1. RICHARD MCKEE BAND 7 PHYSIOTHERAPIST February 2010 Completed Plymouth Survey

2.  Little evidence of GP satisfaction surveys despite them being one of the main stakeholders in Musculoskeletal (MSK) physiotherapy services.  Survey developed after consultation with GP practices and senior physiotherapists.  6 Main sections. 19 questions in total most answers on a 5 point scale (strongly agree to strongly agree) Referrals Communication Waiting Lists Treatment Discharges Self referral

3.  Initial Pilot study aimed at GP’s within Plymptom area of Plymouth.  26 surveys sent out in Mid July 09  50% response rate.  Overall very good feedback on aspects of communication, quality of assessment/treatment and of Discharge summaries.  In total 200 surveys sent out in Plymouth area.  Overall response rate was 34.5 % (n = 69).

4.  75% agreed that referral forms are adequate.  65% felt referral pathway was easy to access.  Over half (53%) were unsure of referral criteria and prioritisation. “Not aware of any referral pathway.” x7 “Not aware of referral/prioritisation criteria.” x8 “Need to update to electronic referrals.” x4 “Information regarding prioritisation criteria would be very helpful.” x3 “Cards outdated.” x2 “Excellent.” x2

8.  Over 60 % felt they did not receive enough information regarding changes to service.  74% thought advice from physiotherapists was accurate and concise.  Nearly 80% agreed recommendations for investigations were acurate/helpful.  Almost 90% stated that a letter was there preferred method of communication. “Exercise sheets would be useful” x 25 “Typed letters are good. Hand written ones were sometimes difficult to read.” x5 “A web based resource of exercise sheets would be great.” “Exercise sheets would be useful. We have a number already but would be interesting to compare and contrast.” “Exercise sheets for, particularly for backs, knees and shoulders.” x 7

12.  Over 80% were unaware of our current waiting list.  Over 60 % would like regular feedback on this.  Roughly 2/3 would prefer feedback via letter. 1/3 would prefer e mail updates. Dont know waiting times x8 “E mail update to practice manager would be best.” “E mail to practice manager, especially if an increase. Only needs to be monthly.” “Would be nice to be given updates regularly.” “Patients wait too long.” “Waiting times seem to change quite a bit.”

15.  83% agreed that patients receive high quality assessment and treatment.  Almost 60 % were unaware of available treatment techniques within Dept. “Patient feedback very good.” x3 “Update on all techniques would be useful.” x4 “Assessment and treatment may be good but quality cannot be said to be high if it takes 2 months to access.” “Skill mix changes would be useful to know, especially if acupuncture is available.” “Would be great if more hydrotherapy was available.” “An update of skills mix would be good.” “Aware of most techniques, but do not feel my knowledge is comprehensive”

18.  66% thought discharge summaries were received within a reasonable time.  Over 70% felt discharge summaries contained enough information on recovery/prognosis.  70% agreed that our summaries include adequate information regarding further management. “Thanks for Typing Letters now.” “The written, and these days printed comments is most useful, the rest is a bit of a box ticking exercise.” “Would like more timely and concise discharge reports”. X 5

22.  Nearly 70% agreed that self referral would be beneficial.  But over30 % felt they had some concerns regarding self referral. “Good idea.” x6 “ The service might be monopolised by the injured sports person”. “Direct access would need audit and feedback especially to practices with higher referral rates. May need some awareness training within the PCT.” “I would like to know asap if someone was seen and would suggest only for recurring symptoms, not for new presentation.” “The system may become overloaded with chronic patients.” x 12 “Some patients would use this service well, some others may not.” “Some concern if patients with visceral pain may present to physio.” x3 “Would require a gate keeper/filter to control” x3

25.  Directory of services/treatments available within the department.  Develop Web based exercise sheets for common musculo skeletal conditions (available on intranet)  Re-send prioritisation criteria to GP surgeries and make available on intranet.  Regular updates on waiting lists, especially if over a certain level.  Develop electronic referral and set up new pathway for this.  Repeat survey in 12 months time to gauge satisfaction with changes to service. Compare results.