Out-patient physiotherapy service delivery post COVID-19: opportunity for a re-set and a new normal?

Since the COVID-19 pandemic was declared by World Health Organization (WHO) in March 2020, there has been seismic shift healthcare delivery including physiotherapy [1Chartered Society of Physiotherapy Remote options. The Chartered Physiotherapy, 2020Google Scholar, 2Keesara S. Jonas A. Schulman K. Covid-19 and health care's digital revolution.New Engl J Med. 2020; 382: e82Crossref PubMed Scopus (545) Google Scholar]. brought challenges but also opportunities. There have calls for profession to maximise opportunities transform adapt itself better meet needs populations. This not only relates tackling impact infectious diseases [3Landry M.D. Geddes L. Park Moseman Lefler J.P. Raman S.R. van Wijchen J. Early reflection on global COVID19, implications physiotherapy.Physiotherapy. 107: A1-A3Abstract Full Text PDF (16) 4Lee A.J.Y. Chung C.L.H. Young B.E. Ling L.M. Ho B.C.H. 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Global, regional, national incidence, prevalence, years lived disability 354 injuries 195 countries territories, 1990–2017: systematic analysis Global Burden Disease Study 2017.Lancet. 2018; 392: 1789-1858Abstract (6548) Traditionally many out-patient services were based post-war models service where are seen face face, usually individually, an initial longer appointment followed shorter appointments over subsequent weeks. model designed predigital era when hands electrotherapeutic interventions prevailed. first follow up ratio musculoskeletal (MSK) out-patients reduced time 2012 just average 3.14 ups per patient [[8]Chartered outpatient survey 2012. London.2013Google reduction appears driven capacity demand responses, well increased emphasis self-management less guidance ‘hands on’ therapies [[9]Lin I. Wiles Waller R. Goucke Nagree Gibberd M. al.What does best practice care pain look like? 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MacDermid MacIntyre Characteristics therapeutic alliance occupational therapy practice: scoping literature.BMC Serv Res. 2017; 17: 375Crossref (95) Supporting includes provision information enabling motivation self-efficacy achieve greater control take appropriate action manage their condition [[11]de requires adherence some form behaviour change such undertaking home exercise programme lifestyle adaptations [14Novak Effective adults: review.Clin Rehabil. 2011; 25: 1066-1085Crossref (32) 15Söderlund von Heideken Wågert P. Adherence maintenance older – theoretical models.J Clin 2021; 15: 303Crossref (8) programmes suboptimal [[16]Peek Sanson-Fisher Mackenzie Carey Patient physiotherapist prescribed strategies: critical review.Int Ther 2015; 22: 535-543Crossref (9) Literature supports notion that multi-dimensional construct, range barriers facilitators being identified [17Peek Interventions aid review.Physiotherapy. 102: 127-135Abstract (84) 18Jack McLean S.M. Moffett J.K. 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Video recordings face-to-face consultations interviews highlighted focussed ensuring had practical capability undertake did address opportunity motivational components adherence. Contextual factors physiotherapists’ environment structure affected patients’ which keeping other studies [10Hall 25Meade L.B. Bearne Godfrey E.L. It's important buy lifestyle”: population pain.Disabil Rehab. 26: 1-11Google Patients’ reported valuing relationship expressed desire social group exercises. None our offered exercises despite cost effectiveness 26O’Keeffe Hayes McCreesh al.Are group-based individual equally effective conditions?. meta-analysis.Br 51: 126-132Crossref telehealth [27Pugliese Wolff value communication, education, providing guideline-based care: lessons learned telerehabilitation during Crisis.HSS 3: 1-4Google 28Turolla Rossettini Viceconti Palese Geri T. Musculoskeletal pandemic: answer?.Phys 1260-1264Crossref (132) 29Bokolo Application telemedicine eHealth technology response pandemic.Health Technol. https://doi.org/10.1007/s12553-020-00516-4Crossref (73) Scholar] accelerated ambitions [[30]Greenhalgh Shaw Wherton Vijayaraghavan Morris Bhattacharya al.Real-world implementation video at macro, meso, micro levels: mixed-method Med Internet 20Crossref (181) However, must be careful replace existing remote instead consider how resources time, technologies optimise based, [[31]Tack C, Grodon J, Shorthouse F, Spahr “Physio anywhere”: digitally-enhanced legacy coronavirus. Physiotherapy; 2020 [in press].Google Pugliese (2020) highlights enabled re-focus interpersonal interactions communication patients. Post contacts blend these telephone communications, short messaging (SMS) online [32Bennell K.L. Campbell P.K. 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Delivering within reducing episodes potentially risks burnout shown problem particularly managing [[35]Rogan Verhavert Zinzen Rey Scherer Luijckx Risk factor symptoms canton Bern.Arch Physiotherapy. 9: 19Crossref (4) If starting beginning would design now future? How ensure safe assessment, whilst utilising ways prefer? provide into longer-term communities? We propose enable adequate debriefing wellbeing learning. Our utilised observation which, current consultations, tool record line consent governance policies) allow easy self-reflection [[36]Fukkink R.G. Trienekens Kramer L.J.C. feedback education training: putting learning picture.Educ Psychol Rev. 23: 45-63Crossref (140) O’Caithain al. (2019) sets out 5 principles developing sound basis us re-set; dynamic, iterative, creative, open looking ahead [[37]O’Cathain Croot Duncan Rousseau Sworn Turner K.M. al.Guidance healthcare.BMJ 9https://doi.org/10.1136/bmjopen-2019-029954Crossref (420) Tack remind post determined result robust evaluation built around user views staff unique re-design science theory research physiotherapist's contribution ensures wellbeing. seize base, users, evaluate future. normal all gift.