Physiotherapists not allowed to touch patients in 'barmy' NHS initiative



12:09 GMT, 10 April 2012

Physiotherapists have been banned from touching their patients in a new set of 'barmy' NHS plans.

Patients in one part of the country are instead being offered 'advice and guidance' instead of hands-on treatment after health bosses barred medics from using their skills.

Instead of massage or the manipulation of joints and limbs patients in Rushcliffe, Nottinghamshire, are now being directed to websites and handed information leaflets so they can teach themselves exercises at home.

No longer allowed: Patients in Rushcliffe can be advised on exercises but not helped by physios

No longer allowed: Patients in Rushcliffe can be advised on exercises but not physically helped by physios

Before January 1, 2011, the Principia clinical commissioning group, which plans and buys healthcare services in Rushcliffe, offered one assessment and up to four treatments for physiotherapy patients.

This includes patients who are suffering from soft tissue injuries and pain in their back, neck or joints.

But, following a review of services, it has changed from a treatment service to an advice and guidance service.

This means that physiotherapists are no longer allowed to touch patients, and instead give advice on what exercises they should be doing and information on how to manage their condition themselves.

The Chartered Society of Physiotherapy has labelled the scheme ‘barmy’.

Chief executive Phil Gray said: 'They seem to have invented a new form of physiotherapy that no one has heard of – do-not-touch physiotherapy.'

'Physiotherapists can’t actually physically touch you at all under this system. It is deeply unscientific.

'There is no research or evidence to back up hands-off physiotherapy.

'Patients have been reporting back to GPs a very strong disappointment, and the physiotherapists providing this service are saying that basically “you are preventing us from doing a professional job”.'

The web link to the Principia Ruschliffe physio page currently shows a blank box

Unhelpful: The web link to the Principia Ruschliffe physio page currently shows a blank box

The professional body asked all primary care trusts in the country about their physiotherapy services and any budget cuts.

Mr Gray said that Principia was the only group not to offer a hands-on treatment to physiotherapy patients.

He added: 'It is a completely barmy form of treating people, which means that the only solution will be to go to the private sector and pay for themselves.'

Patients in Rushcliffe are also capped to a maximum of two physiotherapy appointments a year and have to visit their GP twice, six weeks apart, to get a physiotherapy referral in the first place.
Mr Gray said this was too long to wait.

He added: 'Getting people quickly into early intervention services makes a real difference to their ability to go back to work.

'The less treatment they go on to have and the longer it is left, the more complex problems it causes for people.'

Barbara Venes, of the Local Improvement Network, which represents patients in the county, also raised concerns.

She said: 'I think it is just awful. If you need physiotherapy, you need the treatment, not just advice.

'They are pushing people into paying privately and some people cannot afford to pay for it and so won’t get treatment.'

She added that older patients may struggle to access information online, and that people needed practical demonstrations of how physiotherapy exercises should be done to ensure that they were doing them correctly.

She said: 'If you need physiotherapy, it is painful when you start.'

'If you are doing it with a physiotherapist, then they can reassure you that it is normal to get some pain.

'But if you are doing it yourself, then people are afraid that if it is painful then they are going to get more damage.'

A spokesman for Principia said that the change in service had not been a cost-cutting measure, and that costs were broadly the same as before.

She said that 'more vulnerable' patients received treatment through other means, such as a hospital specialist.

She said: 'Following a review, the service was changed to one of advice and guidance to encourage patients to self-care prior to further review by the GP.

'In some parts of the county this is done by web-based advice or in group sessions, and is the important first step in patients with back and neck problems.'

She added: 'Once a decision to refer to a specialist is made by a GP, patients are seen quickly by a physiotherapist.

'With the advice and guidance service, patients are given practical advice to help them self manage their condition.

'This includes exercises to alleviate and manage their symptoms. This service enables all patients to take control of their condition and get better quicker.'

Janis Powell, of Aspley, who suffered back pain for many years and is part of the Chronic Pain Support Group in Notts, said: 'I think it is really disgusting and is not helping patients whatsoever.

'As a former patient myself, I would feel let down by this new service. Patients might not try and help themselves if there is nobody there to support them.'