A service evaluation of a newly implemented Advanced Physiotherapy Practitioner led shoulder instability service.

The National Health Service (NHS) faces restricted capacity for first reviews of orthopaedic patients. Advanced Physiotherapy Practitioners (APP) offer an effective alternative to doctor consultations, potentially increasing capacity and promoting efficient use of resources. A new APP-led service for shoulder instability was established on this basis, aiming to promote adherence to recommended care pathways, and increase patient satisfaction.  This service evaluation assesses the APP service. Methods included comparing data from the same 6-month period in consecutive years. Wait times from A&E to the first appointment and adherence to care pathways were measured. Process mapping was conducted. Patient satisfaction was measured and thematically analysed qualitatively. Results demonstrated reduction in wait times by 6 days in the APP led service, with 100% patient satisfaction. Adherence to the care pathway improved; all patients under the age of 25 received appointments within 6 weeks, and early imaging referrals increased by 40%.  In conclusion, the APP-led service decreased wait time and enhanced adherence to care recommendations, with high patient satisfaction. This supports the use of physiotherapists in delivering care in this cohort of patients. Future service improvements could focus on raising awareness of referral processes to maximise service use.