First AI-led NHS physiotherapy clinic to start this year | National Health Service

The NHS’s first AI-managed physiotherapy clinic will be rolled out this year in an effort to reduce waiting times amid growing demand and staff shortages.

The new platform will provide same-day automated video appointments with a digital physical therapist through an app that responds to information provided by a patient in real time.

It is the first platform of its kind to be approved by the health regulator, the Care Quality Commission, as a registered healthcare provider.

Patients seeking physiotherapy for issues such as back pain can be referred to the Flok Health platform through a community healthcare or primary care setting, such as their GP. They can also self-refer directly to the service.

The service aims to provide faster care and reduce waiting times and pressure on doctors, supporters say.

Waiting lists for treatment of musculoskeletal (MSK) problems, such as back, neck and knee pain, have increased by 27% since January last year. According to the NHS website, more than 30 million working days are lost each year due to MSK conditions in the UK, accounting for up to 30% of GP consultations in England.

However, some in the industry say AI cannot yet replicate the skill of a fully trained physical therapist and that treatment needs to be nuanced due to the complexity of cases.

The Chartered Society of Physiotherapy (CSP) said the number of physiotherapy posts in the NHS was not keeping up with demand from Britain’s aging and increasingly obese population.

CSP health informatics lead Euan McComiskie said of the AI ​​clinic: “There is no doubt that more needs to be done to address the huge NHS waiting lists, particularly for musculoskeletal services, and AI has a enormous potential to be a complement to the work of physiotherapists. . However, AI cannot yet replicate the clinical judgment and skills of a physiotherapist, who must be registered with a statutory regulator, the Health and Care Professions Council (HCPC).”

McComiskie added that physical therapists manage “increasing complexity in patient presentation and their treatment must be tailored individually.” He said: “It is still early to know to what extent AI may eventually facilitate clinical decision-making and more research is needed… but not at the cost of patient access, safety, experience or trust.”

Those behind the Flok app, co-founded by doctor and former professional rower Finn Stevenson, say initial test results show its effectiveness. As part of a series of three-month pilot studies between May and December 2023, more than 1,000 NHS staff suffering from back pain were referred to an AI physiotherapist for treatment.

All patients surveyed from the NHS pilot said their experience with Flok had been at least equivalent to seeing a human physiotherapist, and 57% of patients said they thought the AI ​​experience was better.

Stevenson said: “Our technology means every patient gets a consistently individualized experience and approach to care based on their feedback, symptoms and progress. “It’s like having a structured video call with a physical therapist, but our part of the call is mounted on servers.”

He added that it is becoming increasingly difficult for patients to access physical therapy, “leaving them in pain and often unable to continue with their daily routines.”

Participants from each of the organizations involved in the pilot (NHS Lothian, NHS Borders, Cambridge University Hospitals and Royal Papworth Hospital NHS Foundation Trust) could self-refer to the AI ​​service.

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An initial video evaluation was performed with an IA physical therapist to evaluate his symptoms. Once approved for treatment, patients had weekly video appointments. The digital physical therapist prescribed exercises and pain management techniques, monitored symptoms, and adjusted patients’ treatment.

More than four in five participants reported that their symptoms had improved during treatment with the platform. Ninety-seven per cent of patients who self-referred to Flok within NHS Lothian received an automated triage result; 92% were immediately approved for the IA physical therapist and given access to an appointment that same day; 5% were automatically referred to another NHS service, such as a GP.

Data from the trial at Cambridge University Hospitals indicated that the digital clinic had helped reduce waiting times for physiotherapy. Waiting lists for in-person musculoskeletal appointments increased by more than 50% after the pilot ended.

Flok is the first and only CQC-approved digital MSK provider, the app’s founder said. This means that, rather than being a technology provider that licenses software to NHS trusts, Flok can directly treat and manage patients on behalf of their trusts. The CQC assesses regulated services on initial registration and then inspects them at varying intervals to ensure all quality and governance requirements are met.

Flok is also the first technology to be granted medical device approval under MHRA regulations to fully automate the classification, assessment and treatment of back pain.

The system provides autonomous evaluation and classification instead of diagnosis. Flok uses an automated process to determine whether a patient can have instant access to physiotherapy appointments or be allocated another service, such as NHS 111 or their GP. Flok has not received any reports of red flags missed in trials, they said. Stevenson said: “The autonomous classification process is subject to continuous and rigorous testing.”

The AI ​​clinic is scheduled to launch with its first NHS partners this summer, although specific dates could not be provided.

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