Physiotherapy triage in general practice helps reduce the strain on primary care teams

At the end of 2023, Tū Ora launched a pilot scheme that introduced a Physiotherapy triage service in General Practice to support first-contact care for musculoskeletal (MSK) conditions.

MSK presentations can account for up to 30% of General Practice visits per year and may include soft tissue injuries, bone and joint problems or pain, mobility issues and falls. This pilot aims to streamline patient access to MSK care; at the same time as freeing up GP and Nurse Practitioner (NP) capacity to manage other medical presentations. Eligible patients can be signposted directly to in-house physiotherapy for clinical triage and early support, eliminating the need to see their GP/NP first.

The pilot adopts a single-appointment service model similar to the internationally recognised First Contact Practitioner (FCP) model of care; emphasizing assessment, advice, and care planning. Patients requiring any ongoing care and treatment will be directed to appropriate community healthcare services. This newly integrated role currently sits alongside other extended care roles in General Practice, including Extended Care Paramedics, Clinical Pharmacists and Health Improvement Practitioners.

Physiotherapist and Allied Health Project Manager Jolene McLaughlin said the introduction of the role was an exciting and beneficial addition to the General Practice team.

“With a high number of MSK presentations to General Practice, introducing a physio to triage and manage these patients without needing to see their GP/NP brings many benefits. Being able to see them early means we can provide quicker access to the help they need. It also broadens the scope of services within the practice, as teams work cohesively and collaboratively under one roof” Ms McLaughlin said.

The pilot is currently available two days per week for patients enrolled at Newtown Medical Centre. To date, a total of 59 patients have been supported through the MSK triage pathway, predominantly in the 50 – 59-year-old age group, with almost 40% of appointments for non-ACC conditions.

General Manager for Wairarapa Katie Mottram, who has over a decade of experience as a Physiotherapist, said the positive feedback from practices and patients shows the benefit and positive impact Physiotherapists can have within General Practice.

“We know that we need to diversify the workforce to ensure timely access to patient care and support the future sustainability of Primary Care services. From my personal experience, there are a wide range of patients presenting to General Practice with MSK conditions that hinder a person’s day-to-day life. Introducing a Physiotherapist to the General Practice team ensures patients with these problems can be seen faster, and offered early education and management tools before being appropriately referred for the next step in their recovery journey. This pilot is also designed to help increase the number of GP or Nurse Practitioner appointments available for those with more specific medical needs.

We have worked with, and continue to work, with Physiotherapy New Zealand and other governing bodies and report back on our progress on the difference this pilot makes. This is one of the first pilots of its kind in Aotearoa and we’re excited to lead the way with this new initiative for General Practice” she said.

Following its initial success, the role is set to be introduced at Te Aro Health Centre in the coming weeks. Should the pilot prove successful in supporting Primary Care services, Tū Ora may look at further expansion across the network.