Innovations

Physiotherapy self-referral has risen over the last 2 years in our hospital trust to almost 50%. As referral numbers have increased so has the ways in which people can access the service. The purpose of the evaluation was to examine the way in which people access the self referral service with a view to improving the efficiency of the service, the ease of access for patients as well as ensuring a fair and safe service.

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.

Within a national specialist orthopaedic hospital, residential rehabilitation programmes are available for patients with complex orthopaedic needs. Two such rehabilitation programmes, the lower limb (LL) and upper limb (UL) have an emphasis on the rehabilitation of long term (LT) musculoskeletal (MSK) conditions. These programmes are physiotherapy (PT) and occupational therapy (OT) led with access to psychology and psychiatry as appropriate. Both programmes' outcome data has demonstrated their effectiveness. Exploring service user experience was thought to be essential for continuing patient centred care as these services evolve to meet their increased demand.

The purpose of the service evaluation was to assess the management of suspected scaphoid fractures in a new physiotherapy-led scaphoid clinic and to compare the standard of care for suspected scaphoid fractures for patients who were previously being managed by the ED doctors in an ED Consultant clinic. Historically, the suspected scaphoid fractures were being managed in the ED Consultant clinic. After a period of observation and supervised practice, the Advanced Physiotherapy Practitioner implemented a new scaphoid clinic in Dec 2015. A revised pathway for secondary imaging and management was discussed an agreed with the ED Consultants and Consultant Radiologists.

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.

Individuals with cancer experience a plethora of symptoms from diagnosis, through treatment and beyond into survivorship. Allied Health Professionals are uniquely placed to impact upon these symptoms by engaging individuals in rehabilitation. Scoping of rehabilitation services amongst individuals with cancer undergoing haematological and oncological treatment highlighted various issues with fatigue, loss of function, pain and breathlessness. A pilot programme was implemented to address these unmet needs.

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.

Haemophilia is an inherited bleeding disorder characterized by recurrent bleeding into muscles and joints with longer term effects including synovial hypertrophy and destruction of the articular cartilage. The national service specification for haemophilia states that 'specialist physiotherapists trained in line with the Haemophilia Chartered Physiotherapists Association' (HCPA) should be a part of haemophilia services. Despite this, there is huge variability in funded, protected hours for physiotherapists working in this area across the UK. Implications of inadequate physiotherapy provision for these patients is far reaching, including increased bleeds and subsequent joint damage for patients, increased factor costs, and increased pressure on haemophilia doctors. One of the key objectives of the HCPA is to establish core principles of care, determine the levels of service provision and improve physiotherapy services for people with haemophilia in the UK.

Cystic Fibrosis (CF) is a genetically inherited condition affecting more than 10,000 people in the United Kingdom. A progressive cycle of infection and lung damage occurs. Worsening lung function results in hypoventilation and ultimately leads to respiratory failure that may require supplementary oxygen and/or mechanical support such as Non-Invasive Ventilation (NIV). Guidelines support the use of NIV for nocturnal hypoventilation, hypercapnic respiratory failure and as a bridge to transplant. At the time of development, there were no published guidelines on the use of oxygen therapy in CF and no published pathways on the set up and management of supplementary oxygen or NIV in CF. This special interest report documents the development of separate oxygen and NIV pathways through interdisciplinary working in an adult CF centre.

Objective To develop pathways for supplementary oxygen and the set up and management of NIV in an adult CF centre.

Historically, provision of MSK Ultrasound diagnostics has been via a referral to Radiology. However, there is increasing evidence that assessment, investigation and initiating treatment at the initial appointment is shown to be cost-effective, increasing patient satisfaction. Utilising this approach also reduces repeated hospital visits for further diagnostics and appointment times for results. The aim of using Point of Care (POC) ultrasound is to enhance the patient experience through instant access to diagnosis, timely implementation of most appropriate clinical pathway and achievement of the optimal outcome in the shortest possible time.

This study aims to investigate the benefits of point of care (POC) and schedule ultrasound clinics using a proof of concepts approach in the orthopaedic setting.