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Patients with musculoskeletal (MSK) issues are typically referred to physiotherapists by GPs.  This takes up valuable GPs’ time, delays MSK patients getting the attention they need and risks the health of other patients waiting to see GPs.

This process is costing the NHS well over £1bn per year.  From 2024 the NHS is planning that all practices offer directly accessible physio appointments.  This is great in theory but there seems to be no practical way to gate and prioritise these First Contact Practitioner (FCP) appointments.  Until now.

Here, we describe how Rapid Health not only solves this problem but can liberate even more time for GPs.  Smart Practice is a suite of products that provide patients with self-service.  That is, patients can manage their own health navigation, appointment booking, referral and self-help without needing practice staff intervention.  At the same time, the practice controls their patients’ access parameters, so practice capacity can be protected.  

Rolled out across the UK, the potential for Smart Practice to improve NHS performance is huge.


The NHS has explained that 30 million working days are lost due to musculoskeletal (MSK) conditions every year in the UK.  Moreover, according to NHS England MSK conditions account for around 30% of all GP appointments.  The NHS plans that by 2024, all adults in England will to be able to see a MSK first contact practitioner (FCP) at their local GP practice without being referred by a GP.  But how will this be effectively managed?

Currently GP appointments cost £40 each.  With more than a million GP appointments per day the cost of those MSK GP appointments is over £12m per day, well over two and half billion pounds per year!  

Having a smart system to assess those patients and refer the bulk of them directly to the appropriate FCP would liberate huge resources for the NHS and undoubtedly improve the health of other patients waiting to see their GP.

How Rapid Health Solves the Problem

Smart Practice products all take the pressure off practice staff by giving patients the power of self-service, all under the control of the practice.  The products use an online eligibility and symptom assessment to gauge a patient’s clinical priority.  Then, based upon practice rules, navigates them to self-book the right appointment.  

In this case, the system assesses request details that would be best addressed by a physiotherapist.  The physiotherapy pathway is only one of many pathways that Smart Practice products can handle.  Requests could equally be directed to a pharmacist, practitioner nurse or a specialist GP.  The care navigation is entirely dependent upon the patients’ inputs.

Unlike other online tools, this system can be set-up to automatically prioritise a patient’s request.  The system then allows the patient to book with the right clinician at a time and date that suits them.  Practice teams can clinically supervise the system to ensure they have ultimate confidence in its safe adoption.  Straightforward integration with Electronic Patient Records (EPR) avoids manually copying information between systems.

Smart Practice products help by:

  • Freeing up clinicians’ time to increase practice capacity by permitting and encouraging patients to self-serve
  • Maximising use of multi-disciplinary teams
  • Providing clinicians and care navigators a prioritised patient list
  • Automating clinical triage notes
  • Reducing the number of manual touchpoints
  • Combined these benefits boost the health of the practice network business alongside outcomes for both MSK and other patients
  • Removing the bottlenecks to utilising network capacity


North West Surrey Integrated Care Services (NICS) looks after 350,000 patients over 36 sites.  NICS uses an FCP pathway within Smart Direct Booking (one of the Smart Practice products).  NICS needed neither product training nor any change management programme to adopt the system.

Patients access the system from the practice website and enter their details, so that the system can confirm their identity.  Once recognised, they are presented with a structured online assessment to check whether they’re suitable for an FCP appointment.  If this is determined to be the case, the patient can either request self-help, or get self-help plus book themselves into either a face-to-face or online appointment.  Appointments are booked into a cross-organisational appointment slot, as part of enhanced access services.  

This removes all manual touchpoints, releasing practice staff to attend to other tasks.  

Within the NICS internal communication on system adoption, they asserted, “The new services [Smart Direct Booking] improves patient experience by putting them in control, making it easy to book and manage appointments.  It also helps to co-ordinate care across different settings by navigating patients to the right service and healthcare professional, first time.”

NICS describes the benefits as, “… getting people to the right healthcare professional first time and improving their overall experience of using healthcare services.  Instead of having to call the GP practice, patients will be in control of managing their appointments.  This reduces the frustration of having to wait to get through to busy practice teams and frees up their time to focus on other patients.  The platform also directs people to the latest self-care guidance to help people manage their condition(s).”


The NHS has highlighted that three in ten GP appointments are for MSK issues.  The bulk of these are referred onto a physiotherapist.  Even if only half of these GP appointments could be saved this represents a significant saving to the NHS, reduced load for GPs and faster service for patients.

Rapid Health has a suite of products that can deliver to this need.  Using an intelligent digital front door, patients are directed to the right clinician, first time, thus avoiding the need for a GP referral to a physio.


  1. Physiotherapy -Accessing physiotherapy - NHS (
  2. NHS England » First contact physiotherapists
  3. NHS England » Musculoskeletal health
  4. NHS England » An improvement framework to reduce community musculoskeletal waitswhile delivering best outcomes and experience
  5. NHS England » Missed GP appointments costing NHS millions
  6. Key facts and figures about the NHS | The King's Fund (
  7. Key facts and figures about the NHS | The King's Fund (

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