SAPC hot topic: is it a dangerous idea to make physiotherapists the gatekeepers of frontline primary care for all patients with musculoskeletal problems?

Physiotherapy managers’ views of musculoskeletal physiotherapy service provision in Ireland: a qualitative study

“…Lack of clear HSE policy was problematic in trying to balance staff’s training needs, service development requirements and service delivery. High skill levels provide the opportunity for physiotherapists to be gatekeepers in the management of musculoskeletal services in primary care (Bishop et al ., 2013). Physiotherapists are specifically trained to manage symptoms and improve function and physical activity which is a key objective in the management of musculoskeletal disorders (Bishop et al ., 2013).…”

“…High skill levels provide the opportunity for physiotherapists to be gatekeepers in the management of musculoskeletal services in primary care (Bishop et al ., 2013). Physiotherapists are specifically trained to manage symptoms and improve function and physical activity which is a key objective in the management of musculoskeletal disorders (Bishop et al ., 2013). Previous research has identified that GPs lack confidence in managing such conditions (Breen et al ., 2007) and direct access to physiotherapy can reduce waiting times, GP workload, improve clinical outcomes and increase patient satisfaction (Holdsworth and Webster, 2004; Ludvigsson and Enthoven, 2012; Mallett et al ., 2014; Goodwin and Hendrick, 2016).…”

Scaling-up an evidence-based intervention for osteoarthritis in real-world settings: a pragmatic evaluation using the RE-AIM framework

“…Worldwide, osteoarthritis (OA) is one of the most prevalent causes of pain and disability, and an estimated 6.83 million people consult for knee or hip OA in the UK [ 14 , 15 ]. Yet current management is largely sub-optimal, and the burden on individuals and society remains high [ 16 – 18 ]. Although rehabilitation professionals (such as physical and occupational therapists) understand the need to implement evidenced-based interventions, their ability to implement new knowledge into clinical practice remains limited [ 19 – 21 ].…”

Core competencies for first contact physiotherapists in a direct access model of care for adults with musculoskeletal disorders: A scoping review

“…Twenty articles used quantitative methodologies, such as cohort, cross‐sectional, and randomized or non‐randomized, controlled designs (Addley et al., 2010; Bishop et al., 2017; Bornhöft et al., 2019; Childs et al., 2005; Domholdt & Durchholz, 1992; Donato et al., 2004; Durant et al., 1989; Gagnon et al., 2021; Gorman et al., 2010; Holdsworth et al., 2007; Jette et al., 2006; Keller et al., 2022; Kilner & Sheppard, 2010; Ludvigsson & Enthoven, 2012; Mitchell & de Lissovoy, 1997; Nordeman et al., 2006; Onyeso et al., 2022; Overman et al., 1988a; Richardson, 2005; Taylor et al., 2011); 9 used qualitative methodologies based on interviews, focus groups, or Delphi methods (Alshareef et al., 2023; Boakye et al., 2016; Burley et al., 2020; Chance‐Larsen et al., 2019; French & Galvin, 2017; Kumar & Grimmer, 2005; Lefmann & Sheppard, 2014; McMahon et al., 2016; Vader et al., 2022); 2 used a mixed methodology (Alkhouri et al., 2020; Fisher, 2020); seven involved knowledge syntheses such as systematic, scoping, critical, and narrative reviews (Boakye et al., 2016; Ferreira et al., 2019; Foster et al., 2012; C. Harris et al., 2020; Lackenbauer et al., 2017; Lin et al., 2020; Ojha et al., 2014); 9 were viewpoints (editorials and clinical commentaries) (Bishop et al., 2013; W. G. Boissonnault et al., 2010; W. G. Boissonnault & Ross, 2012; W. Boissonnault & Goodman, 2006; Crane & Delany, 2013; Fleming‐McDonnell et al., 2010; Juneja et al., 2020; Lebec & Jogodka, 2009; McMahon et al., 2016); and 18 were from grey literature, including international references, books, and theses (APTA, 2012, 2...…”

“…However, the essential competencies found in this review must be adapted to the health care context of each country. Many studies suggest that the competencies required for direct access care can be acquired during entry‐level education programs in countries with a direct access model of care (Bishop et al., 2013; W. G. Boissonnault & Ross, 2012; European Network for Physiotherapy Higher Education, 2022; Lackenbauer et al., 2017; Martini & Kelly, 2017; Policy Statement, n.d.‐a; Policy Statement, n.d.‐c; World Physiotherapy, 2022; Xerri de Caro, 2021). According to the World Physiotherapy survey published in 2012, 73 of 106 (69%) national organisations surveyed reported that their entry‐level physiotherapy programme included training in direct access care (Bury & Stokes, 2013).…”