Concerns raised over rationing of physio for arthritis

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Linda Riordan MP highlights findings that suggest physiotherapy services for people with rheumatoid arthritis are being "rationed".

With all the hullaballoo concerning the second reading of the Health Bill in the House of Lords yesterday, the National Rheumatoid Arthritis Society and the Chartered Society of Physiotherapy have today slipped out a rather interesting report about access to physiotherapy services for people with the long-term condition, Rheumatoid Arthritis (RA), that deserves a mention.

For those of you who don't know, RA is a chronic, progressive and disabling autoimmune disease, which chiefly impacts upon joints but can also affect other organs such as the heart, eyes and lungs. RA is often confused with osteoarthritis, which is a different disease caused by wear and tear of the joints as we get older.

RA impacts heavily on people of working age, affecting around 690,000 of the UK adult population, with approximately 26,000 new diagnoses each year in England alone.

The report, the launch of which coincides with World Arthritis Day, calls for new measures to be introduced in England, Scotland, Wales and Northern Ireland to increase compliance with RA medical guidelines and to protect existing physiotherapy services.

The call comes in light of fresh evidence identified in the report which shows that many people with RA are having problems accessing physiotherapy services. Nearly a third said it took them over a year to get a referral from a medical professional and, shockingly, almost the same number again said they had never been referred to a physiotherapist.

And there's more - a high number reported that their treatment was a 'one-off' rather than being available as and when they needed it, suggesting that services are being rationed. Disappointingly, a third reported that their physiotherapist was not working as part of a multidisciplinary team, which is the model of care promoted in government strategies for the management of long-term conditions, like the Musculoskeletal Services Framework in England.

However, as they say, every cloud has a silver lining. The good news is that the majority of respondents said that physiotherapy helped to improve their mobility and function and nearly three quarters rated the quality of their physiotherapy treatment as good or very good.

What can we conclude from all this? Well, to start with, physiotherapists should be proud of the quality of the service they are providing to people with RA. However, the report also suggests there are problems with the way physiotherapy services are being configured and accessed by patients. In other words there is capacity in the system that is not being used.

Although not mandatory, clinical guidelines published by the main medical bodies in the UK, like the National Institute of Health and Clinical Excellence (NICE), recommend giving all RA patients access to a physiotherapist, operating as part of a multidisciplinary team, with a regular review. If you glance at the RA and Physiotherapy report, you will see evidence that this is not happening for many people with RA.

So don't be fooled by the title of the report. Although it may seem to concentrate on a specific disease, it beckons the question: how many people with other, different long-term conditions are also being denied access to recommended treatments that they are supposedly entitled to?

Linda Riordan has been Labour MP for Halifax since 2005.

RA and Physiotherapy: a national survey is available to download from the National Rheumatoid Arthritis Society and Chartered Society of Physiotherapy website.