Tuesday, 10 April 2012

No-touching Physiotherapy

Just when you began to think that ideas couldn't get any barmier, along comes health commissioners in Rushcliffe. It seems that NHS patients will no longer get hands-on treatment, but will simply be given "advice and guidance". The aim, according to health commissioners is to help patients to "self manage their condition ... and to take control of their condition and get better quicker". 

Let's have a look at the background here. In the Government's Health and Social Care Bill, Clinical Commissioning Groups will take over from all Primary Care Trusts in April 2013.

Nottinghamshire is ahead of the Government's timetable, and has already devolved budgets to new groups. In the Borough of Rushcliffe, which is where I live, the new clinical commissioning group is called Principia, and is responsible for planning and buying healthcare services in the Borough.

This group are responsible for the no-touching rule for physiotherapy. A spokesperson said that the change in service had not been a cost-cutting measure, and that "costs were broadly the same as before". Now call me cynical if you like, but I don't believe it, and what the hell does "broadly the same" mean anyway?

There's no more of this
Today's Nottingham Post says, "For many patients suffering from chronic back, neck or joint pain, physiotherapy is an essential step on the road to recovery". Statistically, 80% of the population suffer from lower back pain at some stage in their lives, which if applied to Rushcliffe gives a figure of over 96,000 patients.

Previously under the NHS in Rushcliffe, if you had problems, you were offered one assessment and up to four treatments for physiotherapy. The clinical commissioning group has reviewed its services, and changed from being a treatment service to an advice and guidance service. As the Post says, "This means the physiotherapists are no longer allowed to touch patients, and instead give advice on what exercises they should be doing and information on how to manage their condition themselves".

Even before you can get a referral to a physiotherapist, you have to visit your GP on two occasions, six weeks apart. If you can navigate that hurdle, all patients in Rushcliffe can expect is a maximum of two physiotherapy appointments a year, and that for advice and guidance.

Following a survey of all Primary Care Trusts in the country, The Chartered Society of Physiotherapy has said that Principia was the only group not to offer a hands-on treatment to physiotherapy patients.  Commenting on the new service, the Society's Chief Executive said, "They seem to have invented a new form of physiotherapy that no one has heard of - do-not-touch physiotherapy". Patient's group are equally concerned about the new service. A spokesperson for the Local Improvement Network in Nottinghamshire said, "I think it is just awful. If you need physiotherapy, you need the treatment, not just advice". 

As someone who suffers from back pain, and has benefited over the years from physiotherapy treatment, I share the concern of many at the withdrawal of hands-on services. Even after getting advice, not everyone is in a position to access online information, and many people need practical demonstrations to ensure that they are doing physiotherapy exercises correctly. My treatment was private as I could afford to pay for it; I can though no longer afford to pay around £40 - £50 for a thirty minute session, and I expect many other people are in the same boat. So, many residents in Rushcliffe who cannot afford to pay for treatment (yes, even in this affluent Borough, there are those struggling with cash flow), knowing that there is no hands-on treatment available on the NHS for them, will probably not do anything, except suffer.

Commenting on the new service of advice and guidance instead of hands-on treatment, The Chartered Society of Physiotherapists said, "It is a completely barmy form of treating people". I agree, and I hope that the day will come when the clinical commissioning group will reverse the decision and allow the residents of Rushcliffe to receive hands-on physiotherapy treatment when they need it.

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