Musculoskeletal Physiotherapy in Primary Care Sites: Survey of English NHS trusts

Abstract

Summary Objective To determine the extent of GP/health centre-based musculoskeletal physiotherapy services provided by NHS trusts in England; to ascertain the value of relocation to primary care settings as perceived by physiotherapy service managers; to discuss implications; and to identify issues for further research. Methodology A postal survey, using a questionnaire with closed and open questions, was carried out. Questionnaires were sent to physiotherapy service managers in all 325 NHS trusts in England who supplied a musculoskeletal physiotherapy service. Questionnaires were piloted before the main study. Results A response rate of 76.3% (n = 248) was obtained. Of trusts responding to the survey, 80% provided musculoskeletal physiotherapy services located in GP/health centres. Rapid expansion in services was perceived to be demand-led with 47.8% of managers planning future expansion. Of physiotherapy service managers 60.6% considered that the provision of this service increased physiotherapy membership of the primary healthcare team which was advantageous for the physiotherapy profession; 49.8% believed the service offered increased benefits to patients. The risk of isolation from peers was raised by 48.8% of managers. Professional isolation, the risk of professional fragmentation, the impact of restricted on-site resources on the quality of patient care, and staffing issues were identified as issues that needed to be addressed. Conclusions The issues raised by this study require consideration during the development of primary care trusts. Managers perceived that a shift in location of physiotherapy services will have implications for equitable service provision. The rapid expansion of these services will require manpower planning and, in the shorter term, may threaten quality in other core areas of physiotherapy practice.