To mark this year’s theme of ‘Move to Improve’ for World Arthritis Day, Minister of State for Care Services Paul Burstow will answer your questions about access to rheumatoid arthritis related physiotherapy services.
Questions will be put to him by Ailsa Bosworth, Chief Executive of the National Rheumatoid Arthritis Society and Phil Gray, Chief Executive of the Chartered Society for Physiotherapy.
You can submit your question using the comments field below, or via Twitter mentioning @dhgovuk and using the hashtag #raphysio.
Keep checking here for updates and to see what questions people are asking.
We love Mayor Johnson, but find it hard to get on a regular bus; how on earth will we climb onto a new Route Master which he is bringing back???? This bus is NOT for semi-disabled people!!!
It would be very beneficial for RA sufferers to have access to Physiotherapy classes on a monthly basis and not be dismissed after a few sessions. Physiotherapy should be on-going to help keep joints moveable. At present there is an attitude that after a few sessions there is nothing more therapists can do to help, but motivation alone can help. Nutritional advice at classes can help too, this together could help sufferers lower doses of medication, a financial saving to the Government.
Why isn’t physiotherapy freely and regularly available to people with Rhuematoid arthritis. It would also be helpful if complementary therapies could be prescribed on the NHS
As a sufferer of R.A, I am perplexed as to why we still pay fror prescriptions when we live with a chronic, incurable , painful disease but my sister who has an under active thyroid and leads a normal life as opposed to my life, doesn’t pay! Why is R.A not treated seriously by the Government?
I was diagnosed with RA in 2008 at the age of 33. Whilst I have received excellent care from my local physiotherapy team, the majority of this care was essentially informal psychological support and MDT liaison (i.e. she translated the actions of the consultant into user friendly terms). I found my diagnosis and the changes it brought to my life devastating and I was arguably depressed for the first year. I am a Clinical Psychologist and with the help of my physio I was able to tentatively reach out and find the answers I needed from the medical practitioners, however, most people do not have this knowledge of health care systems or an understanding of human distress. Research has demonstrated that overlooking the psychological welfare of patients with long-term conditions is likely to lead to longer stays in hospital, poor medication adherence, reduced life expectancy, increased use of healthcare resources and difficulties in engagement with services (Saxby & Svanberg, 1998). NICE guidelines state that the psychological needs of our patient group should be met. Pain management services, where psychological support is provided, are not in my experience generally set up for this wider aim.
Therefore, my question is:
Are there any plans to provide further psychological support, for example possibly like that provided by the IAPT services for people with anxiety and depression, for people who may benefit psychologically, medically, economically and socially from this kind of service? If not, what could be done to address the lack of psychological care for people adapting to and managing a life with RA?
Thank you.
Evidence and experiences both are indicating that regrettably most of Rheumatoid Arthritis and Osteoarthritis patients are not fully aware of the effectiveness of physiotherapy intervention, especially in the early stage of their conditions.
In addition, the rate of referral to physiotherapists in the early presentation of RA and OA is very low (R. Glazier et al., 1996).
Therefore rose clinic performance physiotherapy recommend more exposure to physiotherapy interventions and GPs referrals in the early stage of disease, which are essential factors to prevent severe functional impairment and provide adequate management of these conditions in long-term.
N Zadeh, physiotherapist
why is their no joined up service between Gps and Pain consultants, My GP will not proscribe morphine or when that stoped working fentanol with out a letter from a consultant which takes 12 weeks to get so I waited 12 weeks for Tramadol then 12 weeks to step up and another to sept up again, This is just prolonged un necessary pain
I was diagnosed in August 2011. I have asked for physiotherapy through my GP. He said there should be a routine invitation from a specialist physiotherapist through my team at the hospital. I have not heard anything from them yet. How long should I have to wait for this to come through? I must say I would have welcomed an appointment before now as I am struggling with many tasks and my fitness level has declined considerably since I became very ill in April with RA.
What challenges do those with rheumatoid arthritis currently face when it comes to accessing physiotherapy services?
Why is it essential that arthritis sufferers keep moving, and what sort of exercise should they do?
Manual therapies, such as osteopathy, can also have an important role to play in treating patients with arthritis. Does the Minister agree that promoting multidisciplinary teams, including osteopaths, is important?
is there published medical eveidence that manual therapies work? Physiotherapy usually consistes of active exercies, advice and psyych support, not manaual passive therapies??
I think it would be beneficial for more people to have access to hydrotherapy pools as even those that find physiotherapy too painful would be able to participate and it is very beneficial for those who are unable to move certain joints.
Also, I think more should be done to inform people about the nutritional aspects of this condition and for everyone to have access to groups where a nutritionist and other health professionals are present to offer advice. As a sufferer and nutritionist I know I would be willing to help, and I know many other sufferers who would like this kind of information
Is the Government still planning to move physiotherapy services into primary care?
Is the Government planning to include physiotherapy within personal health budgets?
Were you previously aware of the issues raised in the RA and Physiotherapy report around access to multidisciplinary services, like physiotherapy, for people with long-term conditions?
Do people with RA have access to physio? Is it direct access or does our consultant or doctor have to refer? I have had RA for 2 years and ask for help from a physio for shoulder pain and other areas but have been unable to access this service. If it is available it should be to all and not selected patients as many services in my area of the country seem to be
agreed, sara.
Access matters. I discovered that it was possible to self- refer and spread this information.
What are the current priorities for the goverment in terms of helping people with long -term conditions ?
There do not seem to be any physiotherapists at my local hospital who have any real knowledge of RA. I have recently attended 2 appointments and all he is treating me for is sciatica and is not interested in anything else! Why cannot rheumatology departments have a physiotherapist attached to them who would have specialist knowledge? My rheumatology department has a podiatrist so why not a physiotherapist?
There is some good quality evidence that progressive resistance training exercise can be very beneficial for patients with inflammatory arthritis. However, patients relate that they find attending public gyms daunting and relate that they find fitness staff are not always fully knowledgeable about their medical condition. Physiotherapy departments are unable to offer the long-term exercise therapy that patients require due to pressure on services – what is being done by the government to ensure that patients with arthritis have access to the long-term help and advice that they need?
i agree and support your question.
How do you think the Government’s current reforms, as proposed in the Health Bill, will affect physiotherapy services for people with RA and those with other long-term conditions?
Given the emerging evidence about the benefits of self-referral, should more be done to increase its availability
why is it so hard yo get physio on the NHS we need it when we are suffering not when things settle down.
I have been a RA patient for about 16 years. In this time I have always been very impressed with the physio treatment that I have received. However, to see the physio team I need to be referred via the Consultant each time. Treatment is then offered for approximately 6 weeks, (usually a 6 week block of hydrotherapy, which is very beneficial.) After this time I am then discharged from the physio team. To be able to access this treatment again I need to wait for the next Consultant appointment in order to be referred again. Consultant appointments are most likely to be 6 months apart, plus the added time waiting for the referral, before being assesssed again.
Therefore, I ask if the physio team could be more readily avaliable for those suffering from long term physical conditions? Particularly the use of hydrotherapy pools during the day?
I would also like to second the comment above about free prescriptions for people with long term conditions. I have been on steroids for 16 years and will almost likely remain on them for the rest of my life, yet I pay for prescriptions.
I have found it beneficial when having massages, would these be available on the NHS to help chronic illnesses? Either perscribed or at a reduced rate for massages and any other complimentry therapies that would help us ease pain and save money on painkillers.
Thank you
What are the government’s plans to maintain specialist physiotherapy services for R/A for both patients and therapists to prevent services (including hydrotherapy) being transferred to AQP for cost not quality reasons?
Specialist rheumatology units treat the whole patient holistically not like generic units who only treat one joint per referral and are aware of all the systemic and associated symptoms within rheumatiod arthritis and similar conditions such as connective tissue diseases, thus they can arrange appropraite investigations/ treatments promptly within the team minimising the need for ongoing multiple referrals and GP time. Much of our treatment is preventative and includes hydrotherapy again a costly modality but provides some excellent results both objectively and in quaility of life.
In response to some of the above questions once under our consultants care patients can self refer to reduce costs of unnecessary GP time and patient distress via our helpline. Support groups allow ongoing information and hydrotherapy sessions for self management.
this is an excellent example of effective service delivery by physiotherapy in one lacality, its just a shame that this is not a national standard!
we welcome discussion tomorrow as our physiotherapy team will be within the chat session
I was diagnosed 11 years ago, and havent yet seen a physiotherapist. Is there a policy now about access to advice on safe exercise or does it vary between hospitals
Will it be harder to get a physiotherapy appointment once more control of the budget is given to G.Ps?
A frequently-reported problem is that physiotherapy is currently set up to deal predominantly with acute patients, and is often not delivered in a consistent, joined-up way. Many hospital units do not have musculoskeletal leads, despite many patients having joint problems. In addition, there is a high level of rotation among physiotherapists, and many do not feel sufficiently confident to deal effectively with people with RA. How can the training and delivery of physiotherapy be improved to ensure that more people with RA receive prompt, high-quality treatment by sufficiently experienced physiotherapists?
I second the points raised by Donna Saunders above. I too am a long term RA patient and have experienced the same problems with regard to physiotherapy services. Waiting for availability of service causes needless suffering and may even lead to further problems. I am fortunate in having a physiotherapist who has a special interest in RA; others are not in this position. My physio sessions have always been a resounding success and it seems such a shame when these types of treatment can be beneficial that they are not readily available for all at the point of need.
Likewise the Free Prescription issue for long term conditions. I have been on steroids and RA medication of various sorts for over 23 years. I am, sadly, going to be on these for the rest of my life. Free Prescriptions for long term conditions should either be available to all who meet the criteria or indeed to no-one at all.