Learning and education

To share how and where the stratified care approach (SB) for low back pain is being used globally and to capture barriers and facilitators to its uptake.

Adults with long-term neurological conditions have low levels of participation in physical activities and report many barriers to exercise. This study used a mixed methods approach to evaluate participant experiences and outcomes following participation in student-led, community-based neurological groups and to explore the feasibility of performing a full-scale study.

The Comprehensive Geriatric Assessment (CGA) is a multidisciplinary assessment that identifies the medical, psychosocial, and functional needs of older people. This service evaluation considers the impact of training allied health professionals (AHPs) and community nurses to undertake a CGA assessment in primary and community settings.

Population health and prevention is a major priority of the recently formed Greater Manchester Health and Social Care Partnership and is an area in which physiotherapists can make a positive contribution. The Physiotherapy MSK services within the Bury Care Organisation, have successfully developed a MECC model of practice into their service pathways. This quality improvement, uses evidence based behaviour change principles to support patients in making positive lifestyle changes which can impact on their physical and mental health and wellbeing. It also aims to support Trust staff to become more active and promotes health and wellbeing within the wider communities.

The population of older people is rapidly growing and many are not living in good health; this escalating problem has significant economic and resource implications but more importantly impacts on individual quality of life in later years. In recognition of this 'perfect storm' the importance of embedding prevention strategies and health promotion interventions specific to older people is widely recognised. One approach to tackling this, Making Every Contact Count (MECC), empowers staff to initiate opportunistic conversations with people who report 'risky' health behaviours, supporting the first positive steps towards health behaviour change and self-management.

This quality improvement project was initiated following a record keeping audit which identified that healthy lifestyle conversations were recorded in only 19% of clinical records. It aimed to increase the number of documented healthy lifestyle conversations that clinicians have with Integrated Community Team patients.

Current evidence advocates physiotherapy treatment, for the management of cervicogenic headaches (CGH). A reasoned assessment and clear knowledge of red flags is essential.

An MSK physiotherapy team from southern England received training sessions for CGH. Topics included assessment, evidence based treatment, clinical reasoning and red flags. Physiotherapists completed a questionnaire on headache red flags and signs and symptoms, preceding and following training.

10 patient cases were examined, exploring treatments, against current best practice, after training. Effectiveness was evaluated using patient outcomes before and after intervention.

The purpose/objectives of this study was to:-

• Evaluate participant's knowledge of red flag and signs and symptoms of CGH headache, preceding and following training.
• Examine treatments used by participants for 10 CGH patient cases, against current best practice after training.
• Review patient treatment outcomes, of the 10 CGH patient cases after training.

To explore the impact of putting senior clinicians at the bedside with clinical expertise in their speciality to improve quality of patient care. This role was introduced at Hampshire Hospitals Foundation Trust (HHFT) in 2016, whilst mainly undertaken by senior nurses, 2 physiotherapists and an occupational therapist have also undertaken the role. This presentation explores the impact of physiotherapists undertaking such roles.

To incorporate simulation within the Physiotherapy teaching programme allowing students to engage with simulated clinical situations. Learning alongside peers developing confidence and skills required to be effective physiotherapists.

The South East London and Kent Regional Spinal Network (RSN) aims to provide evidenced-based pathways for management of musculoskeletal spinal conditions from first point of contact through to tertiary care. From 1^st April 2018 all non-emergency referrals to secondary care (Pain and Spinal Surgery) must be referred by Spinal Specialist Triage Practitioners (SSTP). GP referrals will not be accepted. This aligns with the National Back Pain Pathway (NBPP) and NICE CG59 guidelines towards improving spinal care, equity of services and commissioning of spine care across the region. SSTPs, predominantly physiotherapists by background, are multidisciplinary (e.g. osteopaths, nurses) and work in primary or secondary care or in interface services run by NHS and Any Qualified Providers (AQP).

There have been calls for the development of a regional training programme and in the long-term, a nationally recognised qualification, to support SSTPs and promote excellent patient care. Current provision of training is fragmented and learning needs unknown. A learning needs analysis is required to allow for development of future training and development.

There are no validated learning needs questionnaires suitable for the specific purpose therefore a comprehensive tool was required.

In May 2016 rheumatology referrals were outstripping service capacity, leading to increasing waiting times for new patients. Following a review of new patient referrals the team identified that a significant proportion of referrals, though being appropriately referred to rheumatology, were for non-inflammatory conditions. Recognising the changing landscape of the NHS and the emphasis to look at different ways of working we put forward a proposal to pilot a rheumatology advanced practitioner physiotherapist (APP) with the following aims: -

• Improve the triage process
• Streamline the pathway for new patients with non-inflammatory conditions
• Reduce waiting times