Advanced Physiotherapy Practitioners in the Emergency Department

Update from NHS Lanarkshire

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About: NHS Lanarkshire

picture of Claire Rae


NHS Lanarkshire Physiotherapy Service has been working with University Hospital Wishaw Emergency Department to provide “first contact” assessment for people attending the Emergency Department with musculoskeletal injuries and problems.

A musculoskeletal condition is an injury of the musculoskeletal system which includes your bones, muscles, tendons, ligaments, nerves, or discs.

We currently have two Advanced Physiotherapy Practitioners working in collaboration with Emergency Department staff who are able to:

  • Assess musculoskeletal injuries and conditions
  • Provide advice
  • Agree a rehabilitation management plan
  • Refer people onto other specialists and service

This innovative service was developed in 2015 and whilst this is not a traditional role for physiotherapists, it was recognised that a physiotherapist’s expertise could have a positive impact on people through early diagnosis and therapeutic intervention, as well as rehabilitation guidance and advice.

We’ve seen a direct benefit for patients with a musculoskeletal condition and this professional staff mix means that doctors do not need to see all patients who present with musculoskeletal disorders. This has increased capacity for doctors to focus on patients presenting with other medical conditions. The number of patients reviewed by the physiotherapists without any medical input can be seen in figure 1.

Figure 1:

Number of patients presenting with a musculoskeletal condition who were seen by the physiotherapist in the Emergency Department. Some months numbers are lower due to staff being on leave

In addition to being first contact practitioners, the Advanced Physiotherapy Practitioners conduct review clinics. This is a rapid access clinic where any Emergency Department clinician can book a patient an urgent appointment for physiotherapy review; typically when diagnosis and condition specific management is required.

The physiotherapists manage on average nine clinics per month seeing around 80 patients who would previously have been reviewed by an Emergency Department consultant before potentially being referred to physiotherapy. This new model has improved the efficiency of the service we provide and had a positive impact for people attending, as they are provided with the information and guidance they need for rehabilitation and self-management at the earliest opportunity.

NHS Lanarkshire was one of the first Health Boards in Scotland to try this model of healthcare and have shared information and learning with other NHS Scotland Boards who are interested in developing similar services.

We’ve received really positive feedback from the people accessing this service, you can read what some people are saying about the service on Care Opinion:

If you have an experience of the Physiotherapy Service you would like to share, please speak to a member of staff, respond on Care Opinion, or visit the “Your Feedback” Section of the NHS Lanarkshire website to see the other ways to get in touch


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