NHS to launch physiotherapy clinic run by AI

Pilots at four NHS sites showed the new app performed as well as, or better than, a human physiotherapist

10th June 2024 about a 4 minute read
“Our technology means every patient gets a constantly individualised experience and care pathway based on their feedback, symptoms and progress. It’s like having a structured video call with a physiotherapist, but our side of the call is being assembled on servers.” Finn Stevenson, co-founder, Flok Health

The NHS’s first AI-run physiotherapy clinic is to launch later this year.

The new service will enable patients to access an appointment with a digital physiotherapist via an app, Flok Health, which responds to information provided by a patient in real time.

It is the first platform of its kind to be approved by the Care Quality Commission as a registered healthcare provider. This means that rather than being a technology supplier licensing software to NHS trusts, Flok Health can directly treat and manage patients on behalf of their trusts. The app is also the first technology to be granted medical device clearance under  the Medicines and Healthcare products Regulatory Agency (MHRA) regulations for fully automating the triage, assessment and treatment of back pain.

Patients who need physiotherapy for problems such as back pain can be referred to the app by their GP or other primary care provider. They can also self-refer directly into the service.

The aim of the service is to provide faster care and reduce waiting times.

More than half thought Flok was better than a human

The co-founder of the Flok app, Finn Stevenson, said that initial trial results demonstrate its effectiveness. During a series of three-month pilot studies at four NHS trusts between May and December 2023, more than 1,000 NHS staff suffering from back pain self-referred to an AI physiotherapist for treatment.

All of those who took part in the pilot said that their experience with Flok had been at least equivalent to seeing a human physiotherapist, while 57% said they thought the AI experience was better.

Stevenson said: “Our technology means every patient gets a constantly individualised experience and care pathway based on their feedback, symptoms and progress. It’s like having a structured video call with a physiotherapist, but our side of the call is being assembled on servers.”

He added that it was getting harder for patients to access physiotherapy, “leaving them in pain and often unable to continue their daily routines”.

The trusts that took part in the pilot were NHS Lothian, NHS Borders, Cambridge University hospitals, and Royal Papworth hospital NHS foundation trust.

During the pilot, each participant underwent an initial video assessment with an AI physiotherapist to evaluate their symptoms. Once approved for treatment, patients had weekly video appointments. The digital physiotherapist prescribed exercises and pain management techniques, monitored symptoms and adjusted patients’ treatments.

More than four in five participants reported that their symptoms had improved during treatment with the platform. Ninety-seven per cent of the patients who self-referred to Flok within NHS Lothian received an automated triage outcome; 92% were immediately approved for AI physio and given access to an appointment that same day; 5% were automatically referred to another NHS service such as a GP.

Data from the trial at Cambridge University hospitals indicated that the digital clinic had helped reduce waiting times for physiotherapy. Once the pilot ended, waiting lists for in-person musculoskeletal appointments increased by more than 50%.

The Chartered Society of Physiotherapy (CSP) expressed some scepticism, however, about the value of the new service. CSP’s health informatics lead, Euan McComiskie, told the Guardian: “There is no doubt that more needs to be done to tackle huge NHS waiting lists, particularly for musculoskeletal services and AI has huge potential to be an adjunct to the work of physiotherapists. However, AI cannot yet replicate the clinical judgment and skills of a physiotherapist, who is required to be registered with a statutory regulator, the Health and Care Professions Council (HCPC).”

McComiskie added: “It is early days to know how much AI can eventually provide clinical decision making and more research is needed … but not at the cost of patient access, safety, experience nor trust.”

FCC Insight

Musculoskeletal (MSK) problems – which include back, neck and knee pain – are common, and represent a significant burden on the economy, with more than 30m days lost to MSK conditions each year in the UK.

Meanwhile, the NHS is struggling with a backlog of people waiting for treatment. In March this year, 323,965 people were waiting for MSK treatment, a year-on-year rise of 33,257.

While it is important to train and recruit more physiotherapists, that takes time, and this is a problem that needs addressing urgently. The pilot of the Flok Health app delivered remarkably good results, with patients finding it at least as effective as a human physiotherapist. This suggests that the app could be a simple and cheap way of cutting waiting lists, without a loss in quality.

Whether the app performs as well with ordinary patients as it did in a pilot focused on NHS staff remains to be seen, however. We look forward to seeing the results once the app is up and running in the real world.