Third session, third physio
A patient is assessed by one of your physios, who starts a plan. For the second session, the patient books online and picks the earliest slot, which is with a colleague. For the third, reception book whoever has a gap on Thursday evening. Each physio reads the notes, asks the patient to explain again, and adjusts the plan slightly.
The patient starts to wonder whether anyone has a clear picture of their problem. They mention it to a friend who is thinking of booking. Your physios, meanwhile, find it hard to see the progress of any one patient, because they rarely see the same one twice.
Why continuity slips
Most online booking widgets are built to fill the diary. They offer the soonest slot with any clinician who does that appointment type. That is good for utilisation and poor for continuity.
Reception face the same pressure. When a patient rings wanting to be seen this week and their physio is full, the easy answer is a colleague. Nobody records that this was a trade-off, and nobody tells the original physio.
Part-time physios and those split across sites make it harder. Continuity is possible, but only if the booking process knows who the treating physio is and respects it by default.
What broken continuity costs
| Symptom | Effect |
|---|---|
| Patient retells their story | Session time lost and confidence dented |
| Plan adjusted by each physio | Inconsistent treatment approach |
| Physios lose track of patients | Harder to judge progress over time |
| Handover without notes | Next physio starts cold |
| Patients drift away | Plans left unfinished |
Continuity is not always possible or even best, and some clinics deliberately share patients. The problem is when it breaks by accident, because a booking screen chose for everyone.
How we protect continuity by default
- Each patient in an active plan is linked to a treating physio, set at assessment.
- Online booking shows the treating physio's slots first, with other physios' earlier slots available behind a clear choice, such as 'see someone else sooner'.
- Reception's booking screen highlights the treating physio and warns when a follow-up is booked with someone else.
- When a switch is chosen, the original physio can leave a short handover note, and the new physio is prompted to read it.
- If a treating physio leaves or goes on long leave, their active patients are listed for planned reallocation rather than scattered.
- A monthly report shows the share of follow-ups seen by the treating physio, by physio and by site.
Whether a switch is appropriate is a matter for your physios and the patient. The system only stops it happening by accident.
What patients and physios notice
Patients see the same physio for most of their plan, and when they do not, it was their choice and the next physio has a note. Physios get to follow their patients' progress. Reception stop making silent trade-offs. The clinic can see continuity as a figure and decide what level it wants.
It also helps with fairness inside the team. Physios who build a steady caseload keep it, rather than seeing their patients picked off by whoever has a gap. And when a physio has too many active patients to see them all promptly, the figures show it, which is a better basis for a conversation about capacity than a feeling that someone is overloaded.
Patients rarely say that continuity matters to them until it is missing. Once it is protected, the comments you hear change from 'I had to explain it all again' to remarks about their physio by name.
Does this happen at your clinic?
- Online booking offers any physio for follow-ups
- Patients have seen several physios in one plan
- Physios are not told when their patient is booked with someone else
- Handover notes are rare
- Nobody measures how often patients stay with one physio