From
The Guardian in the UK. In the picture, some parents are being forced to take their children to hospital for physiotherapy, where they risk picking up an infection.
Patients with chronic illnesses such as cystic fibrosis, multiple sclerosis and severe asthma are having their NHS physiotherapy services cut, despite coalition claims that frontline care is being protected.
Sufferers of other serious conditions such as emphysema and chronic bronchitis in need of physiotherapy are facing waits of up to six months.
In other places, people with back problems and arthritic knees are seeing their access to physiotherapy disappear altogether and are having to make do with nothing more than advice on stretching.
A new survey by the Chartered Society of Physiotherapists reveals that growing numbers of patients are receiving less hands-on physiotherapy treatment for their ailments. In a poll of more than 1,000 members, 74% said they were seeing rationing or reductions in the quality of services as a result of budget cuts.
Some 87% feared that would lead to patients having fewer sessions with a trained physiotherapist, 81% highlighted longer waiting times, and 71% said some people's conditions could become chronic as a result of delays and denial of treatment. Two-thirds voiced concern that cuts would lead to continuing pain and disability and a greater chance of the patient needing to be readmitted to hospital.
In Glasgow, parents of children with cystic fibrosis are angry that the city's Royal Hospital for Sick Children has recently stopped providing home visits by physiotherapists because two have left and not been replaced to save money. The physios teach parents how to mobilise their children's lungs to help them breathe as fully as possible.
"Patients are being forced to go to hospital in order to access physio services that until recently were offered routinely," said Jo Osmond, director of clinical care with the Cystic Fibrosis Trust. "Parents are concerned because repeated hospital visits pose a risk to their children, because they could pick up an infection there such as pseudomonas which, if they get it in their early years, can shorten their life later. That's unacceptable. I'm dismayed to see this happening."
The cuts are most noticeable in England, where hospitals and NHS primary care trusts are rationing some services to contribute to the NHS's £20bn "efficiency savings" drive and to prepare for flat or slightly reduced budgets until 2015 after a decade of big year-on-year rises under Labour.
The South West Essex PCT has reduced musculo-skeletal services for "priority 3" patients, with conditions such as bad backs, from an assessment and six treatments to an assessment and development of a care plan. Even "priority 2" patients with more serious conditions have had their physio sessions cut from six to two.
"Patients are facing longer waiting times, fewer sessions with a physiotherapist and, in the most extreme cases, could get no treatment whatsoever. In order to save money, some patients will only receive advice – that is quite simply a scandal," said Phil Gray, the CSP's chief executive.
"The longer a condition goes untreated, the worse it will get, and this can have devastating consequences for patients and their families. It can result in extended periods off work, mental health issues and higher costs for the NHS."
Jane Petty, the physiotherapy lead at the MS Society, said that cuts were affecting multiple sclerosis patients in many places.
Central Essex Community Services has restricted the number of sessions for patients with neurological conditions such as MS, Parkinson's disease and motor neurone disease. While the limit of four sessions over six weeks benefits some patients, it is not enough to help others.
Some of the 250,000 people in Britain with severe asthma are also being hit, said Neil Churchill of Asthma UK. "We have evidence that patients are facing waits of up to six months or more for specialist respiratory physiotherapy and pulmonary rehabilitation, and have been told by doctors and patients that there are areas without access to pulmonary rehab at all."
One respiratory physiotherapist said: "Sadly, life is getting harder for people with chronic obstructive pulmonary disorder and asthma because the GP who commissions our services says they are only 'quality of life' activities and he'd be laughed out of the room if he lobbied for more budget on this basis alone."
The Department of Health said that the effort to save the £20bn should not mean fewer services for patients. "Efficiency savings should not affect important patient services, at a time when the budget is increasing by a total of £11.5bn over the next four years," said a spokeswoman.
