Improving access to Paediatric Physiotherapy services within a community team - Physiotherapy drop-in screening service

Purpose

The purpose of establishing the physiotherapy drop in service was:

  1. To improve the appropriateness of referrals being sent to the Physiotherapy department
  2. To provide a universal Paediatric Physiotherapy screening service within the borough for all children and young people
  3. To signpost Children and Young People to the required services or provide information and advice where appropriate

The above purpose links with the aims of the universal service provided by the Physiotherapy department which include: To improve education within the borough about normal development, create free opportunities to develop gross motor skills and educate parents ensuring carryover to the home environment, to highlight the contribution that Physiotherapy can make to the prevention of illness and the promotion of good health through encouraging appropriate physical activity.

Approach

The drop in service is modelled on similar triage services provided already within the NHS. No referral is required to access the service and dates for the drop-in are distributed to members of the MDT at Hackney Ark, GP´s, childrens centres, local offer website and the Homerton University Hospital Trust website.

There are 2 drop-in clinics per month. The appointments are 15 minutes on a 1st come 1st served basis, the clinic lasts for 2.5 hours with 1 physiotherapist (facilitating 10 clients in 1 drop-in session). A second physiotherapist is on stand-by should the numbers at any one drop-in exceed 10 clients.

The outcomes of the appointment can be one of the following:

  1. Information and advice with and invitation to return to drop-in should symptoms persist/visit GP 
  2. Onward referral to Homerton MSK physiotherapy
  3. Onward referral to Foot Health
  4. Full assessment with Paediatric Neurodisability Physiotherapists at Hackney Ark.

Outcomes

From April 2018 to April 2019 108 people attended the physiotherapy drop in sessions. This averaged 9 per drop-in. This reflects the current capacity of the drop-in services (10 per session). Thus far this has been the only data collected from the drop-in services.  

From the service evaluation it was deemed that 2 physiotherapy drop-in sessions per month were appropriate. Information sessions on the following themes will commence in 2019/2020 prior to the Physiotherapy drop-in sessions to assist in achieving the goals set out within the remit of the universal service: in-toeing, progression of gross motor development, footwear, and physical/leisure activities within the borough all with the aim of streamlining the service further.

A service development for 2019/2020 is to assess how many onward referrals are made and to where, how many were booked in for a full physiotherapy assessment and how many were provided with treatment advice. This will enable us to undertake a more thorough investigation into the effectiveness of the service as it currently stands.

Implications

This service ensures that children and young people who need to be assessed by Physiotherapy have access to a universal screening service which will re-direct them to the most appropriate services.

 

Top three learning points

  1. There is need for wider training and information sharing between community health care providers e.g. GP’s, health visitors, allied health professionals and social workers on atypical child development and the universal services available within the Borough of City and Hackney.
  2. A database to collect the following information is needed to further analyse the effect of the service:  Number of onward referrals and to what service, number of patients booked in for full Physiotherapy assessment and number of patients provided with treatment advice only.
  3. As physiotherapists I feel we need to recognise our role as promoters of health as a whole. This includes  recognising the impact of poverty, low socio-economic status and environmental conditions on child development, further reinforcing the need for universal, and easily accessible child development drop-in and screening services.

 

Additional notes

This work was presented at Physiotherapy UK 2019

For further information about this work please contact Aoife Cooper.