The provision of physiotherapy within the NHS is under threat on two fronts:
- Cuts to services
- Recruitment difficulties
A target for service cuts
NHS spending has led to one fifth of cash-strapped CCGs to end the 2016/17 year in deficit. Planned cuts and cancellations to follow this are inevitable.
The Chartered Society of Physiotherapy (CSP) notes that cuts to physiotherapy services are not cost-effective and could result in:
- unnecessary pain, loss of mobility and independence and reduced quality of life;
- an increase in costs to the NHS;
- chronic health problems, disability and more time off work as conditions aren’t treated;
- physiotherapy becoming a privilege for only those who can afford to pay for private treatment.
The Chartered Society of Physiotherapy's (CSP) chief executive Karen Middleton has warned that cuts to physiotherapy could end up driving up overall costs for the NHS. This may outweigh any savings made by reducing services.
"Simply cutting services such as physiotherapy will always prove to be a false economy if patients do not get the care they need. Conditions that could easily have been treated will worsen and require further support at a greater cost to the NHS."
Kevin Dale, a CSP officer in East England, described the results of a YouGov survey in Essex asking people what they would do if they were in pain and unable to get a hospital appointment for physiotherapy: “The top two answers were (a) go to accident and emergency and (b) go to my GP. With this information, we were able to make the argument that financially it made no sense and that physiotherapy actually saved money,”
A shortage of physiotherapists
According to the CSP’s response to the Department of Health’s consultation on the funding of healthcare education:
“There is a serious shortage of physiotherapists in England, caused by insufficient numbers of physiotherapy student places at a time of growing demand. This is creating difficulties in recruiting physiotherapists [...] A minimum of 500 additional physiotherapists need to be trained each year until 2020 to meet the current shortfall.”
Staff shortages are also having a negative impact on the health of physiotherapists in our NHS. A senior physiotherapist, Rob Davies, at a hospital in the south-west reported stress as the biggest cause of workplace sickness.
Mr Davies also notes the reduction in quality of care and service: “When you don’t have the right staff levels, we have to see patients on a prioritised basis,” he says. “Patients don’t get the quality and sometimes it means people get sub-optimal outcomes. It’s frustrating and demoralising.”
And the effect on patients is….
The charity Muscular Dystrophy UK reported in July 2016 that muscular dystrophy patients are missing out “on life-improving treatment, and even dying early, because of a lack of access to specialist physiotherapy”. This is due to a shortage of physiotherapists and lack of funding for physiotherapy.
The charity’s report had numerous findings:
- 60% of people with muscle-wasting conditions were unable to access appropriate physiotherapy.
- Short-term provision of physiotherapy meant patients were receiving little or no benefit from it.
- 20% of patients were paying privately for their physiotherapy.
- 40% of UK neuromuscular centres said they urgently needed increased physio capacity.
The report said there was a ‘serious shortage’ in physio access across much of the country and “inconsistencies in the funding and provision of vital aspects of respiratory physiotherapy and equipment […] leading to avoidable admissions to hospital [...] in some tragic cases, this can even contribute to early loss of life.”
A CSP survey into rheumatoid arthritis and access to physiotherapy on the NHS also revealed some worrying findings. RA causes debilitating pain, stiffness and joint damage. Many sufferers have stressed the importance of physiotherapy in allowing them to maintain physical activity and reducing pain. This can allow people to remain at work and keep up a good standard of life. However, this survey found there to be substantial delays in referrals to physiotherapy for sufferers, or even non-existence of referral in some cases.
The CSP believes the cause of this can not only be accounted for by lack of information but also to economic restraints: ‘We remain concerned that economic pressures being faced by these governments may result in indiscriminate cuts to physiotherapy services, with dire consequences for people with RA.’