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An analysis of the utility, effectiveness and scope of advanced physiotherapy practitioners in an urgent treatment
Andrew McDonough1, Alice Lennox2, Michelle Angus3
1Department of Emergency Medicine, Salford Royal NHS Foundation Trust, Stott Lane, Salford M6 8HD, UK.
Background:
The NHS Five Year Forward View explored the requirement to redesign emergency departments in England. It suggested that by December 2019, all emergency departments should aim to develop urgent treatment centres primarily led by primary care services opposed to the traditional model of being emergency physician led. This redesign aims to improve patient care by "helping people who need urgent care to get the right advice in the right place, first time".
Aim:
One aim was to quantify the proportional presentations of patients attending the emergency department who were suitable for management by advanced physiotherapy practitioners (APPs). A second aim was to analyse patient care delivered by APPs in comparison to other members of the multidisciplinary team.
Methods:
A retrospective service evaluation was undertaken reviewing a pilot urgent treatment centre at a busy major trauma centre. Data was collected to assess number of patients seen by all multidisciplinary cohort members. This was to assess presentation patterns and compare workload delivery.
Results:
The pilot found that APPs could assess and treat a wide range of conditions within the urgent treatment centre. APPs saw 30% of the caseload, organised similar numbers of investigations than GPs and had fewer 30 days re-attendances.
Conclusion:
The service review highlighted APP can assess, treat, discharge and appropriately refer similar numbers of patients compared to multidisciplinary colleagues. This would suggest that APPs are likely to be highly cost effective within an urgent treatment centre environment, but further study is warranted to assess clinical and cost effectiveness.
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