Physiotherapists could help alleviate the burden of overworked GPs by managing 30% of caseload  

• Introducing Chartered Physiotherapists as First Contact Practitioners (FCP) alongside GPs in primary care could help manage 30% of cases
•  Community-based physiotherapists could triage issues and save money across the health system with better outcomes for patients
• Previous initiatives involving physiotherapy-triage in Irish hospitals removed 125,852 patients from hospital waiting lists in over 6 years

The Irish Society of Chartered Physiotherapists (ISCP) is welcoming the principle behind the extension of free GP care to a further 500,000 people, but says the difficulties around managing increased caseload could be alleviated if chartered physiotherapists worked alongside their GP colleagues.

The ISCP represents over 3,000 Chartered Physiotherapists in Ireland and is calling for a similar system to that operating successfully in the UK whereby musculoskeletal issues are treated in the first instance by a physiotherapist.

 CEO of the ISCP Dr. Marie Ó Mír said :“The extension of  GP care is a positive move, but we’re very aware of the pressures being faced by our colleagues. Traditionally, general practitioners  have been the gatekeepers of healthcare access but we see that there is potential to broaden the gateway and alleviate some of the burden.

 Around 30% of presentations to GPs are for musculoskeletal concerns, both in adults and children, and the GP refers most of these people straight to a  physiotherapist.

In the UK, the NHS has seen the successful introduction of physiotherapists as First Contact Practitioners (FCP)  working alongside GPs in primary care, where they are managing 30% of patients. This pathway would work equally well here, where chartered physiotherapists are the musculoskeletal experts.  Patients in the UK have direct access rights so they don't need a referral from a doctor to make an appointment."  

“Here in Ireland a novel musculoskeletal (MSK) physiotherapy triage initiative* to reduce the orthopaedic and rheumatology outpatient waiting lists was hugely successful. Between 2012-2018, 125,852 patients were removed from our national waiting lists after physiotherapists were recruited across hospital sites.  The statistics are there to show that this works.”

Dr Ó Mír continued : “Installing physiotherapists as First Contact Practitioners  GP practices could be even more effective as the patients would be seen closer to home, without having to go on waiting lists. This would mean better outcomes for the patients as they are seen earlier, and reduced costs to the health service, as they are managed sooner in their care pathway, meaning less complexity”.

 “We in the ISCP urge the public with muscle and joint pain to consider attending a physiotherapist first, rather than a GP, as they may have the specialist expertise they need. We call on the HSE to consider that this widening of the free GP scheme could be greatly enhanced by having physiotherapists as First Contact Practitioners in GP practices and Primary Care.” 

 Editor notes

*See: Irish Medical Journal, Issue: Ir Med J; Vol 113; No. 8; P150  Reduction of Orthopaedic and Rheumatology Outpatient Waiting Lists: The National Musculoskeletal Physiotherapy Triage Initiative.