Oluwatoyin Adeniji

Objectives To assess the readiness of primary and emergency care physiotherapy services for continuity of care for patients with musculoskeletal conditions during the coronavirus disease 2019 (COVID-19) pandemic in the United Kingdom and Australia and to identify differences between the 2 countries. Design An international online cross-sectional survey was conducted between January and April 2023. The survey used a 3-point- Likert scale of agreement, neutral, and disagreement to understand readiness. Data were analyzed descriptively. Chi-square was used to determine differences in the readiness between countries. Setting The study setting includes primary care in the United Kingdom and emergency departments in Australia. Participants Study participants are physiotherapists managing patients with musculoskeletal conditions in the primary care and emergency departments in the United Kingdom and Australia, respectively. Interventions The survey was used to understand physiotherapy services in primary and emergency care readiness for continuity of health care during the COVID-19 pandemic. Main Outcome Measures Items identified in Dearing's readiness tools for global health interventions were used to assess the readiness of primary and emergency care for COVID-19 pandemic. Results One hundred and fifty-three physiotherapists participated in the survey, with 64.1% from the United Kingdom and 35.9% from Australia. The main age groups were 35-44 years (42.2%) and 45-54 years (31.2%), with 59.3% female participants. In both the United Kingdom and Australia, respondents reported higher disagreement regarding the availability of technical support (60.7%; 66.7%), stakeholder buy-in of interventions introduced (63.6%; 90.5%), emergency response guidance (51.6%; 41.6%), infrastructure (42.2%, 39.0%), and human resources (37.9%, 39.0%). Conversely, there was more agreement with leadership (65.6%; 53.7%), clear mission and vision (55.2%; 41.0%), compatibility of interventions (48.5%; 32.4%), external partnerships (39.3%; 24.2%), finance (38.1%; 43.2%), supplies and procurement (35.5%; 48.7%), and learning (35.7%; 40.5%). There was no significant difference between countries in terms of readiness (P

Purpose: This study explores telehealth care responsiveness of UK primary care physiotherapy services for MSK patients. Methods: Between January and April 2023, a cross-sectional national survey of physiotherapists in UK primary care managing MSK patients was conducted to assess telehealth care responsiveness, using 10-item indicators adapted from the WHO responsiveness framework. The survey was designed using a 3-point Likert scale ranging from agreement to disagreement. Data were analysed with descriptive statistics. Results: Ninety-nine physiotherapists practicing in primary care participated in the study across the UK. 87.8% noted the adoption of telehealth care, while 75.8% of the telehealth care adoption occurred within the first three months following WHO’s declaration of COVID 19 as a pandemic (March -June 2020). In terms of telehealth responsiveness, there was strong agreement on respect (87.5%), and excellent communication with patients (81.3%). In addition, there was agreement on patient’s autonomy (65.6%) prompt attention – timeliness of care (59.4%), convenience of service (56.7%), and access to social support (51.7%). However, there was disagreement in prompt attention – waiting time for investigations (41.9%), and choice - telehealth care or in person care (34.4%). In addition, participants were neutral regarding patient’s confidentiality with telehealth care (82.4%). Conclusion(s): While primary care physiotherapy services for MSK patients demonstrated reasonable responsiveness with rapid adoption of telehealth care within the first three months of the pandemic, inadequate readiness may have impacted their responsiveness level. Addressing this issue may involve learning from both successes and failures to develop strategies that prepare and equip primary care physiotherapy services for more responsive telehealth care. Implications: This study highlights the importance of telehealth care planning, including both proactive and ongoing strategies for continuous improvement, to ensure healthcare services as an essential human right are delivered in a way that meets the expectations and needs of MSK patients, now, and in case of future crises.

Purpose: This study explores the barriers and facilitators to the rapid adaptation of first contact physiotherapy services for musculoskeletal patients during the COVID 19 pandemic in the UK and Australia. Methods: Physiotherapists in first contact roles, along with key stakeholders (including managers, doctors, nurses, and support staff) from primary care and emergency departments in the UK and Australia, respectively, were purposively selected for the study. One-time, individual online semi-structured interviews were conducted via MS Teams or Zoom between August 2023 and January 2024. A framework analysis was carried out, mapping the barriers and facilitators to the rapid adaptation of first contact physiotherapy services during the pandemic, using the Consolidated Framework for Implementation Research (CFIR) Results: A total of 22 physiotherapists and stakeholders participated in the study, with 10 from the UK and 12 from Australia. Participants reported service disruptions, including the shutdown of services (primarily in primary care), reduced operations, and fewer presentations of MSK patients in both primary care and emergency departments. Despite these challenges, first-contact physiotherapy services adapted rapidly within the first six months of the COVID 19 pandemic. Key adaptations included the increased use of telehealth, service restructuring, redeployments, and the use of personal protective equipment. Through the application of the CFIR, barriers and facilitators were identified across its domains. Additionally, five new factors emerged that had not been previously recognised by CFIR: uncertainties around the pandemic, contingencies, decision-making, duplication of effort, lack of job satisfaction, and the need for touch. These factors were grouped into three key themes: 1) changes in healthcare service delivery, 2) sustainability of change, and 3) readiness for change. Conclusion(s): This study demonstrates that while first-contact physiotherapy services for MSK conditions faced disruptions during the initial phase of the COVID 19 pandemic, they were able to adapt their services within six months of the pandemic's declaration. However, barriers related to preparedness may have delayed their immediate response and impacted the sustainability of these changes. Implications: As efforts continue to improve the rapid adaptation and continuity of healthcare services during public health emergencies, this study offers important insights into the factors influencing these processes in first contact physiotherapy services for MSK patients. These findings can inform policies aimed at enhancing the preparedness of healthcare services. The study also highlights the need for future implementers to focus on strengthening facilitators and addressing significant barriers to implementation.

Limited evidence exists on early COVID-19 related changes in First Contact Physiotherapy Services (FCPS) for musculoskeletal (MSK) patients within the UK primary care (PC) and Australian emergency departments (ED), knowledge that is crucial for understanding their level of responsiveness and readiness for future crises. This study explores the initial changes in FCPS during the COVID-19 pandemic in the UK and Australia. The UK and Australia represent a function of both country and their FCPS context (UK [PC], Australia [ED]). A cross-sectional survey was conducted from January-April 2023. Data were self-reported by physiotherapists in FCPS roles, managing MSK patients in the UK and Australia. Only responses from those who recalled changes in FCPS were included, with 153 participants analysed. Descriptive statistics and two-way ANOVA were used to examine the effects of timing of change, country, and their interaction on readiness and responsiveness to MSK patient needs. Overall, 75.7% of initial changes were perceived to have occurred within three months following the World Health Organisation's declaration of COVID-19 as a global pandemic. Participants from both countries differed significantly in their perceptions of how COVID-19 affected patient access to FCPS (p 

BackgroundThe COVID-19 pandemic significantly disrupted primary care and emergency departments globally, including the UK and Australia respectively, affecting services within these settings, such as first contact physiotherapy services (FCPS) for patients with musculoskeletal conditions. This disruption necessitated rapid adaptation to ensure continuity of care. Before this study, comprehensive adaptations across both primary care and emergency departments FCPS had not been documented. Additionally, the specific adaptation processes, strategies used, and experiences of both staff and patients during the COVID-19 pandemic were unclear. Variations in responses between the UK and Australia also remained unknown. Documenting these rapid adaptations and experiences is crucial for future preparedness, as it provides valuable insights to guide FCPS and similar services, preventing future disruptions and promoting continuity of care. Moreover, findings will contribute significant knowledge to the existing literature.AimThis study explores rapid adaptation of FCPS for patients with musculoskeletal conditions during the COVID-19 pandemic in the UK and Australia.MethodsThis is an ongoing three-phase sequential mixed-methods study. Phase 1 utilises a cross-sectional survey of physiotherapists in FCPS role in the UK and Australia to assess changes in healthcare delivery during the pandemic, as well as levels of readiness and responsiveness, highlighting similarities and differences. Phase 2 employs a case-study approach, including semi-structured interviews and a review of documents produced to direct the management and implementation of proposed changes in FCPS, to further understand the findings from Phase 1. In phase 3, mixed-methods integration facilitates the development of context specific recommendations for the rapid adaptation of FCPS and similar contexts. These recommendations will be presented to experts for feedback and further refinement.DiscussionThe mixed-methods research will provide contextually rich account of FCPS rapid adaptation, providing key learnings that could be applied to implement evidence-informed rapid adaptation in FCPS during public health emergencies.

This presentation highlights physiotherapy responses in UK primary care and Australian emergency departments during the COVID-19 pandemic, delivered at the International Society of Physical and Rehabilitation Medicine on June 3, 2024 in Sydney, Australia

First Contact Physiotherapy Services (FCPS) provides initial assessment and management, and onward referral for patients with musculoskeletal conditions. FCPS like other healthcare services adapted during the COVID-19 pandemic. We currently do not understand how these services changed, what have changed and the impact of the change on those that deliver care and patients. This data provides an insight into the ways FCPS for musculoskeletal conditions was provided during COVID-19 pandemic, understand how decisions were made quickly, and identify the impact of the sudden change on practice and patients. [Contact o.adeniji@surrey.ac.uk to request if possible to access dataset]

Rapid adaptation of healthcare services during public health emergencies is key in ensuring continuous delivery of essential healthcare services. However, challenges associated with rapid adaptation can lead to disruptions in care delivery, impacting responses to population healthcare needs. To prepare for a prompt future response, it is important to identify and understand the barriers and facilitators influencing rapid adaptation efforts. A systematic integrative review was conducted between March and October 2022, with five healthcare-related databases searched from 2012. Weekly auto-alerts continued until March 2023. The Mixed-Methods Appraisal Tool was used for quality assessment and data extraction conducted using the Consolidated Framework for Implementation Research. Seventeen eligible studies utilised quantitative (10/17, 59%), mixed-methods (4/17, 23%) or qualitative designs (3/17, 18%). Most rapid adaptation in healthcare service delivery happened within 3 months after the World Health Organisation declared Coronavirus disease a pandemic (13/17, 76%), with telehealth being the key rapid adaptation that occurred. Inner setting and process factors served as both barriers and facilitators. Two additional factors not present in the consolidated framework, namely: (1) emergency command and control at the healthcare level and (2) acceptability and resilience, were identified as facilitators to rapid adaptation. This systematic integrative review underscores that while healthcare services rapidly adapted within the initial 3 months of the pandemic, inadequate readiness may have hindered their capacity to respond inclusively, potentially impacting on the sustainability of adapted services. Addressing these issues will support greater preparation for public health emergencies.

Primary healthcare is provided in most developing and developed countries to enhance healthcare accessibility for the population. This study accesses the impact of primary healthcare in six Sub-Saharan countries. A systematic search for qualitative and quantitative studies published before the end of 2017 was conducted online. Inclusion criteria were met by 6 studies, one each from Ghana, Malawi, Nigeria, Tanzania, Zambia and Zimbabwe. Five studies are peer-reviewed, and one is a working paper. Three studies reported on the impact of primary healthcare on healthcare accessibility. Four studies reported on the role healthcare resources play in enhancing primary healthcare services. Two other studies mentioned how cost-sharing mechanism led to an increase in healthcare utilization and how the reduction in user changes in all primary healthcare centers led to the reduction in out-of-pocket spending on healthcare services in a short-term. Primary healthcare offers access and utilization to healthcare services in most countries. It also offers protection against the detrimental effects of user fees. However, concerted efforts are still needed in most African countries in revitalizing the operations of primary healthcare centers for the improvement of healthcare services.

COVID-19 has become one of the most significant global health crises in history, with a wide range of socio-economic consequences due to the measures taken to stop the spread of the virus. The socio-economic implications of the quarantine caused by COVID-19 have affected all continents. The purpose of the article is to analyze the socio-economic consequences of the quarantine due to the COVID-19 pandemic in Ghana, Kenya and the Republic of South Africa, as well as to examine the critical social protection policy measures taken by the governments of these countries to reduce the vulnerability associated with pandemic prevention measures. This study used content analysis, which allows for the identification of recurring themes, ideas and terminology in the studied database. Directive documents on social protection programs during the pandemic, scientific publications, and reports of international institutions and organizations served as the source of primary information. Based on the content analysis results, 40 documents were selected that met the inclusion criteria: 14 works from Ghana, 13 from Kenya, and 14 from the Republic of South Africa. To investigate the effects of the lockdown caused by COVID-19, content analysis was chosen to identify recurring themes, ideas and terminology in qualitative data collection. A systematic review shows that lockdown measures implemented by the governments of Ghana, Kenya and the Republic of South Africa to mitigate the spread of COVID-19 have led to increased poverty and inequality, lost incomes, worsening food insecurity and increased unemployment. Content analysis found that the impact of COVID-19 differs significantly for men and women, with women experiencing more excellent destructive effects compared to men. The COVID-19 pandemic has harmed rural residents, with poverty rates rising at higher rates and their well-being declining compared to local residents. To respond to the socio-economic consequences of the quarantine due to COVID-19, the countries studied continued existing or introduced new social protection programs to support their citizens. These include cash transfers, food transfers, utility subsidies and fee waivers, community service programs, tax credits, and unemployment benefits. These welfare programs had different parameters consisting of benefits, rights and beneficiaries. Although this study cannot determine the impact of social programs, future studies will be able to assess their impact and effectiveness on beneficiaries.