Table 2 Summary of key themes, descriptions and illustrative quotes describing the acceptability of the PhysioDirect service

Physiotherapy is a physical intervention

The belief that physiotherapy is “hands on” and therefore could not be accomplished over the telephone.

“Well, you wouldn’t call it physiotherapy would you, not over the phone. You can’t do physiotherapy over the phone, can you?”

Steve, age 40, PhysioDirect arm: telephone care only

PhysioDirect can deliver physiotherapy

Initial scepticism of the PhysioDirect a belief that the service can provide physiotherapy.

“I think, on second thoughts, you know, after I’d done it that wasn’t really so necessary, that whoever you were talking to would be expert enough to understand how the pain affected you and whereabouts and as you described it. This is a condition they must meet with over and over again I would have thought. That was just an initial response. I think on reflection it’s quite good actually.”

Giro, age 80, PhysioDirect arm: telephone care only

No expectations

Patients had no expectations of the PhysioDirect service.

“No, I didn’t. I had no expectations whatsoever. I didn’t know what it would be like.”

James, age 63, PhysioDirect arm: telephone care only

Direct access

Patients got through to the service without any difficulty.

“I got through alright, there was no problem getting through.”

Walter, age 79, PhysioDirect arm: telephone care only

“I must have picked a convenient time because she just answered the phone.”

Lynn, age 69, PhysioDirect arm: telephone care only

Call-back service

Patients rang the service and were offered a call-back at a time that was acceptable to them.

“I phoned this number, she took my details, telephone number and said I will get the person to phone you back and that happened within the hour.”

Somerton, age 51, PhysioDirect arm: telephone care only

“Yeah, I got through without problems. She was busy at the time and, just asked could I, would it be alright if they phoned back later in the afternoon.”

Peter, age 74, PhysioDirect arm: telephone care only

Difficulty in access

Problems arose when the PhysioDirect service was busy and patients were unable to get through.

“It took quite a bit to get through. That was a bit annoying. It took several calls to get through.”

Lucy, age 53, PhysioDirect arm: telephone care and face-to-face contact.

“There was a little bit of a problem, to get through.”

Wendy, age 58, PhysioDirect arm: telephone care only

No access

Explanations as to why patients did not contact the PhysioDirect service.

“It was, yeah, it was basically because I was going on holiday that, they were going to do it on the phone but I was going on holiday on the Friday or the Saturday and it was getting worse, my back and I thought I’ve got to do something, I’ve got to drive down to PLACE, you know and that’s why I went private.”

Brian, age 48, PhysioDirect arm: did not contact the service

“The only reason I didn't phone was because, you know, the injury was gone and I just didn't feel like I needed to, sort of, take that step forward.”

Harry, age 23, PhysioDirect arm: did not contact the service

“I haven’t been able to get in touch because it doesn’t fit into the criteria of a person who is working.”

Pauline, age 43, PhysioDirect arm: did not contact the service

“Because I think that arthritis can probably be treated in a better way. I do exercise quite a lot, I do walk and do that sort of thing. I don’t think physiotherapy would be getting to the root problem.”

Hannah, age 65, PhysioDirect arm: did not contact the service

“It comes to a time when you think bugger it, I can’t be bothered, you know. It’s just too much, for me, it’s just too difficult to try and get out of here, get to the doctors to try and find out, get an appointment with them, come back.”

Aarron, age 42, PhysioDirect arm: did not contact the service

Quick and convenient service

The PhysioDirect service was perceived as quick, efficient and reduced the time to speak to a professional about their problem.

“Well, the thing I liked about it really, it didn’t take long for them to get in touch with me.”

Mary, age 76, PhysioDirect arm: telephone care only

“The immediacy of it was good.”

Helen, age 59, PhysioDirect arm: telephone care only

“It was quick. That was the, um, it seemed to plug the gap of having to wait for an appointment.”

Peter, age 74, PhysioDirect arm: telephone care only

The helpful physiotherapist

The PhysioDirect physiotherapists were perceived as being a positive, helpful, polite, pleasant and knowledgeable.

“I found her very clear, thorough and very pleasant. She was very pleasant. She really was good.”

Wendy, age 58, PhysioDirect arm: telephone care only

“Very helpful, very nice. Yes. Very helpful.”

Lynn, age 69, PhysioDirect arm: telephone care only

“She was very good. She asked me a lot of questions to enable her to be able to get a good diagnosis over the phone.”

Peter, age 74, PhysioDirect arm: telephone care only

PhysioDirect was effective at providing self-management advice

The PhysioDirect service provided advice and information enabling participants to self-manage their musculoskeletal condition.

“It’s a good thing because obviously, not everybody knows the best way in order to aid their injury. When I hurt my ankle and they sent out the information to me after the initial over the phone consultation with the PhysioDirect, they sent me out a book of all the different exercises in order to aid my ankle.”

Robert, 30, PhysioDirect arm: telephone care only

PhysioDirect was an ‘impersonal’ service

The PhysioDirect service was perceived as an impersonal service.

“Because it’s a face-to-face, personal thing. You know that there’s somebody sitting there waiting for you turn up and you don’t or you’re cancelling your appointment that somebody’s gone to the trouble to make for you, whereas a phone call’s just a phone call and it can be anytime and anywhere, so, it’s less personal.”

Hannah, age 65, PhysioDirect arm: telephone care only

“Well, you know, somebody out of the ether is talking to you, not like you laughing like that or something like that, it is simply not personal enough. It’s simply not personal enough. And, I know they’ve got a lot of work to do but that doesn’t make me feel any better.”

William, age 81, PhysioDirect arm: telephone care only

“I just mean somebody who, you know, I just feel that this PhysioDirect, you are just a number on a piece of paper, but, like I say, if you rang me back in a month’s time and actually had a conversation with me, I would feel that that was more personal.”

Faith, age 52, PhysioDirect arm: telephone care only

Communication difficulties

The PhysioDirect service impaired effective communication between the participant and the physiotherapist.

“Yeah, I found it a bit, quite difficult, because it’s hard to explain isn’t it, even, not just on the phone but to anybody. I mean, the pain I was in was really, really bad, so, um, I would have preferred to have saw somebody, you know, because when you try and explain the areas or, you know, where the pain was, which it goes all the way down, down to there, it’s a bit hard to describe on the phone, so, that’s when I would have liked to have seen somebody.”

Jenny, age 36, PhysioDirect arm: telephone care only

Trade-offs

Participants made trade-offs between the accepted and less accepted features of the service.

“Not having somebody there seeing how far you can bend it or move it in a certain direction just takes a little bit of the personal side out of it. But, you know, on the flip side, it takes a lot of the time waiting to be able to see a physiotherapist.”

Robert, age 30, PhysioDirect arm: telephone care only

“I mean, you have to make the journey, you have to go, you have to sit there, you very rarely get in at the time of your appointment, you usually wait half an hour, more, um, then you go in and you're in strange surroundings whereas on the telephone, you're in your own home, it's immediate, you have no waiting time.”

Lynn, age 69, PhysioDirect arm: telephone care only