Development of a physiotherapy led spasticity management service

Background: Spasticity is common symptom following upper motor neurone lesions such as stroke, multiple sclerosis, cerebral palsy, traumatic brain injury and spinal cord injury. It can cause multiple problems for people including pain, difficulty with functions, contractures and skin damage. People often benefit from an integrated physical and medical treatment plan to optimise management of this symptoms. Previously adults from the Hywel Dda University Health Board (HDUHB) who required input from a spasticity management service were referred to a consultant led regional service outside of the organisation. Aims/purpose: Demonstrate the process of developing a physiotherapy led spasticity service and the impact on patient pathways. Methods: Utilising national guidelines and evidence based practice principles HDUHB has developed a physiotherapy led spasticity management service by training advanced physiotherapy practitioners as botulinum toxin injectors and independent non-medical prescribers. Results: A number of benefits have been achieved with the new service model including: • Reducing travel for patients • Improving access for patients who have difficulty travelling by providing treatment in their own homes • Reducing costs by utilising Advanced Physiotherapy Practitioners to carry out roles previously provided by consultants • Freeing up consultant capacity to deal with more complex Conclusion: Many people with long term neurological conditions will need a combination of physical and medical management to meet their needs. Physiotherapists working in advanced practice are in a key position to meet these needs. Within spasticity management there is experience, guidance and evidence available to support the development of these roles