Self-refer for Antenatal Physiotherapy

Izzie Wilson

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ADI Health were joined by Lizzie Livesley, a Clinical specialist physiotherapist in pelvic health, at Sheffield Teaching Hospitals, who presented how MyPathway and Sheffield have worked together to digitise the self-referral of their antenatal physiotherapy service.

Historically in Sheffield, pregnant women accessed women’s health physiotherapy team (WHPT) via a midwife, GP or Obstetric Consultant using a paper referral, which was not always processed in a consistent or timely manner. Therefore, the team wanted to explore alternative options to see if they could improve women’s accessibility to WHPT, improve DNA rate and enhance quality of data on referral. The team explored the option of self-referral and conducted a pilot study in September 2019, using paper referrals from.

500 women, the team received 37 self-referrals over an 8-month period. Although it was a small sample size, they were delighted to see the DNA rate reduce from 10% to 2.7% and that 100% of patients would recommend self-referral as a way of accessing WHPT.

Based on the large reduction in DNA rate and positive patient feedback, this pilot study helped the service create a business case to get the funding to develop a digital self-referral pathway. ADI Health supported Sheffield with the business case and in May 2021, despite some COVID setbacks, Sheffield launched the digital antenatal self-referral pathway.

Within each patient’s maternity notes, they receive a leaflet, with information on how to self-refer and how to download the MyPathway app. Once the patient accessed MyPathway, they automatically gained access to resources, including information on pregnancy related back pain, Carpal tunnel syndrome, pelvic floor exercise and much more. MyPathway also prompted women to complete a self-referral questionnaire, which is a basic version of a subjective assessment, the team gained key information from these questionnaires, in order to triage.

When screening patients, the team use the clinical portal to view patients results and decipher whether they are referred to the video package, group sessions or one to one sessions, this process takes around 1 minute. For patients who are unable to access the service digitally, their GP or midwife can email the team on their behalf and self-refer, which is an alternative option for patients who may not have access to the internet, or if English is not their first language, but it is still a paperless option.

Triage options are face to face groups, video packages, telephone consultations or one to one appointments. However, during the pandemic, face to face appointments were not an option and therefore Sheffield created videos which linked to MyPathway and every patient could gain access. The video package does come with a strong caveat to contact the team if the problem continues or gets worse.  

The results from the first 6 months of data showed 267 referrals were completed and triaged and the team were very proud to see that the DNA rate had reduced to 2.6%, a challenge that had been improved by using digital self-referral. MyPathway enables the service to review data clearly and at any time through Mongo charts. The team could see how many antenatal responses they received each week, and what the triage decision was.

“ADI have been really great and really responsive. There is a good dialogue, where we give feedback and we can tweak things when we need to.”  

What’s next for the service? The team want to gather more friends and family feedback by further prompting patients when they see them for appointments. They want to continue collecting data, reviewing the data and keep auditing it in order to deliver better clinical outcomes. There is the possibility to further develop the pathway to extend to post-natal women, which is an exciting option to consider.

This webinar clearly highlighted that from a simple switch to digital, services can improve patient engagement, patient experience and deliver better care and better outcomes.

If you are interested in MyPathway self-referral antenatal and would like more information please contact us.