Innovations

To provide group based, interdisciplinary, combined physical and psychological treatment (CPPP) service to patients with persistent non-specific back pain, to help restore function and quality of life. 

The service’s aim is to train patients to become experts at understanding their persistent low back pain, to manage flare-ups in pain effectively, to set goals to improve function, to reduce reliance on analgesic medication, and to engage in healthy behaviours

The service uses a cognitive behavioural approach, as recommended in the National Back Pain and Radicular Pain Pathway (Pathfinder) (2017) and NICE Guidelines (2016) as an effective way to manage persistent non-specific back pain and disability.

Recognising that there is limited funding for “doing more of the same” we looked at how we could increase our cardiac rehabilitation capacity by broadening our scope and expertise to encompass a range of long term conditions that cause a high impact on unscheduled care. We acknowledged that multi-morbidity is becoming increasingly prevalent.

We subsequently developed The Healthy and Active Rehabilitation Programme (HARP) and opened up referrals to include people affected by stroke, cancer, COPD, falls, diabetes, and other long-term conditions.  HARP enabled us to widen our rehabilitation capacity to include cardiac groups which are typically excluded due to resource limitations: angina, arrhythmias and devices.  We designed a programme that would embrace activity, self management and support lifestyle change, across all of these groups.

Thus, the overall aim of this project was to proactively support prevention and self-management in an ageing population with increasing prevalence of chronic multiple morbidities. To help reduce health inequality the project has specifically targeted deprived and rural communities.

Secondary objectives 

• To develop an evidence base for multimorbidity rehabilitation that would support a new way of working
• To prove that this new model was sustainable

The number of thoracic surgical procedures performed in the United Kingdom continues to increase annually putting pressure on thoracic surgical bed capacity. Reducing hospital length of stay (LOS) following thoracic surgery can help to reduce pressure on hospital beds. The purpose of this service evaluation is to explore hospital and physiotherapy LOS for individuals following thoracic surgery at our hospital and identify whether any factors influence hospital and Physiotherapy LOS. The findings could potentially allow the identification of individuals at risk of longer LOS and help direct physiotherapy rehabilitation provision to these individuals.

Cauda equine syndrome (CES) is a medical emergency, requiring immediate referral for investigation and early surgical decompression for a favourable outcome (1). Southern Health NHS Foundation Trust (SHFT) musculoskeletal services manage suspected CES with immediate referral to accident and emergency (A&E) at the University of Southampton NHS Trust (UHS) where urgent imaging and surgical decompression can take place.

This evaluation aimed to describe the demographics and clinical features of referred patients, plus summarise the medical management and clinical outcome following A&E examination.

The aim of the service evaluation was to assess the impact of a 6 week general rehabilitation class has on patient functional and pain experience outcomes.

Impaired mobility and balance correlate strongly with an individual's function and overall state of health. The Hierarchical Assessment of Balance and Mobility (HABAM) is a graphic and rapid assessment of balance and mobility originally designed for use within the hospitalised elderly. The measure has been used predominantly within frail elderly populations; however the aims of this study were to assess the utility of the HABAM to an elective orthopaedic population.

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.