P057 Scoping the role of the physiotherapist in the axial spondyloarthritis new patient clinic
Authors: Gregory William J , Adshead Rebecca , Cox Zoe , Deeney Emily E , Dowie P A , Fish S J , Galway Rhona , Harrison H , Hayward Rhys J , Longton C , Motion M , Tonks Catherine , McCrum Carol 
Published: April 2024

Abstract

Background/Aims
Early diagnosis of Axial Spondyloarthritis (Axial SpA) is crucial to reduce negative impacts and support better patient outcomes through early intervention. There are a number of challenges contributing to delayed diagnosis, the focus of this report relates to the capacity pressures limiting timely assessment and diagnosis. There are a number of well-established, and more recently initiated, physiotherapist-led Axial SpA new patient clinics across UK Rheumatology. These clinics have been locally reported to reduce delays in diagnosis. There is growing interest from other rheumatology services to establish these clinics. A working group of physiotherapists providing physiotherapist-led Axial SpA clinics were supported by a BRITSpA Travelling Fellowship Grant to meet to share service experiences and to develop a consensus-driven best-practice set of recommendations to guide planning and implementing physiotherapist-led Axial SpA new patient assessment clinics in rheumatology departments across the UK. The aim of this report is to provide an overview of the two day Travelling Fellowship project process and the key initial outcomes from the workshop.

Methods
A two-day workshop attended by ten physiotherapists meeting in person and four joining virtually, all with expertise in providing physiotherapist-led new and review Axial SpA clinics. The workshop programme included presentations from national and international experts, encompassing GIRFT input, exemplar consensus development examples and an opportunity for all fellows to share their experience in setting up and delivering physiotherapist-led Axial SpA new patient clinics. Discussion time was prioritised to allow shared learning, discussion of similarities and local variations to support information gathering and the development of expert consensus-driven guidelines and implementation advice. Patient and public involvement was embedded into the workshop supporting planning discussions and providing lived experience perspectives, preferences and values concerning the implementation and service delivery discussions.

Results
The major themes and findings identified included the variation in role description and specific responsibilities between centres, including variation in support and mentoring available as well as administration time. However, similar outcomes were found regarding levels of confidence and independence in undertaking thorough triage and assessments of inflammatory back pain referrals leading to confirming or excluding Axial SpA diagnoses, and the skillset to manage these outcomes.

Conclusion
Following GIRFT recommendations, and in light of the workforce crisis in rheumatology, with support from the rheumatology physiotherapy capabilities framework we have seen the expansion of the physiotherapist role. We have good levels of confidence, following our sharing of clinic data and patient experience comments, that there is a valuable contribution to the rheumatology landscape to be made by physiotherapist-led Axial SpA new patient clinics.

Disclosure
W.J. Gregory: Honoraria; W.G. has received honoraria for speaking and advisory board from Abbvie, Novartis, Pfizer, Sobi and UCB. R. Adshead: None. Z. Cox: None. E.E. Deeney: None. P.A. Dowie: None. S.J. Fish: None. R. Galway: None. H. Harrison: None. R.J. Hayward: Honoraria; R.H. has received honoraria for speaking from Abbive and Novartis. C. Longton: Honoraria; C.L. has received honoraria for speaking from UCB. M. Motion: None. C. Tonks: None. C. McCrum: Honoraria; C.McC. has received honoraria for professional education workshops- Novartis, Janssen.