PhysioUpdate 13th July 2021

Physiotherapist missed chance to diagnose baby's hip dysplasia at early stage despite 'red flags'

The Scottish Public Services Ombudsman (SPSO) has ruled that a physiotherapist took an ‘unreasonable’ decision by not requesting an ultrasound scan of a baby’s hips – despite the presence of a number of ‘red flags’ that should have prompted action.

The SPSO reached its verdict – which concerned a physiotherapist employed by NHS Lothian – after taking independent advice from a specialist physiotherapist in the paediatric field.



A baby boy has an ultrasound test for possible hip dysplasia (stock image)

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More research on the effectiveness of common orthopaedic interventions is vital, researchers say

The public’s trust in a number of common orthopaedic interventions would be reinforced if more resources were poured into improving the evidence base.

That is one of the key messages contained in paper – titled Common elective orthopaedic procedures and their clinical effectiveness: umbrella review of level 1 evidence – which appears in The BMJ today (8 July).

Anatomical Illustration showing damaged knee joint and magnified meniscus tear

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Physiotherapist Claire Yerramasu hails benefits of 'Dynamic Scot' project for patients with COPD
Patients with COPD are logging on to tablets and other devices on a daily basis (stock photo)

Advanced practitioner Claire Yerramasu is the lead clinician for NHS Lothian's Midlothian community respiratory team (MCRT). The physiotherapist's team is taking part in a trial to help patients with chronic obstructive pulmonary disease (COPD) manage their conditions.

The pilot scheme, being run in collaboration with Health Innovation South East Scotland, is known as the Dynamic Scot project (remote physiological monitoring). It enables patients to monitor their condition at home, using a digital service that can be accessed via a smartphone, tablet or computer.

Patients are prompted to log on to the project daily and answer questions about their symptoms and how they feel. The initiative – one of a number of digitally-based developments being introduced locally in response the Covid-19 pandemic – encourages patients to self-manage their symptoms with options to seek advice through the messaging service. Any signs of deterioration can be flagged up at an early stage and the data can help to predict if they are at risk of hospitalisation.

So far, I have received nothing but positive feedback from the patients currently trialling this new technology [Claire Yerramasu, physiotherapist]More than 100,000 people in Scotland have COPD 

Ms Yerramasu, who features in an article on NHS Lothian’s website about the initiative, said: ‘So far, I have received nothing but positive feedback from the patients currently trialling this new technology.’

The physiotherapist said innovation in COPD treatment was vital as the condition is the third most common cause of mortality globally and its prevalence is on the rise in the UK and beyond. About 120,000 people in Scotland have COPD and it causes many emergency hospital

Service user Carmel Thompson said: ‘Using the online tool makes me think about the variability of my daily symptoms and how I am managing them and because of this I am more confident to wait longer to see if my symptoms resolve before using my rescue medications.

‘The service gives a good level of basic information for those who are willing to engage with it and the daily questions are very easy for me to do routinely in the morning.’

Scheme could be expanded in the future

Gourab Choudhury, a consultant physician in respiratory medicine, said: ‘We are delighted to be trialling this technology here in Lothian. It is simple to use and patient friendly and the feedback that we have had so far has been really positive.'

Dr Choudhury added: ‘We hope to further expand the role of virtual platforms to other areas in Lothian through this technology and similar others in the coming months.’

To see the original article, visit:


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