A hip and knee orthopaedic specialist triage service evaluation: comparing physiotherapists and chiropractors in an NHS pathway

Background: The burden of musculoskeletal pain and disability is a global problem; reducing waiting times and improving access to care is part of the solution. The need to widen the workforce to improve access is well documented. A possible solution could be chiropractors and allied health professionals working together in a multidisciplinary environment where workforce demands are high. Aims: This service evaluation sought to assess the outcomes of two groups of healthcare professionals in managing a hip and knee orthopaedic interface caseload. The two groups were physiotherapists and chiropractors. Methods: The two groups of healthcare professionals completed an internal competency programme based on national standards. They were evaluated based on outcomes from an interface service as part of a commissioned NHS pathway in a university setting for hip and knee complaints. A total of 810 contacts were achieved over a 7-month period in 2023. Findings: The two groups were comparable in the rate of imaging ordered (MRI, ultrasound and X-ray); while chiropractors ordered less Magnetic resonance imaging (MRI) and offered more self-management advice, the overall results were similar. NHS friends and family tests were also comparable and positive. Conclusions: Physiotherapists working with chiropractors produce similar outcomes within a musculoskeletal lower limb triage service.