Advanced physiotherapy in primary care. Part of the solution for a growing crisis?

Hensman-Crook, Amanda

doi:10.1016/j.physio.2017.11.159

Cited by 3 publications

(7 citation statements)

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“…‘Patient self‐referral’ or ‘self‐booking’ was used by four sources (Akehurst et al., 2019; Doran, 2021b; Halls et al., 2020; Jagosh et al., 2022), and ‘GP referral’ or GP involvement in the patient accessing an FCP appointment was referred to in seven sources (Doran, 2021a; R. Goodwin et al., 2021; Greenhalgh et al., 2020; Halls et al., 2020; iCSP 1‐3, 2021; Pike, 2020). Involvement of Reception was stated as an access method in five of the sources (Hensman‐Crook, 2019; iCSP 1, 2021; Jagosh et al., 2022; Pike, 2020; Wise, 2019), for example, direct from reception and booked via reception. Most of the terminology involving the process of patients accessing FCP appointments was not explained or defined by the sources authors; the only source which had a detailed explanation of how staff interacted with patients to match the ‘right’ patients to the ‘right’ clinicians was McDermott et al.…”

Section: Resultsmentioning

confidence: 99%

“…None of the included studies or other materials explored the clinical or cost‐effectiveness of different access processes, which was not unexpected, given the nature of the studies. However, several studies have discussed the fact that some patients seen by FCPs were not always ‘first contact’, and this undermining of the first contact principle may have a negative effect on the impact of FCP and increase unnecessary steps in the healthcare system (R. Goodwin et al., 2021; Greenhalgh et al., 2020; Hensman‐Crook, 2019). Alternatively, it may improve overall use of the healthcare system if patients receive appropriate MSK care as a second appointment in Primary Care, rather than using several GP appointments or being referred to Secondary Care.…”

Section: Resultsmentioning

confidence: 99%

“…Personnel involved in patients accessing FCP appointments were described as ‘reception/receptionists’ or ‘admin/administration/administrators’ in 17 of the sources (Bater & Sellars, 2022; CSP, n.d.; Davies et al., 2021; Doran, 2021a, 2021b; Goodwin, n.d.; R. Goodwin et al., 2020; Halls et al., 2020; HEE, 2020; Hensman‐Crook, 2019; Jagosh et al., 2022; McDermott et al., 2022; Morris et al., 2021; Pain, 2022; Pike, 2020; Wise, 2019; Ingram et al., 2023), GPs in 10 of the studies and other materials (Doran, 2021b; R. Goodwin et al., 2021; Greenhalgh et al., 2020; Halls et al., 2020; iCSP 1‐3, 2021; McDermott et al., 2022; Pike, 2020), ‘ANPs’ in three (R. Goodwin et al., 2020; Halls et al., 2020; iCSP 1, 2021), ‘primary care team’ in one (CSP, n.d.), and ‘healthcare staff’ in one (R. Goodwin et al., 2020). Three of the studies did not provide any information regarding personnel involved (Akehurst et al., 2019; Bater & Sellars, 2022; Wood et al., 2022).…”

Section: Resultsmentioning

confidence: 99%

“…From the 24 studies and other materials reviewed, there was little evidence investigating this area, demonstrating a clear gap in the research base, and likely reflective of the relative infancy of FCP services. Of the included sources, many had very brief mentions of FCP appointment access methods; nine had only one line regarding access (Akehurst et al., 2019; Bater & Sellars, 2022; Doran, 2021a, 2021b; Hensman‐Crook, 2019; Jagosh et al., 2022; Pain, 2022; Pike, 2020; Wise, 2019). Only one study, the UK‐wide online survey of FCP provision (Halls et al., 2020), specifically asked participants about the variety of access options available.…”

Section: Discussionmentioning

confidence: 99%

“…This was most commonly termed ‘signposting’, but in only one study (McDermott et al., 2022), the term was defined or the processes involved explained. Several sources in the review did not use the term ‘signposting’, but the brief descriptions given suggested a comparable process; “booked via reception” (Wise, 2019), “direct from reception” (Hensman‐Crook, 2019). ‘Triage’ and ‘care navigation’ were other terms that appeared to indicate a process similar to that of ‘signposting’—that of determining a patient's need and directing them to the most suitable member of the GP team (Bater & Sellars, 2022; CSP, n.d.; Doran, 2021a; Wood et al., 2022).…”

Section: Discussionmentioning

confidence: 99%

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Access to first contact physiotherapy appointments in primary care: A scoping review

Lamb

Comer

Walsh

et al. 2023

Musculoskeletal Care

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BackgroundFirst Contact Physiotherapy (FCP) is part of the drive to increase General Practice (GP) capacity by providing access to expert musculoskeletal (MSK) Physiotherapists in GP surgeries. For the FCP model to provide effective MSK care at the start of the patient's journey, it is essential that patients are directed to FCP appointments in a timely manner. It is therefore important to know how patients are accessing FCP appointments.ObjectiveTo provide an overview of the literature regarding patient access to FCP appointments.DesignScoping review.MethodsWe reviewed studies published from January 2016 to May 2023 that focused on FCP and made a mention of patient access to FCP appointments. A search was performed using six databases as well as grey literature sources. Study selection and data extraction were independently conducted by two reviewers. Extracted data were tabulated and analysed according to our research questions.ResultsFrom 186 records identified, 24 studies and other materials were included in the review. A variety of terms were used to describe access routes to FCP appointments, the most common being ‘signposting’. These studies suggest the importance of the role of GP reception/administrative staff in enabling efficient patient access to FCP appointments.ConclusionThere is a clear gap in the literature concerning how patients access FCP appointments. Since the importance of appropriate access is acknowledged as an essential feature of the expansion of FCP in Primary Care, future research is needed to refine and implement optimal FCP access models by identifying the key components needed to ensure timely and appropriate access to FCP.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Access to first contact physiotherapy appointments in primary care: A scoping review

Lamb

Comer

Walsh

et al. 2023

Musculoskeletal Care

View full text Add to dashboard Cite

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Advanced practice physiotherapists in primary health care: stakeholders’ views of a new scope of practice

Stotter,

McKinlay,

Darlow

2024

J. Prim. Health Care

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Introduction. Advanced and extended primary health care practice roles have been developed in Aotearoa New Zealand (NZ) for dietetics, nursing, pharmacy, and physiotherapy professions. Advanced musculoskeletal physiotherapy roles in primary health care could address escalating health care costs, challenges to workforce sustainability and inefficient primary/secondary care interfaces. Little is known about how stakeholders perceive the recently introduced Advanced Practice Physiotherapist (APP) scope of practice. Aim. This study aimed to explore health professionals' perceptions of the APP scope of practice in NZ and how APPs could influence physiotherapy service delivery for people with musculoskeletal conditions in primary health care. Methods. Qualitative, face-to-face, semi-structured interviews were conducted with 15 participants including physiotherapists, general practitioners, medical specialists and Accident Compensation Corporation case managers. Inductive interpretive analysis was undertaken. Results. Five themes were identified: perceptions of current musculoskeletal management in primary health care; lack of a career pathway; ways in which APPs might facilitate change and what their role would be; characteristics of an APP; and the implementation of the APP role into practice. Discussion. Stakeholders were supportive of the APP scope of practice and thought it has the potential to improve patient pathways, health care delivery and health outcomes for those with musculoskeletal conditions. Stakeholders also thought it would fill an important gap in the physiotherapy clinical career pathway. Successful implementation will require assessment of applicants' personal attributes as well as clinical experience and academic qualifications to ensure all stakeholders have confidence to engage with the service, clear communication, active promotion and specific funding.

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Characterising the outcomes, impacts and implementation challenges of advanced clinical practice roles in the UK: a scoping review

et al. 2021

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ObjectivesIn response to demographic and health system pressures, the development of non-medical advanced clinical practice (ACP) roles is a key component of National Health Service workforce transformation policy in the UK. This review was undertaken to establish a baseline of evidence on ACP roles and their outcomes, impacts and implementation challenges across the UK.DesignA scoping review was undertaken following JBI methodological guidance.Methods13 online databases (Medline, CINAHL, ASSIA, Embase, HMIC, AMED, Amber, OT seeker, PsycINFO, PEDro, SportDiscus, Osteopathic Research and PenNutrition) and grey literature sources were searched from 2005 to 2020. Data extraction, charting and summary was guided by the PEPPA-Plus framework. The review was undertaken by a multi-professional team that included an expert lay representative.Results191 papers met the inclusion criteria (any type of UK evidence, any sector/setting and any profession meeting the Health Education England definition of ACP). Most papers were small-scale descriptive studies, service evaluations or audits. The papers reported mainly on clinical aspects of the ACP role. Most papers related to nursing, pharmacy, physiotherapy and radiography roles and these were referred to by a plethora of different titles. ACP roles were reported to be achieving beneficial impacts across a range of clinical and health system outcomes. They were highly acceptable to patients and staff. No significant adverse events were reported. There was a lack of cost-effectiveness evidence. Implementation challenges included a lack of role clarity and an ambivalent role identity, lack of mentorship, lack of continuing professional development and an unclear career pathway.ConclusionThis review suggests a need for educational and role standardisation and a supported career pathway for advanced clinical practitioners (ACPs) in the UK. Future research should: (i) adopt more robust study designs, (ii) investigate the full scope of the ACP role and (iii) include a wider range of professions and sectors.

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Advanced physiotherapy in primary care. Part of the solution for a growing crisis?

Cited by 3 publications

References 0 publications

Access to first contact physiotherapy appointments in primary care: A scoping review

Access to first contact physiotherapy appointments in primary care: A scoping review

Advanced practice physiotherapists in primary health care: stakeholders’ views of a new scope of practice

Characterising the outcomes, impacts and implementation challenges of advanced clinical practice roles in the UK: a scoping review

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