Outcomes of a consultant physiotherapy upper limb clinic: reducing the patient journey through early access to specialist care

Abstract

Background: Many patients referred into secondary care for a ‘surgical opinion’ do not have a surgical target. Aims: An intermediate care consultant physiotherapy upper limb clinic was set up to reduce the patient journey and deliver the right advice/treatment at the first point of assessment. Method: A clinic was set up to: enable an expert clinical assessment; deliver education to the patient regarding diagnosis, treatment options and likely outcomes; arrange appropriate imaging; and deliver care on the day (advice, specialist physiotherapy, injection or splinting). This creates a proactive approach to waiting list management and ensures early management for patients. Results: Complete data from the first 173 patients seen are presented. A total of 99.5% had treatment delivered on the day. Waiting times were reduced by a mean of 3.5 months for appointment, and 27 weeks for physiotherapy input. All received on-the-day expert physiotherapy advice, exercise programmes and progression advice. Oxford Shoulder Score improved by 17.5 (mean). QuickDASH scores improved by 34.72 (mean). Patient satisfaction was extremely positive. Conclusion: The clinic has been successful at shortening the patient journey, reducing the burden on secondary care and delivering best care in a timely manner.