Service Evaluation of Physiotherapy Musculoskeletal Community Appointment Days
Brian Slattery1, Craig Grant2, Alison Peters1
1NHS Lanarkshire, Bothwell, UK.
Background:
NHS Lanarkshire (NHSL) Physiotherapy Musculoskeletal (MSK) service receives approximately 30,000 referrals annually, facing long waiting times and workforce pressures. To address these challenges, NHSL piloted Community Appointment Days (CADs)-a patient-centred model offering same-day assessment, advice, and community support in non-medical settings.
Methods:
A mixed-methods service evaluation was conducted using retrospective analysis of data from ten CADs delivered across three leisure centres in 2024-2025. Quantitative data from the Patient Management System included attendance, outcomes, and re-access rates. Qualitative data were collected via patient passports, surveys, and interviews. Objectives were to assess impact on waiting times, patient experience, cost avoidance, and sustainability.
Results:
Of 2,287 patients booked, 1,866 attended. Outcomes included discharge (10%), patient-initiated review (PIR) (53%), and return appointment (37%). Average time per CAD was 69 minutes. PIR return rate was 8%, with 0% ED attendances for the same condition. CADs enabled a 3.7-fold increase in new patient capacity on the day, reducing waiting times in targeted waiting lists by 5 weeks in 2024 and 9 weeks in 2025. Initial setup costs were £16,388; subsequent CADs projected cost avoidance of £4,132 each. Patient feedback was highly positive, with strong Care CollaboRATE scores, though some reported environmental challenges. Staff reported CADs as less stressful or similar to routine work.
Conclusion:
CADs are a scalable, patient-centred model that improves access, reduces waiting times, and supports self-management while maintaining safety. Future work should refine triage, enhance booking systems, and evaluate long-term outcomes to ensure sustainability.
