A few blogs ago we covered hip fractures, the effects and how physiotherapy can help recovery from a hip fracture. So, when I read this article about a recent audit from the CSP about access to physiotherapy following a hip fracture (https://www.csp.org.uk/frontline/article/hip-fracture-and-rehab-postcode-lottery) I thought it might be good to cover some of the findings and my own thoughts in a blog.

In order to highlight and assess variations in patient access to rehabilitation and physiotherapy the Chartered Society of Physiotherapy (CSP) commissioned an audit recently. Its findings I have to say as a physio working in the community are fairly worrying and highlight how varied provision is. It found that the average wait before beginning rehabilitation is 15 days. Now, possibly some people reading this may think that isn’t too bad. After all a 6 week wait to see an NHS physio for a bad shoulder or bad back is not uncommon. However it’s worth having a think about the type of patients that this affects and the effect of a 15 day wait on them might be. Firstly most hip fracture patients are very elderly and a large proportion of them have been experiencing a general decline in their mobility for a long period, some will also have dementia to some degree. They will most likely have spent a week (possibly longer) in hospital mostly in bed. Yes, the guidelines state that they are meant to be mobilised as early as possible post surgery but often this doesn’t happen or if it does it is only for a few minutes each day and the rest of the time they spend in bed. So if you include 2 weeks in bed at home or in a nursing home then this means that the patient waiting 15 days for rehabilitation will have spent approximately 3 weeks flat on their back. For these kind of patients (as mentioned they are mostly elderly and often very frail to begin with) this often means they are completely unable to walk and if it is even possible for them to get back on their feet (often it isn’t) then it takes a long period of intensive rehabilitation to get them going again. The guidelines are clear that rehabilitation in the community needs to start as soon as possible but unfortunately this seems not to be happening everywhere and certainly my own experience as a physiotherapist would bear out this. The audit also revealed that often patients were only receiving 1 hour of rehabilitation a week! For a patient who has been immobile for 3 weeks – physiotherapy for 1 hour per week will make minimal difference, these patients need a lot of rehab!

I suppose some people reading this blog may think I have picked out the worst statistics from the audit but this really isn’t the case. In fact many people wait much longer than 15 days and certainly my own experience of seeing patients as a private physiotherapist is that 1 hour per week of NHS physiotherapy following a hip fracture would be a very good service and mostly people receive much less. Now, before anyone thinks that I am having a go at NHS physiotherapists – I am not! I think the NHS physiotherapy service is great and the physiotherapists do a great job, they are just overstretched and over burdened and unable to cope with the large demand being placed upon the service.

Okay, I hope you have found this blog interesting. If you or anyone you know has had a fall or broken their hip and needs physiotherapy then please get in touch. We are a home visit physiotherapy service based in Lichfield and serving Sutton Coldfield, Tamworth, Cannock, Rugeley and Walsall.