Innovations

Physiotherapy role-emerging placements can occur at sites where there is minimal or no physiotherapy service or established physiotherapy role. Lack of physiotherapy provision has been identified in care home settings, and this lack impacts on the quality of care in managing complex physical and mental health conditions such as dementia.

The Care Home Liaison team uses a multi-disciplinary model to develop interventions to support individuals living with dementia to have positive lived experiences of the care home setting. However, where physical health is a component of the individual's mental well-being, the team is limited to over-stretched community physiotherapy services.

This gap in knowledge and practice highlights the unique role physiotherapy could offer in managing such a complex client group. Physiotherapists working in dementia care offer an important role in the management of physical conditions, together with promoting and maintaining mobility and function. This has a positive impact on the behavioural and psychological symptoms of dementia and so reduces the use of pharmacological interventions.

Role-emerging placements can highlight the value and impact physiotherapy has, and allows students to develop skills and experience in increasingly diverse, complex and evolving workplaces.

Rotator cuff related shoulder pain (RCRSP) is a prevalent complaint of the upper limb with growing research suggesting a possible relationship between cardiometabolic risk factors.

This study aimed to systematically review case-control, cross-sectional and cohort studies investigating the association between metabolic syndrome (MetS) and RCRSP.

The purpose of this service evaluation was to help better understand the impact and value of running a Recorded Physiotherapy Webinar (RPW) programme to Nuffield Health Physiotherapists.

RPW's are a series of 20-40 minute presentations recorded with both visuals (PowerPoint) and audio (presenter's voice). They are delivered by subject matter experts from across Nuffield Health and aim to promote learning on clinical topics (i.e. ACL rehabilitation, Shoulder red-flags and Cervicogenic headaches).

A total of 14 self-selected RPW's are currently available and can be accessed from anywhere, at any time after the recording via a Learning Management System (LMS).

Until recently, virtual physiotherapy services represented the minority of support offered by the private and public healthcare sectors. The Covid-19 outbreak created a sudden need for digital health services to be rolled out more widely.

Ascenti wanted to use its dataset of 27,000+ virtual appointments to see how results for online physiotherapy compared with those for in-clinic care and to gather views from patients and clinicians to enable further improvement.

Patients accessing Physiotherapy in Blackburn demonstrate multiple co-morbidities, physical and biopsychosocial issues. This unique, cost-effective, collaborative service redesign addresses the specific co-existing health issues and behaviours associated with MSK conditions in Blackburn and offers a cost-effective, high quality solution to empower and support the MSK population to better manage their own health and well-being in alignment with Public Health England priorities.

Historically, at GSTFT, patients with ACL pathology have been managed in weekly exercise classes. Anecdotally, Physiotherapists felt that they were unable to effectively manage both the post-operative and ACL deficient (ACLD) populations due to high class numbers. After an internal service evaluation and audit, a unique ACLD pathway was established to separate the ACLD population, and better manage both ACL cohorts. This included a specific fortnightly ACLD Induction Clinic and ACLD rehabilitation class.

This data collection aimed to:

• Evaluate the demand for the ACLD pathway, including the new ACLD rehabilitation class, and analyse patient demographics
• Ensure the ACLD pathway is utilised correctly, by monitoring patients being referred
• Start analyzing the data and trends of patient attendance and onward management in the ACLD rehabilitation class and begin early root cause analysis.
• Commence a systematic review around the quality of pre-operative physiotherapy intervention and how this effects outcomes post-operatively, in order to guide the temporality and content of our ACLD rehabilitation class.

Constipation is a common condition that impacts quality of life, often causing psychological distress and incurring considerable healthcare costs in terms of unnecessary emergency admissions due to poor management.

Aintree University Hospital offers one of the only Specialist Physiotherapy led healthy bowel clinics (HBC) in the UK that assess, treat and manage patients presenting with functional bowel problems, including constipation. Patients referred into the service are directed straight to HBC and the majority will never see a medic. The service is run solely by Physiotherapists. We can refer for appropriate tests (transit marker studies, defecating proctograms, anorectal physiology and various blood tests). We independently interpret results and decide on appropriate treatment/management. Our service offers specialist assessment, medication management, lifestyle advice, pelvic floor re-education, Posterior Tibial Nerve Stimulation, rectal irrigation and cognitive behavioural therapy. The majority of our patients are managed conservatively as surgery is rarely an option.

From December 2013 to November 2014, Hospital Episode Statistics (HES) data showed that 301 patients were admitted to Aintree University Hospital with a primary diagnosis of constipation, 216 of these through the Accident and Emergency Department (AED), with an average length of stay of 3.3 days. The HBC Physiotherapists recognised that there should be a more cost-effective, efficient way to manage these patients and proposed a new pathway. The pathway allows patients to manage their symptoms in their own home with support from specialist Physiotherapists, enhancing patient dignity. Assessment identified 5 patients with potential red flag symptoms and allowed appropriate onward referral.

Exercise and physical activity is increasingly being encouraged with palliative care patients due to emerging evidence suggesting the physical and psychosocial benefits to patients. This small, local audit analyses the changes in physical outcome measures of a group of patients undertaking a weekly circuit exercise group.

To analyse and add further understanding of the extent and nature of stress and burnout in the physiotherapy workforce, its impact on the workforce and patient care. To identify coping strategies that can be used by clinicians and managers in the workplace to reduce stress and burnout.

1 in 4 people experience mental health problems in any given year, 1 in 6 experience work related stress, depression or anxiety. Only 25% of those experiencing emotional distress seek and receive treatment, with many being dependent on the informal support of family or colleagues.

Physiotherapists are also encouraged to investigate Biopsychosocial issues with their patients, through management of persistent pain conditions and may not feel equipped to successfully interpret or manage the information that they receive from the patient. This additional stress can also impact on the Physiotherapists emotional wellbeing and have an impact on patient care.

The aim of this project was to ensure that all Physiotherapists have an appropriate level of emotional literacy so that they are able read/notice the signs of emotional distress in themselves and others and then act appropriately to support themself and others.