Physiotherapists embedded in Wexham Park’s emergency department helped to prevent the equivalent of a whole ward of avoidable hospital admissions in their first two weeks.

One experienced physio and a student, with senior support, joined the ED team on 5 June, complementing the occupational therapists (OTs) already there.

The move has helped to improve joint working across teams in the department, including OT and frailty specialists.

The physiotherapists provide a Monday to Friday service, 8am-4pm, supporting capacity and flow by seeing patients early in their hospital journey and helping many to go home as soon as it is safe.

Over the first two weeks of the service the physiotherapists saw and discharged 63 patients. Thirty-one went straight home from ED without having to be admitted – double the team’s initial target.

Therapists join ED morning huddles to identify patients they can support, while also screening those being cared for across ED and on the 24-hour first floor of the Emergency Assessment Centre. Patients can also be referred on Epic.

A similar service is already running at Frimley Park.

Chelsea Calvert, principal physiotherapist - medicine and neuro, said: “Our teams pick up patients they can make a difference to. There’s a large cohort who can be seen for early intervention and advice to try to reduce their length of stay, such as those with infective exacerbation of COPD or bronchiectasis.

“Patients may come in for medication for a few days, but early intervention can prevent them getting worse and help them to go home earlier once their IV treatment has finished.”

Other patients include those presenting with back pain, or who have suffered falls or been in road traffic accidents. Many are assessed, given advice and referred to community services, then go home on the same day with a care plan.

Chelsea added: “There’s some real gold standard care, too. For example we had a query stroke patient who our physios and OTs assessed to identify their needs before they went to the stroke unit at Wycombe Hospital. That’s great in terms of stroke guidelines and patients being seen by a therapist within 24 hours. It didn’t have a big impact on us because the patient was going to Wycombe, but for the patient it was amazing.

“We’ve also given advice to patients on the acute assessment unit for managing COPD and bronchiectasis, and we’ve been able to give spirometers to patients with sickle cell disease to make sure they are managing their lung volumes and don’t deteriorate and need to be readmitted. That’s real gold standard care.”

Embedding physiotherapists within ED at Wexham is just one of the changes we have been making to improve flow through our hospitals, reduce waiting times in ED and improve quality of care for our patients.

In May we returned to reporting the four-hour emergency care standard which states that patients should be seen, treated and then discharged, admitted or transferred within four hours of arriving in in ED. Evidence shows that patients who spend longer than four hours in ED are more likely to come to clinical harm.

The four-hour standard is not just a target for our emergency teams – it’s a barometer for the whole Trust and the wider health and care system, and everyone has a role to play in ensuring patients receive the right care in the right place as quickly as possible.