanne CA, Ishaku CM, Okonkwo UP, Ihegihu EY, Nwosu I, Modu AA. Physiotherapists’ perception on first contact practice in Nigeria: a cross-sectional survey. BULLETIN OF FACULTY OF PHYSICAL THERAPY 2022. [DOI: 10.1186/s43161-022-00088-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Objectives
Physiotherapy has evolved over the years in training and practice. Physiotherapists’ perception of first contact physiotherapy (FCP) and the patient self-referral (PSR) practice model in Nigeria may form a basis for the actualization of FCP practice in Nigeria. This study assessed physiotherapists’ perception of FCP practice and PSR in Nigeria.
Design and setting
This study was a cross-sectional survey of 72 physiotherapists from purposively selected academic and health institutions.
Methods
A previously validated questionnaire on the global view of FCP and PSR was used in this study. Data were analyzed descriptively.
Results
The majority of the physiotherapists were aware of national legislation regulating physiotherapy practice (97.2%) and defined the scope of practice (94%) in Nigeria. Respondents who expressed the view that the expected competency of entry-level physiotherapy is sufficient for first contact practitioners were in preponderance (75%). More than half (52.8%) of the respondents perceived medical and political views, as well as professional skills of the physiotherapists as strong barriers to first contact physiotherapy practice in Nigeria.
Conclusion
Physiotherapists in Nigeria seem to intuitively recognize some form of first contact practice or direct access to patients, but unfortunately lack the legislative backing for such practices. There is a widespread assumption of professional autonomy among physiotherapists in Nigeria.
Collapse
|
12
|
Wood L, Bishop A, Goodwin R, Stynes S. Patient satisfaction with the first contact physiotherapy service: Results from the national evaluation survey. Musculoskeletal Care 2021; 20:363-370. [PMID: 34709711 DOI: 10.1002/msc.1599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 10/14/2021] [Accepted: 10/17/2021] [Indexed: 11/10/2022]
Abstract
BACKGROUND Musculoskeletal (MSK) First Contact Physiotherapists (FCPs) are diagnostic clinicians able to assess and manage undifferentiated and undiagnosed MSK presentations. The FCP role in primary care has been introduced to allow patients with MSK pain to see a FCP directly rather than wait to see a General Practitioner (GP) first, which improves capacity within primary care. A national evaluation was undertaken of the FCP model. This article reports the thematic analysis of the free-text responses of patients who participated in the national evaluation. METHODS An online platform collected patient-reported experience and outcomes following the FCP consultation and at 1, 2 and 3 months follow-up. Free-text responses to the Friends and Family test, reasons for consulting another health care professional (HCP) and general comments were thematically analysed and grouped according to their responses. RESULTS Over 13 months, 680 of 2825 registered patients (24%) completed the initial questionnaire and 54% (n = 370) completed the 3-month follow-up. During the course of the evaluation, 785 participants provided free-text responses. Themes identified from free-text responses were: communication and knowledge, clinicians' characteristics, efficiency, treatment provided, assessment skills and service provided in comparison to GP care. Complaints represented 4% (n = 26 comments) of total feedback. The main reasons for consulting other HCPs after seeing a FCP were persistent pain, delays in referrals or already attending NHS physiotherapy. CONCLUSION Thematic analysis of free-text responses in the national FCP evaluation provides context and detail to the positive outcomes reported by patients after consulting a FCP in primary care.
Collapse
Affiliation(s)
- Lianne Wood
- Spinal Outpatient Department, Queens Medical Centre, Nottingham University Hospitals NHS Trust, Nottingham, UK.,School of Medicine, Keele University, Keele, UK
| | | | - Rob Goodwin
- School of Medicine, University of Nottingham, Nottingham, UK
| | - Siobhan Stynes
- School of Medicine, Keele University, Keele, UK.,Midlands Partnership Foundation NHS Trust, Haywood Hospital Spinal Interface Service, Staffordshire, UK
| |
Collapse
|