Waverley Gate 2-4 Waterloo Place Edinburgh. Date 16/12/11 Your Ref Our Ref. Enquiries to Richard Mutch

Transcription

1 Lothian NHS Board Waverley Gate 2-4 Waterloo Place Edinburgh EH1 3EG Telephone Fax Date 16/12/11 Your Ref Our Ref Enquiries to Richard Mutch Extension Direct Line Dear FREEDOM OF INFORMATION PHYSIOTHERAPY I write in response to your request of 17 November 2011 for information in relation to physiotherapy services within NHS Lothian. I have been provided with information to help answer your request by Ms Lynne Douglas, Allied Health Professional Director NHS Lothian. Request 1: Please confirm or deny whether the Health Board has undertaken an assessment of the provision of physiotherapy services in its region. If confirmed a. Please provide details and findings of any assessment for i) adult and ii) paediatric physiotherapy services. No assessment of provision has been undertaken. Request 2: Please confirm or deny if the Health Board has undertaken an assessment of the outcomes delivered by physiotherapy services in its locality. These have been carried out with within Edinburgh Community Health Partnership (CHP) and West Lothian Community Health and Care Partnership ( WLCHCP). If confirmed a. Please provide details and findings of any assessment for i) adult and ii) paediatric services. Edinburgh CHP Physiotherapy Service Unknown 24% 25% 28% 32% 29.0% eé~çèì~êíéêë= t~îéêäéó=d~íéi=ojq=t~íéêäçç=mä~åéi=bçáåäìêöü=ben=pbd= = `Ü~áê=aê=`Ü~êäÉë=g=táåëí~åäÉó= `ÜáÉÑ=bñÉÅìíáîÉ=mêçÑÉëëçê=g~ãÉë=g=_~êÄçìê=lK_KbK= içíüá~å=kep=_ç~êç=áë=íüé=åçããçå=å~ãé=çñ=içíüá~å=eé~äíü=_ç~êç=

2 Worse 1% 1% 1% 1% 1.0% No Change 7% 4% 9% 7% 7.0% Improved 15% 14% 20% 17% 11.0% Much Improved/Resolved 53% 56% 42% 43% 52.0% Within West Lothian CHCP the Global Impression of Change questionnaire measures improvements in activity limitation, symptoms/pain, mood/emotions, quality of life and satisfaction. 153 patients completed the questionnaire on discharge from the MSK physiotherapy services over a one month period (Feb-Mar 2010). 205 patients completed the questionnaire on discharge from the MSK physiotherapy services over a one month period (Feb-Mar Results were calculated for four different categories (Spinal. Upper limb, Lower limb and overall results). West Lothian CHCP Were moderately to a great deal better in terms of improvement in activity limitation. 90% 94% Were moderately to a great deal better in terms 97% of improvement in symptoms/pain. 91% Were moderately to a great deal better in terms 85% of improvement in mood/emotions 88% Were moderately to a great deal better in terms 86% of improvement in quality of life. 88% Were very satisfied with their physiotherapy 90% management. 84% Conclusion - These results demonstrate that patients made a significant improvement in several domains following a physiotherapy intervention and were very satisfied with their management. Request 3: Please provide details of the number of referrals made in a) primary care, b) outpatient secondary care and c) inpatient secondary care for adult patients to physiotherapy services for the following financial years: i) 2008/09, ii)2009/10, iii) 2010/11 and iv) 2011/ / / /11 Primary Care 63,467 66,004 64,768 Outpatient Secondary Care 2,801 12,276 17,110 Inpatient Secondary Care 7,978 27,134 31,626 Data for 2008 is not available for LUHD. Information for 2011/12 is not yet complete.

3 Request 4: Please provide details of the number of referrals made in a) primary care, b) outpatient secondary care and c) inpatient secondary care for paediatric patients to physiotherapy services for the following financial years: i) 2008/09, ii) 2009/10, iii) 2010/11 and iv) 2011/ / / /11 Primary Care Outpatient Secondary Care 1,942 2,551 2,732 Inpatient Secondary Care 1,340 1,240 1,347 Data for 2008/09 is not available for WLCHCP. Information for 2011/12 is not yet complete. Request 5: Please provide details of the number of referrals made to musculoskeletal (MSK) physiotherapy for the following financial years: i) 2008/09, ii) 2009/10, iii) 2010/11 and iv) 2011/ / / /11 Referrals made to musculoskeletal (MSK) 43,693 52,591 56,582 Information for 2011/12 is not yet complete. Request 6: Please confirm or deny whether the Health Board or Service Managers measures waiting times for MSK physiotherapy from referral to first outpatient appointment. Yes a. Please provide details of the maximum waiting time for a) adult and b) paediatric b. Please provide details of the average waiting time for a) adult and b) paediatric c. Please provide details of how many people are currently on a waiting list for a) adult and b) paediatric physiotherapy

4 Waiting Times Please provide details of the maximum waiting time for a) adult appointments Please provide details of the maximum waiting time for b) paediatric Please provide details of the average waiting time for a) adult Please provide details of the average waiting time for b) paediatric Please provide details of how many people are currently on a waiting list for a) adult Please provide details of how many people are currently on a waiting list for b) paediatric physiotherapy Figures are not recorded by Edinburgh CHP. Answer , Request 7: Please confirm or deny whether the Health Board has any referral management schemes for physiotherapy services. Yes there are referral management schemes. If confirmed a. Please provide details of these schemes for i) adult and ii) paediatric services. b. Please confirm or deny if health professionals are incentivised through any referral management scheme for physiotherapy services in the health board region. NHS Lothian has the following referral schemes for adult services:- Consultant referral, GP referral, Patient self referral. NHS Lothian is a pilot site for MSK referral via NHS 24. This will be piloted in March Adult Acute accepts referrals made by consultants for other Out Patient specialities. Within East and Midlothian Physiotherapy a centralised referral management centre is in operation, receiving all electronic & paper referrals for all adult Out Patient and domiciliary services. The Centre is staffed by administrative staff led by the Physiotherapy Manager. Health professionals are not incentivised through any referral management scheme in within NHS Lothian.

5 Request 8: Please provide details of the Health Board a) budget and b) spend for adult physiotherapy services in primary care for the following financial years: i) 2008/09, ii) 2009/10, iii) 2010/11, iv) 2011/12 and v) 2012/ / / / /12 Budget Actual Budget Actual Budget Actual Budget Actual '000 '000 '000 '000 '000 '000 '000 '000 8,027 7,942 8,691 8,718 8,573 8,613 8,304 8,139 The actual figures quoted for 2011/12 are based on forecast outturn. Budgets have not been agreed for 2012/13 so we are unable to provide this data. It is not possible to separate the budgets any further. Request 9: Please provide details of the Health Board a) budget and b) spend for paediatric physiotherapy ser vices in primary care for the following financial ye ars: i) 2008/09, ii) 2009/10, iii) 2010/11, iv) 2011/12 and v) 2012/ / / / /12 Budget Actual Budget Actual Budget Actual Budget Actual '000 '000 '000 '000 '000 '000 '000 ' The actual figures quoted for 2011/12 are based on forecast outturn. Budgets have not been agreed for 2012/13 so we are unable to provide this data. It is not possible to separate the budgets any further. Request 10: Please provide details of the Hea lth Board a) budget and b) spend for adult physiotherapy services in secondary care for the following financial years: i) 2008/09, ii) 2009/10, iii) 2010/11, iv) 2011/12 and v) 2012/ / / / /12 Budget Actual Budget Actual Budget Actual Budget Actual '000 '000 '000 '000 '000 '000 '000 '000 3,616 3,608 3,638 3,644 3,534 3,739 3,710 3,703 The actual figures quoted for 2011/12 are based on forecast outturn. Budgets have not been agreed for 2012/13 so we are unable to provide this data. It is not possible to separate the budgets any further.

6 Request 11: Please provide details of the Health Board a) budget and b) spend for paediatric physiotherapy services in secondary care for the following financial years: i) 2008/09 ii) 2009/10, iii) 2010/11, iv) 2011/12 and v) 2012/ / / / /12 Budget Actual Budget Actual Budget Actual Budget Actual '000 '000 '000 '000 '000 '000 '000 '000 1,414 1,500 1,596 1,607 1,756 1,765 1,784 1,773 The actual figures quoted for 2011/12 are based on forecast outturn. Budgets have not been agreed for 2012/13 so we are unable to provide this data. It is not possible to separate the budgets any further. Request 12: Please confirm or deny whether the Health Board has found any efficiency savings physiotherapy services over the following financial years: i) 2008/09, ii) 2009/10, iii) 2010/11 and iv) 2011/12. Yes a. Please provide details of these savings for adult physiotherapy services in each of the financial years in question. b. Please provide details of these savings for paediatric physiotherapy services in each of the financial years in question. Physiotherapy services have delivered a 10% saving target over 2010/11 and 2011/12 as part of a corporate approach to the delivery of LRP. Prior to 2010/11 LRP targets were delivered at a local level and as such corporate figures are not available. However, overall the organisation met its LRP targets in 2008/09 and 2009/10. Request 13: Please confirm or deny whether the Health Board has changed the level of physiotherapy service provision for patients in each of the financial years: i) 2008/09 ii) 2009/10, iii) 2010/11 and iv) 2011/12. There has been a change in the level of physiotherapy service provision. a. Please provide details of the change in provision for adult physiotherapy services.

7 b. Please provide details of the change in provision for paediatric physiotherapy services. Within LUHD staffing levels have been reduced to meet LRP targets, however service redesign has enabled physiotherapy service to be delivered in a different model of care whilst maintaining conta cts as reflected in the ISD contacts. Adult Service 1 st Contacts Follow Up Treatments Total Patient Contacts 2010/11 39, , ,169 Apr Oct ,257 80, ,715 There have been no changes within the Paediatric Service. Request 14: Please confirm whether the Health Board has made any assessment of the average number of outpatient physiotherapy treatment sessions provided to patients in each of the financial years: i) 2008/09, ii) 2009/10, iii) 2010/11 and iv)2011/12. a. Please provide details of the average number of treatments provided to adult patients for each of the financial years in question. b. Please provide details of the average number of treatments provided to paediatric patients for each of the financial years in question. c. Please provide details of the average number of treatments provided to adult patients with MSK conditions for each of the financial years in question. This information in not recorded centrally in an extractable format. In order to provide information to answer your request fully NHS Lothian would have to extract information from individual patient files. To extract the detail required would involve large numbers of files and the level of work required to extract this detail would take NHS Lothian over the 600 threshold as set out in the Freedom of Information (Scotland) Act Request 15: Please confirm whether the Health Board has ceased offering physiotherapy services to a) any patient groups or b) for any conditions in each of the financial years: i) 2008/09, ii) 2009/10, iii) 2010/11 and iv)2011/12. We have not ceased to offer treatment to any condition.

8 a. Please provide details of the patient groups or conditions for which physiotherapy is no longer offered. Request 16: Please provide details of the staffing numbers for adult MSK physiotherapy. Please confirm: Question:- a. What is the funded whole time equivalent (WTE) establishment for MSK physiotherapy services in each of the financial years i) 2009/10 ii) 2010/11 iii) 2011/12? Establishment as at October whole time equivalent. Question:- b. What is the current WTE establishment for MSK physiotherapy services? In-post figure as at October whole time equivalent. Question:- c. If there is a difference between the current establishment and the funded establishment, please provide details of the number of funded WTE posts vacant due to i) sick leave, ii) unfilled posts, iii) maternity leave and iv) other [please state]? Maternity leave 4.02 whole time equivalent and unfilled 3.8 whole time equivalent We can only provide current figures as the database is live and does extract historical data not allow us to I hope this helps with your request. If you are unhappy with our response to your request, you do have the right to request us to review it. Your request should be made within 40 working days of receipt of this letter, and we will reply within 20 working days of receipt. If our decision is unchanged following a review and you remain dissatisfied with this, you then have the right to make a formal complaint to the Scottish Information Commissioner. If you require a review of our decision to be carried out, please write to FOI Reviewer - NHS Lothian, at the address at the head of this letter. The review will be undertaken by one of our two Reviewers not involved in the original decision making process.

9 FOI responses (subject to redaction of personal information) may appear on NHS Lothian s Freedom of Information website at :- Yours sincerely Alan Boyter Director of Human Resources and Organisational Development Cc: Chief Executive