How do we personalise Physiotherapy? (Part 1)

A blog by Nicola Bussey, Physiotherapist at United Lincolnshire Hospitals NHS Trust. Nicola Bussey has been working, along with fellow physiotherapist Alison Wilkinson, with the It's All About People Personalisation Programme Team to explore ways of embedding personalisation approaches within the musculoskeletal (MSK) pathway. As a physiotherapist, she has seen changes to the pathway first-hand and shares her thoughts through this blog.

Over the past few years, I've seen a gradual change in the way physiotherapy is offered. The tone of conversations I hear between clinicians and patients is changing. Clinicians are now becoming more comfortable with patients wanting to have a say in the treatment they receive. And I've observed in the people I provide physiotherapy for that outcomes are better and their satisfaction is greater when their opinions and choices are really listened to.

How ready people are to be involved in conversations about their treatment varies hugely between individuals. The reasons for this are varied and complex. Cultural and generational beliefs play a part, as well as confidence and understanding. And it's not always obvious to the clinician how able the person feels to be involved.

This is where I feel the Patient Activation Measure (PAM) can really add value, helping us to understand where the person is in terms of their confidence and abilities to self care, so we can tailor the support they need. 

This also helps to address health inequalities, making it more likely that people who need more support are identified and don’t slip through the net.

Physiotherapy as a profession is already very tuned in to the ideas of personalised care without necessarily being aware of it. Patients are routinely asked during the assessment process about their own perceptions of their condition and what expectations they have from physiotherapy. Goals are set that are meaningful to the patient and treatment options are discussed to allow patients to take an active part in decision-making around their treatment plan.

We're starting from a very good base. Personalised care approaches will build on this further. Some people will need more support than others, but ultimately it's about empowering people to be in control of managing their own health when they can and knowing where to reach out for support if they need it. 

And in this, Physiotherapists can play an important role, helping people to access support from a whole range of sources to suit the individual. This could be from healthcare professionals, community-based support, or online resources.

There is so much information and guidance on offer, so start by having a look on https://www.lincsphysio.nhs.uk/ and the It's All About People website (this site!).

Thanks, Nicola!

Nicola can be contacted via Nicola.Bussey@ULH.nhs.uk to discuss Shared Decision-Making Tools and other approaches within the MSK pathway.