Trust seeks feedback on physiotherapy proposal

Patients, carers, local residents and other stakeholders are being asked for their views on the proposal to close the hydrotherapy pool at Charing Cross Hospital and replace the service it provides with land-based therapies.

The proposal has been developed following a safety and effectiveness review prompted by the increased challenge of maintaining and running the pool, combined with evidence that land-based therapies produce very similar benefits to aquatic therapies. 

By closing the pool, therapy staff will have more time to see a potential 370 extra new patients per year with an additional 2,500 appointment slots created across the service, helping to reduce waiting times. Use of the hydrotherapy pool space will also allow expansion for other clinical services. 

Evidence of the clinical effectiveness of hydrotherapy is inconclusive and similar outcomes for patients can be found when compared to land-based therapy treatments. The land-based therapies which would be used to provide alternative, safe and effective care for hydrotherapy patients include:
postural and ergonomic advice and back care education
gait re-education to improve mobility
manual therapy to mobilise the joints and soft tissue
joint management
strength training regimes
teaching specific exercises to improve strength or flexibility
functional task practice
respiratory and cardiovascular exercise regimes
self-management strategies and healthy lifestyle choices

Hydrotherapy pools are required to operate to particular standards to ensure they are safe and effective.  After many years of operation, the hydrotherapy pool is now in poor condition, making it very difficult to meet modern health and safety standards. This has led to repeated unplanned closures of the pool, often at short notice and for prolonged periods, affecting patients’ quality of care and causing inconvenience to all users. 

Hospital-initiated rescheduling of hydrotherapy appointments has increased from 7 per cent of all appointments in 2016/17 to 18 per cent so far in 2018/19. There continues to be a high risk of unplanned, repeated and indefinite closures of the pool on health and safety grounds. The service currently runs at a loss even when the pool is fully functional, and the level of on-going investment needed to bring the pool up to the required standard is very significant.

Charlotte Allanby, Head of Adult Occupational Therapy and Physiotherapy, said: 

“Our first priority is the safe and effective care of our patients and currently we are not able to provide the level of high quality patient experience that we wish to.

“Switching to all land-based therapies will enable us to improve patient experience and reduce waiting times for all physiotherapy outpatients, without impacting on clinical outcomes. “

The key benefits to be gained from the proposal are to:
increase physiotherapy outpatient capacity and reduce waiting times
prevent poor service to both NHS and private users of the pool through repeated, unplanned and indefinite closures
re-allocate the existing space occupied by the pool for alternative clinical space
re-allocate estates resource from pool repairs to other important areas of hospital maintenance
avoid recurring financial operating loss

Two private companies also hire the pool in a private capacity each week to teach babies/toddlers to swim; and to provide private aquatic/hydrotherapy for adults. The Trust would look to signpost these private users to alternative facilities.

The Trust is working with local Clinical Commissioning Groups, the local council, patient and service user groups and other stakeholders to get a full range of feedback. Please submit any comments and questions to the Trust via email to: imperial.therapieshydrotherapy@nhs.net

Subject to the feedback the Trust receives on its proposal, the timeframe would be for a decision to be made in April 2019.