Rapid Access Specialist Neurological Physiotherapy Service

NHS Greater Glasgow and Clyde

For many years we have seen patients remain in an acute hospital bed, trying to maximise their rehabilitation before the sometimes lengthy wait for community services to take over their care.

In 2017, we undertook a small scale feasibility project over 6 months.  We offered a rapid access physiotherapy service to reduce hospital stay and provide physiotherapy at an intensity appropriate to meet the patients’ needs. 

This proved successful and we demonstrated improved quality of life measures and functional objective measures.  We also were able to save the NHS over 100 bed days, resulting in a cost saving of over £20,000.

Neurological Rapid Access Physiotherapy

Following a successful application, the Neurological Rapid Access Physiotherapy (NRAP) service has been funded for 15 months through Healthcare Improvement Scotland’s Improvement Fund.

The service continues to provide specialist neurological physiotherapy for patients, for those who are medically fit for discharge or are in crisis and risk of admission. Our aim is that for the duration of the funded project, no patient should remain in an INS bed when their needs can be met by the NRAP service.

Referrals received are vetted and those fitting our criteria are appointed. On entering our service patients will set their goals with the therapists and complete a series of outcome measures.  They will receive a max of 10 x 1 hour physiotherapy sessions and will be discharged from our service with ongoing self management strategies when their goals are achieved. 

The Impact So Far

We are striving to provide a responsive, person-centred, high quality service, while maximising independence, promoting self-management and supporting a return to work and activity, while looking at changes in service delivery and the benefits for patients. 

We have been able to discharge several patients with significantly improved outcomes in functional ability, including return to employment, activities and improved quality of life.  We are getting positive feedback from patient statements and this is indicative in the changes to quality of life.

“… sessions have gave me valuable tools and exercises which have vastly improved my standard of living, so I’m very happy.”

- NRAP patient

Next Steps

In addition to maintaining a full caseload with ongoing referrals into service we hope to see further discharges, with follow-up calls, and ongoing development of our PDSA.

We will be sharing our work via:

  • stakeholder and community training with local and rural areas
  • representation at Scottish Access Collaborative Neurology Workshop Series
  • presenting at regional AHP development day

We also plan to start collating and analysing Quality of Life measures and functional gains.

For further information on this project please contact: hcis.improvementfund@nhs.net