Oh my gosh, I've been meaning to write a blog on Pelvic Health Red Flags + Helping Your Client Obtain a Clinical Referral for so long, it's untrue so finally and with huge thanks to Michelle Lyons for her generosity in providing us with a definitive guide to Pelvic Health Red Flag, how to direct your client to get a referral and what she should expect from an appointment with a specialist for Pelvic Health issues such as incontinence and Pelvic Organ Prolapse. Obviously this is UK biased as this is where we both live but still there's huge information for both professionals and the laywoman alike in the video.
The 'GP Referral' Route
The Self-Referral Route
This report documents the findings from seven pilot sites which were asked to gather a wide range of data and it was produced by the Chartered Society of Physiotherapists in April 2013....I've just pulled out a few key quotes from the report below.....
Key Points of the Report
"Patient self-referral is a system of access that allows patients to refer themselves directly to a physiotherapist without having to see anyone else first or without being prompted to refer themselves by a health professional. This can relate to telephone, IT or face-to-face services."
"Patient self-referral is not a fast track access to services; it is simply an additional way of accessing NHS physiotherapy services, which some patients may prefer. There is no change to either the delivery of physiotherapy or the waiting time for assessment/treatment."
"The case for patient self-referral for women with urinary problems Urinary incontinence (UI) is the complaint of involuntary loss of urine. UI is distressing and socially disruptive and may be the cause of personal health and hygiene problems. (7) It may restrict employment and educational or leisure opportunities and lead to embarrassment and exclusion. The size of the problem Incontinence is highly prevalent in the general population but under-diagnosed and under-treated. It has been estimated that UI affects 20.4 per cent of people aged 40 years and over, equivalent to five million people in the UK, although not all may need or want help. In women this figure increases to 35.6 per cent at age 80 and over."
"Urinary incontinence is the second most common reason for admission of an individual to a nursing home. The financial cost affecting people of all ages, the condition is largely treatable or preventable; however, in some cases poor continence care can lead to unnecessary catheterisation, associated urinary tract infections, and pressure ulcers which alone caused 51,000 hospital admissions in 2008-09 and are estimated to cost the NHS £1.4 - £2.1 billion each year."
"In comparison, continence services cost the NHS £112 million in 2009/10 – a relatively small amount. The cost to the individual due to the highly sensitive nature of this health care issue, women may take up to 10 years before seeking help. They may be too embarrassed to seek advice and may not wish to bother their general practitioner (GP). Many believe UI to be a normal consequence of the ageing process or may not appreciate that effective treatments are available. A review, which aimed to summarise help-seeking behaviours for UI symptoms among non-institutionalised women of all ages with all types of UI, found that less than 38 per cent of women sought help for their UI symptoms. Factors affecting help-seeking included perceptions women had regarding the normalcy of UI and beliefs about treatment options available for the problem. Embarrassment was also found to be significantly related to help-seeking in most, but not all, of the reviewed studies. Physiotherapy is a clinically effective treatment".
"The National Institute for Health and Care Excellence (NICE) clinical guideline for the management of urinary incontinence in women recommends conservative treatment (pelvic floor muscle training and/or bladder retraining) as first-line treatment for women with stress, urge or mixed urinary incontinence. Pelvic floor muscle training (PFMT) is also recognised as a preventive strategy within this guideline. In addition, NICE recognises that women are at risk of pelvic floor dysfunction during/following pregnancy, in that it advises that all pregnant women should be given specific information on pelvic floor muscle exercises at the booking appointment (ideally by 10 weeks gestation). As well as symptoms of urinary incontinence, another problem related to pelvic floor dysfunction is pelvic organ prolapse (POP). A recent multi-centre randomised controlled trial of PFMT for women with pelvic organ prolapse has demonstrated that the intervention is effective in reducing prolapse symptoms and recommends PFMT as first-line management of this problem."
The 'Going Private' Route
Lastly, going the 'Private Route'. Women's Health Physiotherapists also work privately and outside of the NHS, so provided you are willing to pay for your treatment yourself or via Private Insurance in many cases, you can truly paddle your own canoe. I think it's important to check whether their speciality matches your particular issue as just like any professional group, CPD varies and individuals will have their niche specialities. Doing your homework is important and also the recommendation of great professionals by others who've experienced successful interventions is important too.
Maria Elliott, one of the leading Women's Health Physiotherapist in the UK with a (practise in Harley Street) has trained a crack team of Specialist Post Natal Physiotherapists all dedicated to Women's Health Issues but especially in the Post Natal period. Her programme is called 'The Mummy MOT' and these specialist Physiotherapists can be located via The Mummy MOT website. They operate widely both in the UK and Ireland.....
I hope that's all been helpful to you as the professional and in turn the women that you serve....ultimately, let's support these ladies to become the ULTIMATE ADVOCATES for their own health and never quit asking questions until they are truly happy with the answers they receive. I learnt this the tough way so hopefully you and your clients don't have to!
Are you ready to take your Pregnancy and Post Natal Exercise PRACTISE to the NEXT LEVEL?? They're BACK + Better Than Ever!
Go HERE for Modern Pregnancy Exercise AND HERE for Modern Post Natal Exercise - 1 Day LIVE CPD's