Advanced Physiotherapy Practitioners delivering

Point of Care Ultrasound within "One-Stop"

Rheumatology clinics

Dr Mhairi Brandon

Consultant Physiotherapist / Musculoskeletal Sonographer

NHS Scotland

ResearchNHSGGCOne-stop

clinics

Point of Care Ultrasound (POCUS) integrated into physiotherapy

care pathways for Rheumatology

Political Drivers

Transforming Roles

Advanced

Physiotherapy

Practitioners (APPs)

supporting increased

capacity and capability

within the health and

care workforce across

Scotland

NHSGGC catchment

area over 1.2 million

people

Interface of primary

and secondary care to

ensure a seamless

pathway of care across

both sectors

Direct Access to

services and fast track

to APPs

Improve the patient

journey POCUS

physiotherapy

pathways

Case management

unscheduled care

scheduled care

Interdisciplinary AHP

team to develop a

clinical - academic

partnerships

• physiotherapist

• podiatrist

• Sonographer

• orthotist

Clinical teaching

NHSGGC physiotherapists undertaking ultrasound trainingIn House Ultrasound Course Days

(120 clinical hours / e-portfolio)

CASE accredited courses aim to promote the best ultrasound practise through the accreditation of UK training programmes that develop safe and competent ultrasound practitioners.

Courses are recognised nationally and internationally for rigorous and robust quality standards which ensure that the education and training of sonographers is delivered at the highest level.

Courses• Glasgow Caledonian University GCU - (PG cert)

• SRUG / GCU CASE accredited focused synovitis course

• EFSUMB accreditation for teachers/mentors (level 1/2)

18 WEEK RTT “One – Stop” Foot Clinics

“One-stop” Visit

reduce patent journey from 24 wks / 5 visits to 4 wks / 1 visit

lean thinking - bottom-up approach

Point of Care Ultrasound (POCUS)

imaging and interventions remove the “bottle neck” of the waiting times e.g. joint aspiration / ultrasound guided injection therapy

Direct access (Day Ward)

early bird clinics from 7.30 /designated helpline / self referral /GP referral to Rheumatology Day ward ( led by Consultant Physiotherapist/ Lead Clinical nurse Specialist )

preventing hospital admissions bypassing Emergency Department

attend as unscheduled care patients for POCUS/blood investigations/ joint aspirations /prescribing management (prevent hospital admissions)

e.g. gout, joint sepsis

POCUS “One-Stop” Hand / Foot Clinics

Person Centered

Care

Interventions: injections /casts /orthoticsAssessment/ Imaging

Rehabilitation/Exercise

POCUS “One-Stop” Foot Clinic

NHSGGC Referrals to Foot Clinics

Foot Clinics - Arthropathies

Referrals to FOOT Clinics

Inflammatory Arthropathy

“Diagnostic Dilemma”

Ankle Joint (anterior)

1- Subtalar synovitis (sinus tarsi)?

2- Peroneal tendon tenosynovitis?

3- Ankle joint synovitis

4- Chronic ankle oedema?

Hind foot (lateral)

Hind foot (posterior)

normal

bursa

Doppler

Achilles Tendon

ANY QUESTIONS?