1) A retrospective study of over 4,271 patients across five physiotherapy centers in England from 2012-2016 found that patients experienced a mean improvement of 0.203 in their EQ-5D scores, and 68% of patients saw a clinically important difference. 2) Previous studies have found hip and knee arthroplasty patients see EQ-5D improvements of 0.31 and 0.42 respectively, higher than the typical 0.16 improvement found in previous physiotherapy studies. 3) While a journal editor declined to publish the findings due to lack of a randomized controlled trial design, the data shows community-based physiotherapy effectively improves patients' health-related quality of life and provides justification for continued funding.

1. Data
Dr Graeme Wilkes
Consultant In Sport & Exercise Medicine
Medical Director Connect Health
Physiotherapy UK 2017

2. "In God we trust, all others bring data."
William Edwards Deming 1950

3. 33 years of practice
• 1984-90 Hospital Junior Doctor X MRCP
• 1990- 94 GP Registrar Training X MRCGP
• 1994-2007 GP partner X
• 1996-2010 Lead Doctor X MSc SEM
Newcastle Falcons Rugby
• 2003- 2017 Sports Physician EIS X PG Cert U/S
• 2007– 2017 SEM Connect Health
3

4. 4

5. 5

6. DATA
1. Retrospective multi-centre study of physiotherapy
2. Extracts from Connect Data Warehouse
3. Live demo of Data Warehouse

7. EQ5D
 Health related quality of life (HRQoL).
 Score – 0.594 ( dead) to +1 ( full normal life)
 Change between scores used as PROM
e.g. + 0.15
 minimum clinically important difference (MCID)
> + 0.1 change
 Pre-2016 published mean change for physiotherapy
interventions = +0.16

8. Connect Health / University of Northumbria
Retrospective EQ5D data 2012-16 – five centres across England
Accepted for publication Health & Quality of Life Journal 2018

9. The effectiveness of community-based musculoskeletal physiotherapy on
health-related quality of life 2012-16 a multi-centre retrospective analysis
+0.203
68 % MCID

10. Page 10
Knee Arthroplasty EQ5D + 0.31
Hip Arthroplasty EQ5D + 0.42
EQ5D - National Joint Registry 2015

11. 2010
“Improvement in health-related quality of
life (HRQOL) is one of the most important
goals of orthopedic surgery”

12. EQ5D Orthopaedic study Stockholm

13. Musculoskeletal Science & Practice
13
“Your healthcare research data is extremely useful for the
justification of future funding of community based
physiotherapy. However, I am very sorry to say, that I don't
think your manuscript is suitable for publication….. “
“We don't know, whether the improvement
your are presenting is due to natural healing
processes or to physiotherapy “
(4,271 patients)
( Need RCT’s)

14. Physiotherapy
Mid – Essex CCG proposal 2015
14
The Mid Essex Clinical Commissioning Group (CCG) is consulting on plans to
save £15.7million, with restrictions to GP physiotherapy services making a
large proportion of the savings. Options:
• The first, saving £1m, is for patients to go private,
• A “telephone advice only” service would save £825,000
• Limiting the service to one assessment and one follow-up
would save £600,000.

15. 2017
Connect Data Warehouse

16. Page 16
Aaron Bergin Connect Data Warehouse
Head of Business Intelligence
Connect Health

17. 17

18. 18

19. 19

20. 20

21. 21

22. 22

23. 23

24. Connect Health EQ5D Trends April 16 to November 17
Mean EQ5D change ( 0 - 1)
Completed EQ5D scores (%)
Number of discharges per
month (000)

25. 2017
Data Warehouse
Live demo

26. The next steps

27. 10/10 Guideline project

28. 2017-18 Connect Objective – How are we treating patients?
Individual
EQ5D
Data
Diagnosis
Coding
Treatment
Coding

29. Episode 2 !
Predicting health related quality of life improvements
using EQ-5D following community-based
musculoskeletal physiotherapy
Physiotherapy UK
November 11 2017
Helen Robson BSc PGC MCSP
Clinical Lead North of England
Connect Health
Room 11B 11am

30. Thank you
graemewilkes@connecthealth.co.uk
@wilkesy49
"In God we trust, all others bring data."