The first community based service for treating a common orthopaedic problem has been found to improve patient experience and reduce costs, and been awarded funding to spread nationally.
A specialist physiotherapy team at Central London Community Healthcare Trust developed the arthrographic hydrodistension service for frozen shoulder last year.
The Health Foundation, which funded the development of the service, has awarded the project a further £29,000 to spread it to other sites.
Frozen shoulder results in severe pain, restriction of movement, and disturbed sleep and is more common in people with diabetes. The treatment involves injecting a large amount of saline into the joint capsule, which causes it to swell, resulting in improved range of movement and reduced pain.
Previously this has only been carried out by radiologists in secondary care. Patients are generally referred by their GP to an orthopaedic doctor-led service, then to radiology, then back to be reviewed by orthopaedics. The team at Central London, led by the trust’s musculoskeletal clinical lead physiotherapist Eoin O’Conaire, has developed a primary care-based clinic which can both diagnose and treat patients more quickly.
An assessment published by the Health Foundation, a charity which promotes service quality improvement, says the service has demonstrated good outcomes and patient experience. It is also £136 cheaper for each patient treated than hospital services.
The trust this week said the Health Foundation had awarded the project a further £29,000 to develop training programmes for physiotherapists at the University of Hertfordshire and the University of Cumbria, with the aim that the service can be introduced elsewhere.
Mr O’Conaire told HSJ: “We would love to see more physiotherapists trained to carry out the procedure and to demonstrate on a larger scale how safe, effective and cost-effective this pathway is.”