Scotland

Effects of Aerobic and Strengthening Exercise Combined with Behaviour Change Interventions in Fatigue Management of People with Multiple Sclerosis(pwMS).

Fatigue is one of the more debilitating symptoms as it affects the ability to carry out daily activities. Despite the increasing evidence for the effectiveness of exercise and behavioural change interventions for fatigue management in pwMS, there have been no published critical review that has investigated a combination of exercise and behavioural change interventions. This review aims to investigate the effect of aerobic and strengthening exercise combined with behavioural change interventions in fatigue management in pwMS.

Critter Quest: An Inclusive Physical Activity App for Children

The current paediatric population are not reaching targeted government's guidelines of physical activity. This can lead to serious implications to children's health and wellbeing. Furthermore children with chronic health conditions and/or impairments participate in activity less than the general population. Activity apps have been shown to support positive behavioural change. Although many apps exist, promoting physical activity, an opportunity to design an app inclusive and accessible for children with challenging health conditions and disabilities was identified. The aims of this study were:  

  • To design an app that parents and children would use that promotes inclusive physical activity.
  • To evaluate the feasibility of using the app.
  • To use feedback and demand from users to make adjustments to app functionality prior to public release.

Redesign of NHS Forth Valley´s Community Rehabilitation AHP Single Point of Referral.

NHS Forth Valley Community AHP services have redesigned how they deal with referrals received into their services. Until recently, point of receipt of referrals was purely administrative, with staff signposting to various parts of service that are delivered. Referrals that were deemed “inappropriate” were often lost in the system; there was no cognisance of how these “inappropriate” referrals should be dealt with. There was no understanding of time spent dealing with these queries. We redesigned the service, 'going live' in November 2018, to bring clinical staff into SPR, triaging the referrals received using a Personal Outcomes Approach and have reduced the number of referrals going forwards for intervention at the rehab teams, and increased signposting and self management in the community. This has had a knock on effect to reducing waiting times and enabled a more specific and tailored approach to those requiring rehabilitation in the community.

Can a Local NHS Musculoskeletal Facebook™ Page Influence Physiotherapy Referral Numbers?

According to latest research Facebook™ is still the most widely used social media platform worldwide. In 2017 a local evaluation found growing appetite from Ayrshire service users to have a specific musculoskeletal social media page to facilitate education about common conditions. A musculoskeletal physiotherapy Facebook™ page for NHS Ayrshire and Arran was thus set up in April 2017 which helps promote a locally devised self-management website. Initial exercise videos on the website were for anterior knee pain due to the evidence base supporting their use in self management. This innovative approach to rehabilitation implements Scottish Government digital drivers to focus health on prevention, anticipation and supported self-management. The aim of this study was to determine whether a local NHS musculoskeletal physiotherapy Facebook™ page influences referral numbers into the service.

Can patients with Bronchiectasis in Grampian use online Physiotherapy resources and patient information leaflets to self manage their condition?

At present within NHS Grampian there is minimal Respiratory Physiotherapy provision in primary care. Aberdeenshire is a large geographical area, with the specialist respiratory services based in Aberdeen Royal Infirmary. This requires patients to travel long distances for a Respiratory specialist review. Furthermore due to a lack of standardised pathway for patients with Bronchiectasis, there is an even greater waiting time before they are seen, even in the acute sector.

To add to this, there are ongoing staff recruitment difficulties locally which mean there is only resource for more complex patients to be assessed. With this, a Bronchiectasis toolkit was developed to provide airway clearance advice to all patients in NHS Grampian. The aim of the toolkit is to provide information that is accessible to all patients within the area, to reduce the length of time before they are provided with physiotherapy advice about airway clearance,exercise and improve patient outcomes.

Physiotherapists in ED: A city wide service supporting board performance, government targets, professional growth and most importantly patient care

The Scottish Government's Emergency Access Standard aims for 98% (95% target) of all patients to be admitted, transferred or discharged within 4 hours from arrival at Emergency departments. This is supported by a National Improvement Programme following collaborative methodology to dynamically spread best practice and learning nationally. Work to date in this area has focussed less on how MSK physiotherapists can support this and support optimum benefit across Scotland.

Growing numbers of patients with acute MSK problems attend the Emergency Department (ED). These minor conditions are often left waiting and are more likely to breach the 4 hour target, as nurses and medics focus on sicker patients. But physiotherapists are touted as being experts in MSK? So why not test this and see not only how it affects the 4 hour access standard but the patient journey?

Advanced Physiotherapy Practitioner consultation as an alternative to GP consultation for patients with Musculoskeletal Conditions

General Practice is currently experiencing considerable capacity and sustainability challenges. With General Practice carrying out 90% of patient contacts in the NHS and musculoskeletal (MSK) conditions accounting for 10 - 30% of GP appointments it is essential to explore new ways of coping with this demand.

In Midlothian, half the practices were operating with restricted lists as a result of increasing demand: a demand which is predicted to quickly rise as the influx of new housing has resulted in Midlothian being the fastest growing local authority area in Scotland.

The strategic principle of this work is therefore to redirect appropriate patients from General Practice to MSK APP services with the aim of:

•           improving GP capacity.

•           improving patient outcomes.

•           improving the patient experience.

•           being cost effective and efficient.

•           enabling quick and easy access to highly specialised musculoskeletal input.

•           reducing referrals to secondary care, helping throughput and improving the conversion rate to surgery.

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