OK, so you have made the wise decision to see a Physiotherapist to get your problem addressed -well done! You finally want to get rid of those persistent aches and pains that are stopping you doing the things you want or need to do, or maybe you want to optimise your recovery, mobility, and independence if you have a Neurological condition (e.g Parkinsons or following a stroke). A question you then might have is ‘should I go to my GP and get referred on the NHS or should I find a private physio’?
In this blog today I would like to share my thoughts on this frequently asked question. Now for transparency, I own a Private Physiotherapy clinic (Thorpes Physiotherapy) so you may well feel that my thoughts will be biased -and this may possibly be the case. However, I have worked in the NHS for over 10 years and my private clinic has an NHS contract (which I will discuss later), therefore I feel that I am well qualified to offer a balanced viewpoint. I would like to put across what I feel are the pro’s and cons for both routes (both here at Thorpes and elsewhere) and then hopefully you will be able to make your own mind up in a balanced way.
Benefits of the NHS / Hospital Physiotherapy route (not at Thorpes): –
- The obvious and main one is that its FREE, you go to your GP, they make a referral, and you can often get 3-5 sessions allocated within that referral (which is great). Therefore, if money is very tight or you have a cash flow problem, this route may be the one for you. Also, if you’re not sure if Physiotherapy is right for you, then on the surface, this is a risk-free way of trying it out.
- Your local hospital / GP surgery may be very near where you live, therefore convenient for you. We have an NHS contract for North East Hampshire, alongside 7 other local providers, therefore you should be able to choose which NHS location you want to go to (which is a lot better than it used to be)
- There are some excellent Physiotherapists in the NHS (I have worked alongside some great clinicians over the years and learned loads from working in the NHS). Many of the Physiotherapists I employ have ether worked in the NHS or still do on a part-time basis. My recommendation to all newly qualified physio’s is to go down the NHS route to get some sound education and professional development.
- NHS physio’s do regular In-service training, therefore they should be clinically good and up to date with evidence-based practice. Private clinics should also do this -but some may not do as much as others.
- You might get access to exercise / rehabilitation classes that can be very useful. Hospitals often have gyms, and some have hydrotherapy pools, which can be helpful for certain conditions (at Thorpes Physiotherapy we are fortunate to have access to a hydrotherapy pool and offer exercise classes)
- Specialist departments -In the NHS they often have specific / specialist services, e,g ‘Hand clinics’, ‘Paediatrics’, ‘Women’s Health’, ‘Chronic Pain’. Therefore, if your problem falls into one of those categories then the chances are you will see a specialist physio in that area in the NHS -which I would recommend.
- Multi-Disciplinary teams. In the NHS setting, the Physio’s will often have access to other health professionals, which can be very helpful. E.g Occupational Therapists, Podiatrists, Orthopaedic Consultants, Pain Consultants, and being able to tap into these services for advice or cross referrals can be very useful
So, as you can see, there are many benefits from going to your GP and getting an NHS referral to your local hospital.
Now let’s looks at the benefits of seeing a Private Physiotherapist at Thorpes Physiotherapy:-
- Speed of access and convenience. At Thorpes, its very likely that you will be able to get an appointment within a day or 2. From my 20 years of being a Physio, one of the most important things to do when you have an injury or you’re in pain, is getting an accurate diagnosis and then receiving correct information about what you should or shouldn’t be doing. People often search on google for this, but this can be risky. If you go down the NHS route, then firstly you must make an appointment with your GP (which is getting more difficult and may take a couple of weeks, plus can be a little hassle), then you will wait several weeks for your Physiotherapy appointment (4 weeks I would say would be a fair average). Therefore, if all goes to plan, you may be waiting at least 6 weeks via the NHS route compared to immediate access via the private route. If you are in pain, if you are worried, or if the problem is stopping you from doing the things you want or need to be doing, then those 6 weeks can feel like a long time. The waiting lists in the NHS for pathways into specialist departments, e.g. Orthopaedics or Pain departments can be a lot longer than what I’ve mentioned above. If your problem however is not urgent then you may not be too concerned about this wait
- Choice over your appointment day and time. At Thorpes Physiotherapy, we have 3 different clinic locations (Sandhurst, Yateley and Fleet) and we offer early morning and evening appointments (8am-8pm) -to my knowledge you don’t get this in a hospital or GP setting. Therefore, if it is difficult to get time off during the day to go to an NHS physio session, or it ends up costing you money to take time out of work, it might be more desirable, convenient, and cost effective to see a private physio at a time and day that suits you.
- Choice over your Physiotherapist. At my clinic, we get people calling up requesting to see a particular physio as they have seen them before, had a great experience, trust them, and want to see them again (Over the years I have often seen 3 generations of the same family, which is really nice). Via the NHS route, you may not be able to request a particular physio. In the NHS route, you may be fortunate and see an experienced and great physio (as I said earlier, there are lots of these in the NHS), however, there is the chance that you might see a newly qualified physio or a physio who’s interest might not be in the area of your particular problem (e.g musculoskeletal). Let me expand further, Junior Physiotherapists often do 4 monthly rotations throughout the different areas of Physiotherapy (e.g. Musculoskeletal out-patients, Neurology, Respiratory and ICU, Elderly care, Orthopaedics etc), and after doing this for a few years they then decide which area they want to specialise in. For example, my wife is a Neurological Physio, she was not that interested in musculoskeletal (MSK) out-patients as she knew she always wanted to do Neurology. Now, I’m sure my wife will have treated her MSK patients during those 4 months to the best of her ability, however I’m sure she would be the first to admit that other Physio’s (with a special interest and more experience in MSK) would have done a better job. At Thorpes, we have Physio’s who either specialise in MSK, Neurology or Women’s Health.
- No restrictions over appointment frequency and time. At my private clinic, after an initial assessment we will diagnose your problem and then recommend a treatment plan based on the best way to get you better and to achieve your individual goals. This plan might for example consist of 2 sessions a week for 2 weeks if this is in your best interest. We have no restrictions and will advise what is best for you based on our expertise. We offer 30-, 45- or 60-minute sessions depending on what you want and need. In the NHS, the sessions are a standard time length, and they are often so busy that there might be several weeks in between sessions -which ultimately delays recovery, plus there is a limit on the number of sessions authorised.
- The best type of care that you need and want. At Thorpes, through regular training, our Physio’s are kept up to date with current evidence (like in the NHS) and our treatment programmes often consist of lots of hands-on treatment alongside rehab exercises. I hope I’m not being unfair here but over the years I have seen lots of patients who have been down the NHS route and said that they were ‘just given exercises’. Now don’t get me wrong, appropriate exercise prescription is a very important part of our care, but we find that combining this with a hands on approach tends to get better results and higher levels of satisfaction with our patients
- Start private whilst waiting for NHS. Some patients do both -they go to the GP to get an NHS referral and whilst waiting for those 6 weeks (or longer) come to us to make a start. We have no issue with this, and I do see the logic. This only thing I would say is that’s it’s not often recommended receiving treatment from both NHS and private physio’s at the same time as this can get confusing for the patient. Different physio’s can have different ideas and approaches and combining the 2 may not be ideal.
Difference between Private and NHS Physiotherapy at Thorpes
I mentioned at the start of the blog that we are fortunate at Thorpes to have an NHS contract for North East Hampshire. This means that depending on where you live, you may be able to be seen by us on the NHS. The key differences between seeing us via the NHS rather than privately are: –
- Speed of access –The same referral pathways and waiting times as the hospital route exist (likely around 6 weeks)
- Appointment time – The early morning and evening appointments are prioritised for private patients; therefore, you may not be able to get these slots. Our NHS contract states that the length of each appointment should be 20 minutes –this is fine, however we find not as effective as the longer sessions offered privately (30, 45 or 60 minutes)
- Appointment restriction –The local CCG state that we should average between 3-5 sessions for each NHS referral, therefore whilst you can certainly expect to improve, you may not fully reach your goals with this limited number of available sessions.
- Contract Restrictions. It is also important to note that our NHS contract is for Musculoskeletal conditions for people aged 16 and over. Therefore, if the Physiotherapy you require is for a Neurological condition, a Women’s health problem, a home visit or for someone under the age of 16, we unfortunately wouldn’t be able to see you via the NHS pathway.
I hope this has been interesting for you, thought provoking and helpful when deciding if you want to go down an NHS or private route. This blog may have identified certain things you were not aware of, or may possibly make you think a little differently when deciding what your key priorities are when looking after your health and wellbeing.
If you are interested in exploring the private route at Thorpes Physiotherapy but are not yet sure if we can help your problem, or if you have had a poor experience in the past from Physiotherapy and are sceptical about trying any more, then we do offer free Discovery calls, where you can speak to an experienced physio first to see if we can help you. Just click here to fill in a form or alternately call the clinic on 01276 37670 or visit www.thorpesphysiotherapy.com for more information.
Jonathan Smith (MSc BSc FSOMM MCSP SRP)
Director of Thorpes Physiotherapy