Structure of this report

This study was based on a randomised controlled trial (RCT) of PhysioDirect compared with usual care, incorporating an economic evaluation and nested qualitative research. The report begins with a summary of the background to the problem of access to physiotherapy and a review of research on new approaches to improving access to physiotherapy and the use of telephone-based services in other relevant contexts. The first chapter concludes with a description of the research objectives. The report then describes the methods and results from the RCT, followed by the methods and results from the economic analysis and then the methods and results from the qualitative research. Slightly unusually, the findings about the variables relating to the process of care are described before the results about the primary and secondary outcomes, because that makes it easier to interpret these outcomes. The final chapter summarises and synthesises the findings from all three components of the study, providing interpretation in the light of previous studies. It also discusses the strengths and limitations of the research and its generalisability to the NHS and to other health-care systems. The conclusions are followed by recommendations for future research.