NHS physiotherapy: what people are telling us
Physiotherapy is one of the most widely used NHS services, playing a vital role in improving public health and reducing health inequalities.
Physiotherapists help people manage pain, recover after injury or surgery, and stay active, independent and in work. They also support people after strokes, and those with cardiac or pelvic health problems, and are crucial in preventing falls among older or frail patients that can lead to emergency admissions and increased pressure on hospitals.
People access physiotherapy through a range of routes, including GP referral, self‑referral and hospital discharge.
How physiotherapy is changing
NHS data shows demand for physiotherapy is rising, driven by an ageing population and more people living with long-term and chronic conditions. Musculoskeletal (MSK) problems account for an estimated 30% of all GP appointments, while workforce pressures remain severe.
To manage this rising demand, services are adapting.
In recent years, the NHS has expanded ‘first contact physiotherapy’, placing senior physiotherapists directly in GP practices. This model has resulted in high levels of patient satisfaction, but implementation has been inconsistent across England.
The NHS also encourages “self-referral” pathways to help more people access assessments and advice without first seeing a GP. Alongside this, many services have increased their use of digital triage and remote support, including apps, online resources and telephone-first models.
What people told us
To understand how people are experiencing physiotherapy services in practice, we reviewed 500 pieces of feedback shared with us during February and March 2026.
Five key themes in people’s feedback
- Long waits to access care are causing frustration and harm
- Digital care is becoming more common – and sometimes replacing ‘hands‑on’ support
- Confusing referral pathways are creating delays
- People with complex needs are not always well supported
- Positive experiences show what good physiotherapy looks like
Closer look at key themes
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Long waits to access care are causing frustration and harm
People told us they were waiting months, and in some cases more than a year, for physiotherapy appointments, follow-up care and onward treatment.
These delays often led to worsening pain, reduced mobility, and growing difficulty managing daily life. In some cases, long waits also held up further hospital treatment.
Delays can often stack up across different parts of physiotherapy, MSK and hospital pathways:
“Referred by GP for physio assessment, waited 2 months for an appointment and was referred onwards for ultrasound scan. Had to wait another 3 months for a scan then 2 months for the report to be discussed. A further 2 months for an injection, now [I] am overdue by a month for a follow up appointment .In total have spent a year waiting for my shoulder to be sorted out - it's still painful, not able to use it fully and it's affected my ability to work, ironically as a Physio!” - Story shared with Healthwatch England
In some cases, long waits meant some patients had no choice but to go private:
“I called the number I was given but was told the nearest appointment was 5 weeks away and some 30 miles from where I live. They said I could go on a list for cancellations and would be contacted when a nearer location became available. They never contacted me so I paid privately” - Story shared with Healthwatch England
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Digital care is becoming more common or replacing ‘hands-on’ care
Like many parts of the NHS, physiotherapy triage and ongoing support are increasingly delivered by apps, online assessments and phone calls, often through third‑party providers.
While some people welcomed the quicker initial contact, many felt remote care was less personalised and less effective, especially for those with complex conditions.
“I was given a telephone consultation with physio. I thought it would be to discuss problem and make a face-to-face appointment. No, I now have an email with 7 different exercises from a man who does not know me even slightly, does not know my problems and has never met me” – Story shared with Healthwatch England
A common frustration was receiving exercise sheets or app-based programmes with no hands-on assessment, no demonstration, and no follow-up to check whether patients are doing them correctly or safely:
“I was there for under ten minutes. He looked briefly but didn’t touch or ask me to describe or demonstrate the problem. He sent a range of exercises to my phone but didn’t demonstrate. Said I should choose which ones I need to do and progress them but offered no guidance.” – Story shared with Healthwatch England
For older people or those less digitally confident, exercises delivered remotely created avoidable barriers, such as difficulties printing materials or viewing exercises on small screens.
“The exercises were sent to my phone and too small for a 67 yr old to see, [I was] not able to get into the positions suggestions. 2nd therapist, given different exercises on printout, could not do these either because the ankle is far too painful. Both issues would have been avoided if they had shown me first and then watched me do them. I now have severe muscle wastage in my legs and extensive rehab needed” – Story shared with Healthwatch England
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Confusing referral pathways are causing delays
Despite physiotherapists having the right to see patients without a referral since 1977, many areas still require people to first see a GP.
People described being passed between GPs, physiotherapy services, MSK teams and hospital clinics, often receiving conflicting information about who could refer them, what counted as a valid referral, and who was responsible for the next step.
“Terrible. [I] had to self refer via MSK route even though hospital physio and consultant said it was needed, and the consultant was to see me in 3 months after physio. [But] my MSK self referral was rejected by assessor, so didn’t get an appointment” – Story shared with Healthwatch England
Some people found themselves assessed, sent back to their GP, re-referred, and placed back at the bottom of a waiting list:
“The physiotherapist told me to rest it and phone in when I was ready to return. I did this and the receptionist wouldn’t let me have an appointment or speak to the physiotherapist, she insisted I refer to my GP which I have done, and have been re referred. I have been waiting since June 2025. I am now seeing a physiotherapist privately, who stated this has been left far too long”- Story shared with Healthwatch England
We also heard that information gathered at one stage, for instance by an AI bot sometimes failed to follow people to the next stage of triage:
“I Had to see my GP’s physio first and wait a month before I could start the referral to MSK. The start of that referral included a 20 minute assessment by an AI, to which I gave a full and detailed history. When I got my phone appointment 6 weeks later, all they got was ‘left knee’. That appointment was me just repeating all the information I already gave” – Story shared with Healthwatch Nottingham & Nottinghamshire
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People with complex needs are not always well supported
Even when people successfully navigated referral routes, some found themselves in services not equipped to meet their needs. In the worst cases, this led to harm. One person with abdominal cancer was referred by a GP to a standard physiotherapy service with no training in post-cancer care:
“ The GP referred me to their usual physiotherapy provider who were not trained in abdominal cancer support. As a result the therapy they tried caused further problems. The GP did not know what to do differently as they are not familiar with the needs of patients with abdominal cancer.” Story shared with Healthwatch England
For people with complex conditions or conditions affecting multiple systems simultaneously, such as hypermobile Ehlers-Danlos syndrome, the restriction of referrals to one body part at a time was a source of frustration.
“At one time I was under 6 different physios. Looking at joints, neurological, bowel, bladder, it’s unsustainable to attend all of these appointments and pointless because what is done to one body part, affects others and knock other parts of the body” – Story shared with Healthwatch Tameside
To lessen this burden on patients, The Community Rehabilitation Alliance has called for community-based services where a range of professionals work under the same roof to meet all of a person's needs.
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Positive experiences show what good physiotherapy can look like
People who had good experiences described quick access, thorough assessments, exercises that were explained and demonstrated rather than simply sent, and physiotherapists who listened and understood their wider circumstances.
“[I got] Quicker [access to] to first telephone appointment because I could get to a local hospital for future sessions rather than at [the] GP centre. Physio listened to what I had to say as she did at future face to face appointments. Exercises helped and she suggested ways [they] could be adapted to my circumstances. Very pleased with the service.” - Story shared with Healthwatch England.
People told us the impact of this care was lifechanging, helping people walk again after a stroke, recover after surgery, and return to everyday activities.
“I have MS and have physio… I wouldn’t be walking now if it wasn’t for these lovely ladies. I know they are only a phone call away if I have any concerns. They’ve helped me so much over the last 3 years.” - Story shared with Healthwatch Herefordshire
Calls for policy change
The Chartered Society of Physiotherapy welcomed greater recognition of physiotherapy and rehabilitation in the NHS 10 Year Health Plan, particularly as part of the shifts from hospital to community and from sickness to prevention.
However, as physiotherapy is delivered across a wide range of hospital and community settings, spanning both adults and children’s services, there is no single national picture of how many people are waiting for physiotherapy care. Data limitations make this even harder to measure. For example, community health waiting list statistics do not include specific information on self‑referral wait times, despite the Government’s intention to expand this route.
Additionally, the variability in care that people have shared with us – from generic exercise sheets to ‘hands-on’ sessions, shows the consequences of having no national minimum standards. Apart from some specific therapy-related stroke guideline, there are no mandatory or recommended maximum wait times to prevent irreversible harm or deterioration of symptoms, nor ideal appointment lengths, frequency or continuity plans to guide physiotherapy delivery.
Our recommendations
We have set out a number of recommendations to improve physiotherapy services.
For the government:
- To set out in its forthcoming 10 Year Workforce Plan how it will recruit and retain physiotherapists to support its ambitions.
- To improve data collection on how many people are waiting for physiotherapy across various services, to understand and tackle postcode and service variations
- To set national standards on how quickly people should be seen, appointment lengths and frequency and follow-up care, possibly through a new Modern Service Framework.
- Promote more joined up working between different services to avoid patients being bounced between services or back to the start of access routes
For physiotherapists:
- to check with patients their accessibility needs in relation to using digital tools or printing off exercise sheets at home, and to offer alternatives where required
- To help patients better understand initial treatment options, including why they might not need to be physically examined and why following exercise sheets would work for the patient’s particular issue.
