Physiotherapy

In Milton Keynes we pride ourselves on being able to provide a friendly, efficient and extremely professional service. We offer a wide range of treatments and benefit from having a vast array of resources at our disposal, which enable us to treat our patients to the highest level. The atmosphere amongst the team is very lively, friendly and interactive, with professionals at all levels involved in hands-on treatment, including our senior clinical managers. We have a commitment to providing the best care for our patients.

The Physio Team.

The Physiotherapy Department provides services for:

  • Inpatients at MKGH
  • Outpatients at MKGH
  • Paediatrics
  • Domicilliary
  • PCT Rehabilitation Services
  • Adult Learning Disabilities

All physiotherapists who work in the Trust and against the MKPCT SLA are employed by the General Trust. This enables good peer support and CPD for all the Physiotherapy staff. It also ensures good communication between units; therefore ensuring more efficient and effective patient care pathways.

Adult Inpatient Physiotherapy

This service aims to provide high quality physiotherapy to patients on the Medical, Surgical, Women’s Health, Trauma and Orthopaedic wards. This is achieved by specialist teams of physiotherapists working across the wards and being active members of the multi-disciplinary teams. These specialist teams are led by highly skilled Senior Clinicians in the following areas:

  • Neurology / Stroke Rehabilitation
  • Neurology / General Medicine
  • Respiratory Care / Critical Care
  • Trauma and Orthopaedics
  • Women’s Health

This service is available between 08.30 and 16.45 from Monday to Friday. An on-call respiratory service is available between 16.45 and 08.30 from Monday to Friday, and twenty-four hour cover on Saturday and Sunday.

A weekend Orthopaedic service is available for allocated patients and any new admissions on Saturday and Sunday from 08.00.

Referrals are accepted from:

  • Medical Practitioners
  • Nurses
  • Members of the MDT
Adult Inpatient Physiotherapy

This area of physiotherapy aims to provide a comprehensive service of assessment and treatment for patients with musculo-skeletal and specialist pathology in an accessible, appropriate setting.

There is a direct access GP referral service. There are many providers of musculo-skeletal physiotherapy with in the MK PCT. The Milton Keynes General NHS Trust provides a musculo-skeletal physiotherapy service for specified GP practices (see Appendix A).

Specialist outpatient physiotherapy services are available for the whole of the MK PCT area in:

  • Hydrotherapy
  • Pulmonary Rehabilitation
  • Women’s Health
  • Amputee Rehabilitation

Referrals for physiotherapy are accepted from:

  • Consultant Medical staff
  • General Practitioners
  • Midwives
  • Nurse Practitioners
  • Physiotherapists

These services are available between 08.30 and 16.45 from Monday to Friday.

All referrals are categorised by a Senior Physiotherapy Clinician based on the information on the referral form. Acute referrals are seen within three days, subacute referrals are seen within six weeks and chronic referrals are seen within twelve weeks.

The actual referral to appointment time will depend on the number of referrals received and current staffing levels.

Patients are contacted for appointments either by letter or directly by phone. An answer-phone service is available for patients who are unable to attend their appointment or no longer require treatment.

Previous audits have shown that ninety per-cent of patients are seen within five minutes of their appointment time.

If a patient does not attend without making contact then they are immediately discharged, in line with the Trust policy on DNA appointments.

All new patients are assessed by a state registered physiotherapist who then determines the appropriate physiotherapy treatment(s) and progression. The patient may be treated individually or in groups. Patients are expected to take responsibility for their rehabilitation and will be discharged when they can continue to full recovery with a personalised home exercise programme, for which they will be provided with exercise and advice sheets.

Domicilliary Physiotherapy

This is a service provided in the patients’ homes, for people who are unable to attend the Outpatient Physiotherapy Department due to their illness / disability.

The aim of this service is to prevent the need for admission to hospital, or to aid early discharge.

Physiotherapists with particular expertise and ability will assess and treat patients with the following pathology:

  • Acute respiratory
  • Neurological – to maintain optimal function at home
  • Orthopaedic – post operative
  • Acute musculo-skeletal with inability to travel
  • Elderly care e.g. reduced mobility

This service is available between 08.30 and 16.45 from Monday to Friday. It is a next day service.

Referrals are accepted from:

  • General Practitioners
  • Consultant Medical staff and their team
  • Other Physiotherapists

It is the decision of the Domicilliary Physiotherapist whether the patient is treated at home.

PCT Rehabilitation Services

There is a service level agreement with MK PCT to provide physiotherapy for their rehabilitation services.

Physiotherapists from the General Trust are based at:

  • Bletchley Community Hospital – Jubilee and Windsor wards
  • Bletchley Rehabilitation Unit
  • Fraser Day Hospital
  • CHAT
  • Orchard House
  • Ward 14 and Linford Day Unit
  • Adult Learning Disabilities Team (see separate section)

The aims of these services are, within a multidisciplinary team setting:

  • To return patients to their fullest possible function and level of independence
  • To continue rehabilitation following acute admission to MKGH, therefore aiding early discharge
  • To prevent admission to MKGH

The physiotherapists have skills in many areas and are able to treat a wide variety of conditions. These services are available between 08.30 and 16.45 from Monday to Friday. The Bletchley Rehabilitation Unit is currently a three day service on Mondays, Wednesdays and Fridays.

Referrals are made to multidisciplinary teams in the units and decisions on physiotherapy needs are made by the physiotherapist on those teams.

Audit and Effectiveness

The Outpatient Superintendent Physiotherapist is the clinical audit lead. Clinical audit is actively encouraged within the department, and physiotherapy staff can attend regular specialist audit meetings within their area of expertise.

Recent and current audit projects include:

  • Use of epidural in knee replacement surgery - with Anaesthetics Department
  • National benchmarking audit – Acute Hospital Profile – National Audit Office
  • Patient satisfaction and outcome after attendance at pre-op hip and knee replacements
  • Audit of Back Fitness Group – Outcomes and satisfaction
  • CPD within physiotherapy staff of MK compared with similar NHS Trusts
  • Pulmonary Rehabilitation
  • Audit of appropriate location and timing of discharge of neurological / medical patients
Risk Management

‘Statements of Concern’ and incidents are fed back to the individuals concerned and, where appropriate, discussed at Directorate meetings. All staff are encouraged to report critical incidents; a culture of no blame is promoted.

 

Paediatric Physiotherapy

Paediatric Physiotherapy provides a comprehensive service for assessment, treatment and advice / teaching to parents and carers of all children from birth to sixteen years, and children with long tem problems from birth to eighteen years.

Referrals are received from:

  • Acute and Community Paediatricians
  • General Practitioners
  • Other hospitals when transferring to this area
  • The Multidisciplinary team

All referrals are categorised by a Senior Paediatric Physiotherapist based on the information on the referral.

High priority referrals are seen within three working days. Medium priority are seen with in four weeks. Low priority referrals or multidisciplinary team referrals are seen within two months.

Patients are contacted either by letter or by phone call.

All patients are assessed by a state registered physiotherapist. This assessment may be done as part of a multidisciplinary assessment depending on the needs of the child.

Following assessment, appropriate treatment will be agreed with the parent / carer and a written exercise plan will be given to them.

The venues for assessment and treatment are:

1) Milton Keynes General Hospital Site

  • Child Development Centre
  • Acute Ward (5)
  • S.C.B.U.
  • Outpatient Portacabin
  • Hydrotherapy Pool
  • Orthotic Clinic

2) Community

  • Special Schools in Milton Keynes
  • Mainstream Schools
  • Designated Nurseries
  • Playgroups
  • Social Services Respite Homes
  • Children’s Homes
  • Hydrotherapy (Special School)
  • Adult Learning Disabilities Physiotherapy

Physiotherapists in this area work with other members of the multidisciplinary Community team and Social Service colleagues to provide a comprehensive service of assessment, treatment, advice and support for people over the age of fifteen years who have a learning disability. This also involves working closely with parents and carers.

In order to have a successful outcome, physiotherapy intervention requires an innovative approach with this client group.

We accept referrals from:

  • General Practitioners
  • Consultants
  • Other professionals
  • Social Service staff
  • Parents
  • Carers
  • Clients themselves

Clients are contacted for appointments in person, by phone, by letter, or directly via parents, carers, or other staff. Contact is made within three days and clients are seen, wherever possible, within two weeks.

All new clients are assessed by a State Registered Physiotherapist who then determines the appropriate treatment and progression. The client may be treated individually or in groups. A care plan is drawn up for each client and this may be carried out by the physiotherapist, an assistant, a carer, parent of staff at the Resource Centre, school or the clients’ home.

We work in any appropriate accessible setting e.g. gymnasium, dance studio, riding stables, swimming pool, Resource Centre, or in the home.

Specialist Physiotherapy Service in this Area

  • Hydrotherapy
  • Special Needs Gymnastics
  • Yoga
  • Rebound Therapy
  • Hippotherapy
  • Line Dancing

We also provide individual advice on therapeutic handling and we have a training role within the Dysphagia and Nutrition team.

Clients’ progress is monitored by the qualified physiotherapist and continued advice and support are given for as long as necessary.

For some clients it is more apprioriate clients it is more appropriate to access generic services .e. outpatient physiotherapy and we will encouraged and supported those whochoose to do this.

 

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