Providing physiotherapy advice by phone gives equal results and
reduces waiting times
30 January 2013
A physiotherapy service based on initial telephone assessment
has the ability to provide faster access to the service and cut waiting
times, a study published on bmj.com suggests.
Providing access to physiotherapy has long been a problem in the
NHS with waiting times of several week or months. Furthermore,
waiting lists may be congested with those who will benefit from
physiotherapy advice but have little to gain from a course of
With an ageing population and rising healthcare expectations,
healthcare providers need to explore new ways of delivering
healthcare with one such suggestion being initial assessment by
telephone. However, this has not yet been rigorously evaluated.
Researchers from around the UK therefore assessed the
effectiveness of PhysioDirect, where the patient can telephone a
physiotherapist for initial assessment and advice without waiting
for a face-to-face appointment. Services which have already
implemented PhysioDirect claim it has reduced waiting times and was
popular with patients. Researchers compared PhysioDirect with usual
care in a randomised controlled trial.
The study involved 2,256 patients aged 18 or over with
musculoskeletal problems who were studied between July and December
2009: 1,513 to PhysioDirect and 743 to usual care.
Almost half the PhysioDirect patients (711) were managed entirely
by telephone. They also had fewer face-to-face appointments than
those in usual care and fewer physiotherapy consultations of any
type. The PhysioDirect patients also had a shorter wait for
physiotherapy treatment (seven days versus 34 days) and were less
likely to fail to attend appointments.
The University of Bristol-led study found that care based on
PhysioDirect is equally clinically effective compared with usual
care and provides faster access to advice and treatment. However, no
evidence was found of improved patient satisfaction.
The authors say the fact that 47% of PhysioDirect patients were
managed entirely on the telephone, and were almost as satisfied with
their consultations as usual care patients, shows that
physiotherapists are able to provide assessments and advice by
telephone in a way that is reasonably acceptable to patients.
The researchers conclude that PhysioDirect “is equally clinically
effective compared with usual care, provides faster access to
physiotherapy, and seems to be safe" but there is no evidence that
it is associated with increased patient satisfaction.
Salisbury C et al. Effectiveness of PhysioDirect
telephone assessment and advice services for patients with
musculoskeletal problems: pragmatic randomised controlled trial.