The acceptability to patients of PhysioDirect telephone assessment and advice services; a qualitative interview study.

Jennifer Pearson,Chris Salisbury,Nadine E Foster,Jane Richardson,Michael Calnan

doi:10.1186/s12913-016-1349-y

Abstract

BackgroundIn response to long waiting lists and problems with access to primary care physiotherapy, several Primary Care Trusts (PCTs) (now Clinical Commissioning Groups CCGs) developed physiotherapy-led telephone assessment and treatment services. The Medical Research Council (MRC) funded PhysioDirect trial was a randomised control trial (RCT) in four PCTs, with a total of 2252 patients that compared this approach with usual physiotherapy care. This nested qualitative study aimed to explore the acceptability of the PhysioDirect telephone assessment and advice service to patients with musculoskeletal conditions.MethodsWe conducted 57 semi-structured interviews with adults from 4 PCTs who were referred from general practice to physiotherapy with musculoskeletal conditions and were participating in the PhysioDirect trial. The Framework method was used to analyse the qualitative data.ResultsThe PhysioDirect service was largely viewed as acceptable although some saw it as a first step to subsequent face-to-face physiotherapy. Most participants found accessing the PhysioDirect service straightforward and smooth, and they valued the faster access to physiotherapy advice offered by the telephone service. Participants generally viewed both the PhysioDirect service and the physiotherapists providing the service as helpful. Participants’ preferences and priorities for treatment defined the acceptable features of PhysioDirect but the acceptable features were traded off against less acceptable features. Some participants felt that the PhysioDirect service was impersonal and impaired the development of a good relationship with their physiotherapist, which made the service feel remote and less valuable.ConclusionThe PhysioDirect service was broadly acceptable to participants since it provided faster access to physiotherapy advice for their musculoskeletal conditions. Participants felt that it is best placed as one method of accessing physiotherapy services, in addition to, rather than as a replacement for, more traditional face-to-face physiotherapy assessment and treatment.

Highlights

In response to long waiting lists and problems with access to primary care physiotherapy, several Primary Care Trusts (PCTs) ( Clinical Commissioning Groups CCGs) developed physiotherapy-led telephone assessment and treatment services
Many people with musculoskeletal problems are referred to physiotherapy, with approximately 6.7 million new referrals made to physiotherapy services each year in the National Health Service (NHS) [2, 3]
The main objective of this paper is to describe the key variables that determined patient acceptability of the PhysioDirect service and to understand how the patient experience differed from those accessing usual physiotherapy care

Summary

Introduction

In response to long waiting lists and problems with access to primary care physiotherapy, several Primary Care Trusts (PCTs) ( Clinical Commissioning Groups CCGs) developed physiotherapy-led telephone assessment and treatment services. Arrangements concerning how and when people with musculoskeletal pain access physiotherapy services vary across the UK, depending on local circumstances This often means physiotherapy services have long waiting lists, resulting in waits for treatment from several weeks to months. Several initiatives have been developed to help address this problem, including the introduction of physiotherapy-led telephone assessment and advice services known as ‘PhysioDirect’. These services allow patient to contact a physiotherapist who will assess their musculoskeletal symptoms over the telephone. Consultation, physiotherapist, information and advice, call length Outcomes: I would like to know if the physiotherapy you received has helped your problem? Do you telephone bank? Have you ever used NHS Direct or the GP out of hour (OOH) services? Closing: Thanking re information given, reflection on what was said, and other questions?

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Conclusion