Defining priority access in community physiotherapy services

Priority 1

Clients presenting for management of recent (less than 1 week):

• Severe and acute Pain; radicular pain with or without neurological symptoms; wry neck; acute LBP; musculoskeletal injury
• Significant and rapid decline in mobility/functional status (i.e. off work, significant reduction in ADL or equipment failure) where there is a risk of hospital admission, emergency department presentation and/or risk to safety of the client/carers.

High falls risk - fall or multiple falls within the past week or falls risk related to acute dizziness/sudden change in functional status affecting; mobility and transfers, ADLs or related to equipment/environment and/or recent cognitive decline.

Acute infective exacerbation of airways disease with either increased SOB and/or sputum retention at risk of emergency department presentation or hospital admission.

Priority 2

Clients presenting with acute (1 to 4 weeks) presentations unlikely to deteriorate without physiotherapy intervention prior to 10 days:

• Musculoskeletal injuries, acute spinal pain and vestibular conditions
• Clients with an increased risk of developing persistent pain, i.e. yellow flag indicators on referral
• Acute exacerbation of a respiratory condition

Hospital discharges following surgical procedure (joint replacement, tendon repairs) as per clinical pathway/referral request.

Post removal of plaster/brace or surgical review as directed by clinical pathway/referral request e.g. neurosurgical and orthopaedic surgery.

Medium Falls risk related to a fall or multiple falls within the past 6 months or fall risk related to ongoing dizziness and gradual decline in mobility and functional status.

Patients transferred from other services at risk of decline if not seen within 10 business days.

Priority 3

Acute / Subacute / Chronic conditions unlikely to deteriorate without physiotherapy intervention prior to 30 days and present for:

• less than 4 weeks with previous intervention and unlikely to deteriorate without intervention sooner

Hospital discharges following surgical procedure or conservative management (neurosurgery, orthopaedic surgery) with referral request to review within 4 to 6 weeks and no increased risk of developing persistent pain i.e. yellow flag indicators on referral.

• greater than 4 weeks with no previous intervention and unlikely to deteriorate without intervention sooner:

Spinal or musculoskeletal condition referred from GP or RHH specialist screening clinics with no previous intervention and/or for clinic review within 6 months.

Low Falls risk related to a fall or multiple falls within 6 to 12 months with early signs of functional /physical decline.

Patients transferred from other services having received Physio intervention and with capacity to self-manage/ maintain.

Priority 4

Chronic (present for greater than 12 weeks) conditions with previous Physiotherapy intervention and unlikely to deteriorate without intervention sooner.

Spinal or musculoskeletal condition referred from GP or RHH specialist screening clinics with; previous Physio intervention, discharged from clinic and with no plan for surgery/ specialist intervention.

Review of home exercise programme.

Assessment for hydrotherapy for chronic conditions.

Physiotherapy functional review for longstanding and / or lifelong conditions.

If the patient has access to other funding through: DVA, MAIB, Workers compensation, private health insurance, or Medicare funded “chronic disease management” programmes but chooses to access public physiotherapy services.