The Occupational Therapy (OT) service at Leicester City Council (LCC) faced some difficulties when they were working with a person who required Physiotherapy (PT) input in the community. Namely the long waitlist for input and an inability to establish a person’s baseline level of mobility when this was needed before recommending care packages, equipment or adaptations. The impacts on LCC were an increased need for formal care, equipment and adaptations as well as increases in OT staff’s workloads and/or delays in picking up new cases. Additionally, the cost to the person is highlighted as delays in accessing PT input can lead to further deterioration in their abilities (dependence) and/or the need to wait longer for equipment/ adaptations which may put them at risk.
Patient-reported outcome measures (PROM's) following Secondary Care NHS Musculoskeletal Physiotherapy
The aims of this report were:
- to provide a large, transparent dataset from which other organisations can benchmark clinical outcomes
- to provide the first documented large-scale musculoskeletal (MSK) physiotherapy outcomes evaluation using the MSK Health Questionnaire (MSK-HQ)
- to compare clinical outcomes of MSK physiotherapy with NHS England average clinical outcomes associated with surgical procedures.
The use of outcome measures is well evidenced and documented. Despite prevalent use of various clinician reported outcome measures (CROMs), patient reported outcome measures (PROMs) are often in the form of detailed quality of life questionnaires, which are not appropriate in acute, fast paced environments. A new PROM tool (called thera-PROM) was devised and used with the aim of measuring the effect of goal-focused physiotherapy interventions in an acute adult in-patient setting. Process and data evaluation aims to identify standards and guidelines for future use to support service evaluation and quality measurement.
The small scale project was carried out as a starter to implement an appropriate PROM tool for the clinical area where there was not previously any PROM tool used as it had not been possible to identify an existing PROM tool that was fit for purpose. The findings may be useful to share with other therapists for wider use or consideration when implementing a PROM tool.
Early rehabilitation of patients in critical care (CC) units demonstrates clear patient benefits for outcomes of physical function, muscle strength and length of stay. Cycle-ergometry as a modality for early rehabilitation is safe and feasible in mechanically ventilated patients once they are medically stable. However, it is widely recognised that implementing such an intervention outside of a clinical trial can be challenging.
Nottingham University Hospitals NUS Trust introduced a protocol for cycle ergometry for all eligible adult patients in CC. The aim of this service evaluation (SE) was to determine whether an early cycle-ergometry protocol could be safely delivered and was operationally feasible. The SE also aimed to highlight any barriers to implementation that were modifiable. The SE was registered with the Trust number 17-239C
Tennis elbow is a common painful condition that may affect daily function and ability to work. Physiotherapy is the most commonly used primary intervention but there is a wide range of treatment options within the umbrella of physiotherapy. Our aim was to report which treatments are currently used by physiotherapists in a UK National Health Service setting.
Tennis elbow is a common condition in the UK but there are no guidelines on how best to manage the condition. The purpose of this study was to establish the current UK practice in managing patients with chronic tennis elbow (symptoms over six months).
There is limited published evidence to guide physiotherapists when treating patients with atraumatic shoulder instability. The aim of this study was to update the results of a previous small service evaluation investigating the outcomes for patients following a specific structured physiotherapy programme.