ABSTRACT
BackgroundFrom July to November 2020, Nottingham City Hospital trialled a respiratory physiotherapy weekend late shift (RWLS) service in response to the COVID-19 Pandemic, running on Saturday and Sunday from 16:00 to 21:00. It aimed to decrease emergency call-outs, improve patient flow and improve timeliness of assessment and treatment. Literature relating to the efficacy of emergency and weekend physiotherapy services in the UK is limited due to inter-service variation. Local factors serve as barriers and facilitators to the provision of these services, justifying the need to evaluate services individually.AimsTo determine the viability and staff acceptability of the RWLS. Viability was defined as the success of the RWLS in meeting its three main aims, staff acceptance was defined as its perceived success.MethodMixed-methods design. Quantitative data was collected prospectively using a bespoke data collection form completed by staff at the end of their shift. Data included;number of patients seen, area of speciality, emergency calls attended and number of discharges per shift. An online semi-structured focus group with staff who worked the RWLS explored staff perceptions of the success and future acceptability of the RWLS, in depth.ResultsThe RWLS successfully reduced emergency call-outs by a mean of 1.06 call-outs per shift. Patient flow, measured by the number of interventions facilitating discharge was not directly improved, although staff felt discharge planning was initiated sooner. Staff felt the RWLS improved timeliness of assessment and treatment, but reported inefficiencies related to handover. The RWLS was well accepted by staff due to the shift’s perceived benefits to patients, COVID-19 socialisation restrictions and overtime pay. Junior staff felt working the RWLS aided transition to emergency on-call work. Concerns included maintaining staff commitment and lone-working.Conclusion and RecommendationsThe RWLS appears viable, two of three main aims were met. Further investigations into patient benefit and flow, cost and handover efficiency would potentially improve the justification for implementing the service long-term. Staff accepted continuing the RWLS following the trial period. Maintenance of the service may require opt-in rostering, and promotion of the benefits to staff in light of the potential easing of COVID-19 restrictions.