"I commend the physiotherapy service"

About: Nottingham North & East / Primary care therapy

(as a staff member posting for a carer/relative),

I would like to take the opportunity to commend the quality of the physiotherapy service provided for my mother by Mr JT of the NHS. I was fortunate to be visiting from Australia when Mr JT attended my mother over a course of four home visits.

My mother is nearly 89 and has had a couple of serious falls in recent times. These have left her with a painful right shoulder and a painful knee which together with existing ailments had seriously restricted her walking and limited her ability to accomplish simple day-to-day tasks around the house.

The four extensive home visits to my mother have greatly improved her walking and her confidence in further improving the strength in her arms and the flexibility in her shoulder. Having witnessed the skill and sensitivity of Mr JT’s approach, I have no doubt that the improvements in my mother are directly attributable to the approach that Mr JT adopts in his work.

During the first visit, which lasted about an hour, Mr JT carefully assessed my mother’s physical limitations and constructed a detailed description of her current health profile. This was achieved through detailed questioning, sensitivity, and a careful physical examination of the movements that were giving her pain and discomfort.

At each step in his measured approach, Mr JT explained how his aim was to identify movements which were triggering her pain and then identify the exercises which could best alleviate her problems and increase the strength of her arms and legs. He also gave my mother every opportunity to ask questions and alert him if a movement was painful or not.

The patience and thoroughness of his approach enabled him to develop a strong and positive rapport with my mother. She felt that Mr JT had a genuine interest in helping her. The improvements in her walking following the first session and the first set of exercises boosted her confidence in Mr JT and motivated her to persevere with the exercises and participate positively in each of his subsequent visits.

I was also attendant at each of the subsequent visits. My mother was very eager to make the most of his expertise. On each occasion there was no sense of rushing things; my mother was respected as an individual personality with a singular identity and life history. She felt that she was not merely just a name or a number on a list of patients. Mr JT’s approach made her feel that her needs were being listened to. Although she doesn’t expect to make a full recovery, she does now have confidence that she can continue to make worthwhile improvements in her mobility and flexibility.

At the commencement of each of the home visits, Mr JT asked my mother whether the exercises were working for her and emphasised the need to avoid aggravating any pain she might have. He also observed her undertaking day-to-day tasks around the house and indentified methods by which she could avoid or minimise discomfort in her daily life. Thus he effectively linked his advice to her specific daily needs around her house.

I think it is pertinent to contrast the success and effectiveness of Mr JT’s in-depth home visits with my mother’s experience of two earlier visits that she made to a local NHS physiotherapy unit. These visits to a local unit were undertaken some months earlier, following one of my mother’s falls. The two sessions were relatively brief and left her to ‘continue’ the recommended exercises at home. However she felt abandoned and became dispirited because both her shoulder and leg continued to give her pain; and yet she was given no opportunity to get follow up advice or appointments at the unit.

I conclude that the home visit approach has many benefits for older patients, even if the number of patients treated per day is less than the number of patients that may be seen within a day at a local NHS unit. Through-put of patients may be higher, but qualitatively higher patient outcomes would seem to be the best achieved by the kind of approach adopted by Mr JT. I heartily commend him for the quality of the service he provides.

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Response from Lynda Penford, Clinical Facilitator Adult Community Services, Nottingham North & East Locality, County Health Partnerships

Dear Mr X

Thank you for your lovely letter regarding the care provided by one of our physiotherapy team. I am pleased to hear how JT listened to your mothers concerns and designed an individualised exercise programme to help minimise her discomfort in her daily life routine. It is nice to know that as a result of this your mother has felt listened to and her confidence has now improved.

Thank you

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