This clinic currently operates on a Wednesday afternoon and is run by physiotherapy practitioner Peter Dawson. Peter has over 20 years experience in managing musculoskeletal conditions. Following a period of training and mentorship from Dr Holt, Peter has also been performing steroid injections at the practice for the past 3 years.
This venture was started in October 2014 as part of the Scottish Government’s “Project Acorn”. This recruited motivated, GP practices in Scotland to participate in a “bottom up” approach to the redesign of general practice for the future. The project supported a diverse range of projects – all initiated by grassroots GPs and their practice teams who were keen to make positive changes to the delivery of care within their local communities.
Here in Eyemouth, we quickly identified a need to future proof our clinical team, improve appointment availability and harness the enthusiastic expertise of a local physiotherapy colleague. Our rural location makes future recruitment of GPs very challenging against a national shortage of GPs so Project Acorn provided us with an opportunity to look at alternative ways of working to ensure patients see the right clinician at the right time. The development of the advanced physiotherapy practitioner role within a GP practice was unique in Scotland at the inception of this project and as a result, some of the clinical mentorship during the project was provided from a physiotherapy colleague in England.
The MSK clinic was established to provide an alternative, clinically safe route for the autonomous management of patients with musculoskeletal conditions. Musculoskeletal conditions are those affecting the muscles, ligaments, tendons and bones including conditions such as arthritis, sprains, strains and joint problems. This clinic is designed to offer patients a safe, effective and accessible alternative to an appointment with a GP. At this clinic, Peter can independently order investigations, arrange onward referral and administer joint injections as required. The provision of physiotherapy is not within the remit of this clinic. Patients can self-refer to the NHS Musculoskeletal Assessment and Treatment Service on 0800 917 9390 if they feel that physiotherapy would be appropriate for their problem. Advice is also available on-line at www.nhsinfom.co.uk/msk
The MSK clinic has been established for the past 13 months. During this time, data has been collected which is overwhelmingly supportive of this approach. GP involvement is only necessary in 2% of cases. Patient feedback has shown that the majority of patient responses rated the service as “excellent” with comments such as “extremely helpful and understanding”.
The practice has recently supported Peter to attend an “Understanding Blood Results for Physiotherapists” course in London to continue the development of this role. This will allow Peter to request blood tests and investigations where clinically necessary.
Future developments include Peter under taking his Independent Prescriber course in September with mentorship for this qualification provided by the practice. This will enable Peter to prescribe medication autonomously without the routine need for involvement of a GP. We are also considering future further involvement of allied health professionals in advanced practitioner roles to compliment GPs in the clinical team.