Our experience of employing a musculoskeletal practitioner in general practice

We read with interest about physiotherapists as an alternative to GPs.¹ We recognised that the management of musculoskeletal (MSK) problems could be improved in our practice. In 2015, we employed an MSK practitioner to work across three practices (total patient population 26 000). It needed to be cost-effective compared with a GP. The salary of an MSK practitioner is around half that of a GP’s. The MSK practitioner should see at least half the number of patients that a GP sees. These patients should not also see a GP for the same problem. The practitioner should provide direct treatment and reduce referrals to physiotherapy and orthopaedics. We evaluated whether our MSK practitioner achieved this and we believe he did.

In March, April, and May 2018 the practitioner saw 789 patients in 58 4-hour sessions, with an average of 13 patients per session. The average number of visits were 1.25. Sixty-two patients were referred to secondary care (8.2%) and 48 to physiotherapy (6.3%).

An audit of 25 peripheral joint injections found 16 carried out by the MSK practitioner and nine by a GP. There were no complications recorded on follow-up.

A 2019 patient satisfaction survey found that 80% of patients preferred seeing the MSK practitioner to the GP or advanced nurse practitioner. Ninety-five per cent said they would see the practitioner again and recommend him to family and friends.

• © British Journal of General Practice 2020