The first NHS AI-run physiotherapy clinic will be rolled out this year in a bid to reduce waiting times due to growing demand and staff shortages.
The new platform will enable automated same-day video appointments with a digital physiotherapist through an app that responds in real time to information a patient provides.
It is the first platform of its kind to be approved by the healthcare regulator, the Care Quality Commission, as a registered healthcare provider.
Patients seeking physiotherapy for problems such as back pain can be referred to the Flok Health platform through a community or primary care setting, such as their GP. They can also refer themselves directly to the service.
The service aims to provide faster care and reduce waiting times and pressure on doctors, say the people behind it.
The waiting lists for treatment of musculoskeletal complaints (MSK), such as back, neck and knee pain, have grown by 27% since January last year. According to the NHS websiteMore than 30 million working days are lost every year in the UK due to MSK conditions, and they account for up to 30% of GP consultations in England.
However, some in the industry say AI cannot yet reproduce the skills of a fully trained physiotherapist, and treatment needs to be nuanced due to the complexity of the cases.
The Chartered Society of Physiotherapy (CSP) said the number of physiotherapy posts in the NHS was not keeping pace with demand from Britain’s aging and increasingly obese population.
Euan McComiskie, CSP’s head of health informatics, said of the AI clinic: “There is no doubt that more needs to be done to tackle the NHS’s huge waiting lists, especially for musculoskeletal services, and AI has enormous potential to complement the work of physiotherapists. . However, AI cannot yet replicate the clinical judgment and skills of a physiotherapist, who must be registered with a statutory regulator, the Health and Care Professions Council (HCPC).
McComiskie added that physiotherapists are dealing with “increasing complexity in patient presentation and their treatment must be individually tailored”. He said: “It is too early to know how much AI can ultimately benefit clinical decision-making and more research is needed… but not at the expense of patient access, safety, experience or confidence.”
Those behind the Flok app, co-founded by medic and former professional rower Finn Stevenson, say initial trial results show its effectiveness. As part of a three-month series of pilot studies between May and December 2023, more than 1,000 NHS workers suffering from back pain referred themselves to an AI physiotherapist for treatment.
All patients surveyed from the NHS pilot said their experience with Flok was at least equivalent to seeing a human physiotherapist, and 57% of patients said they thought the AI experience was better.
Stevenson said: “Our technology means that every patient receives a continuously individualized experience and care pathway based on their feedback, symptoms and progress. It’s like having a structured video call with a physiotherapist, but our side of the conversation is collected on servers.”
He added that it became “more difficult” for patients to access physiotherapy, “leaving them in pain and often unable to continue their daily routines”.
Participants from each of the organizations involved in the pilot – NHS Lothian, NHS Borders, Cambridge University hospitals and Royal Papworth Hospital NHS foundation trust – could self-refer to the AI service.
after newsletter promotion
An initial video assessment with an AI physiotherapist was performed to evaluate their symptoms. Once approved for treatment, patients had weekly video appointments. The digital physiotherapist prescribed exercises and pain management techniques, monitored symptoms and adjusted the patient’s treatment.
More than four in five participants reported that their symptoms had improved during treatment with the platform. Ninety-seven percent of patients who self-referred to Flok within NHS Lothian received an automated triage outcome; 92% were immediately approved for AI physio and accessed an appointment that same day; 5% were automatically referred to another NHS service, such as a GP.
Data from the University of Cambridge hospital trial indicated that the digital clinic had helped reduce waiting times for physiotherapy. Waiting lists for in-person musculoskeletal appointments increased by more than 50% after the pilot ended.
Flok is the first and only digital MSK provider to be approved by the CQC, according to the app’s founder. This means that, rather than being a technology provider licensing software to NHS trusts, Flok can treat and manage patients directly on behalf of their trusts. The CQC assesses regulated services on initial registration and then inspects at variable intervals to ensure all quality and governance requirements are met.
Flok is also the first technology to receive medical device approval under the MHRA regulations to fully automate the triage, assessment and treatment of back pain.
The system provides autonomous assessment and triage instead of diagnosis. Flok uses an automated process to determine whether a patient can access physiotherapy appointments directly or be referred to another service, such as NHS 111 or his or her GP. Flok has not received any reports of missed red flags during the trials, they said. Stevenson said: “The autonomous triage process is subject to rigorous, ongoing testing.”
The AI clinic will launch alongside the first NHS partners this summer, although no specific dates can be given.