Background

Non-specific low back pain (NSLBP) is a leading cause of disability in the United Kingdom with one in six adults seeking care every year, and a similar proportion opting for self-management. Healthcare demand continues to grow, surpassing the availability of existing resource.

Flok Health have developed an automated digital clinic to deliver gold standard multidisciplinary MSK pathways at population scale. Flok’s technology – which incorporates a UKCA-marked software medical device – streams interactive generated video appointments direct to patients through a smartphone application. Patients are screened for red flags using the latest guidance, carry out physical movement assessments, and receive real-time feedback on exercises and progress. The technology responds live, delivering specific and entirely personalised treatment over a multi-week programme.

Flok’s digital clinic is designed to deliver automated MSK triage and assessment, appropriate safety signposting, and individualised treatment delivery for non-specific low back pain (with or without lumbar radicular symptoms). In addition, Flok has achieved certification as a CQC-registered healthcare provider in England, allowing it to manage full patient pathways from self-referral to discharge.

How the platform works

Patients seeking support for conditions that require physiotherapy, such as back pain, may be referred to Flok through a community or primary care healthcare setting, such as their GP. They can also self-refer directly into the service, taking pressure off GP and other primary care appointments.

Once referred or self-referred to Flok’s on-demand service, patients get same-day access to the clinic via a mobile app.

Patients begin by completing an initial video assessment with an AI-powered, clinically regulated digital physiotherapist to ensure Flok can offer safe and effective treatment for each individual patient’s specific needs.

After this, regular automated video appointments are accessed via the app at whatever times suit the patient. During these sessions, an AI-powered physio delivers a constantly personalised interactive treatment programme for that patient’s specific needs. This will include exercise prescription, pain management techniques, and ongoing assessments. Each patient receives a completely unique, responsive, and conversational clinical experience, just as they would with a regular physio.

Once the course of treatment finishes, or the patient’s condition improves, the AI physio can discharge them from the service or advise them on their best next steps in terms of treatment. Flok also offer ongoing access to preventative care to help patients reduce the risk and severity of future pain flare-ups, and increase confidence in self-management.

Pilot studies with the NHS showed promising results.

As part of a series of 3-month pilot studies between May and December 2023, >1000 NHS staff who were suffering from back pain self-referred to Flok’s AI physiotherapy clinic to receive treatment.

Participants at each of the organisations involved in the pilot – NHS Lothian, NHS Borders, Cambridge University Hospitals, and Royal Papworth Hospital NHS Foundation Trust – were able to self-refer themselves to the AI service, which they accessed via the Flok app.

An initial video assessment with an AI physiotherapist was performed to evaluate their symptoms and ensure Flok could safely provide the right treatment for their condition. Once approved for treatment, patients had a weekly AI video appointment with their digital physio, which could be accessed at a time that suited them from the comfort of their own home.

During these appointments, the AI physiotherapist was able to prescribe exercises and pain management techniques, monitor each patient’s symptoms, and adjust their treatment in real-time. The majority of patients were initially prescribed six treatment appointments with Flok’s AI physio. After these weekly appointments had been completed, patients were given unlimited access to personalised sessions for several months, during which they could focus on preventative care and reducing the risk of recurrent issues, in line with their needs.

97% of the patients who self-referred to Flok within NHS Lothian received an automated triage outcome. 92% were immediately approved for AI physio and given access to an appointment that same day. 5% were automatically referred to another NHS service (for example, NHS 111 or their GP).

The remaining 3% of patients were given an additional assessment via telehealth appointment with a member of Flok’s clinical team. All but one of these individuals were then cleared to receive treatment with the AI physio, with the remaining patient successfully referred to an alternative service for urgent care.

Flok followed up with patients that were directed to another service out of courtesy and to validate the safety of the clinic’s automated triage system. As far as Flok is aware, no red flags were missed during any of the trials.

More information can be found here: UK’s first AI physio clinic trialled by NHS to tackle wait times – East Region Innovation (edinburghbioquarter.com)

NHS Lothian Patient Pilot

As part of our innovative 3-month pilot, we will conduct a comprehensive service evaluation to assess the effects of Flok Health on the healthcare system. This evaluation will examine key outcomes, including:

•        Measure of effectiveness
•        Safety
•        Health economic benefits
•        Patient outcomes
•        Patient experience

While the majority of these outcomes can be measured using data collected by Flok, we will also collaborate with the NHS Lothian Analytics Service to gather additional data and gain a deeper understanding of the system-wide pathway effects.

Live Pilot Launched July 2024

Our live pilot, commencing in July 2024, will be onboarding a diverse group of GPs to the Flok Health system. Patients experiencing back pain within participating GP practices will be offered the opportunity to access our digital back pain service through one of three convenient channels:

• Following a consultation with a primary care clinician, who will provide a direct link to the service.
• Through interaction with administrative and clerical teams within the practice, who will identify suitable patients and provide them with a link to the service.
• Via self-referral, using posters within the practice that provide a link to the service.

This large-scale UK pilot presents an exciting opportunity to explore how technological innovations like Flok Health can complement and enhance the range of healthcare services for individuals with non-specific lower back pain complaints.

Pilot Completion Announcement

Flok Health’s AI back pain clinic closing to new patients from 7th March 2025.

Flok’s physiotherapy service for low back pain will stop accepting new NHS Lothian patients at 23:59 on 7th March, as the trial is coming to its planned end. After this time, all registered Flok Health patients will continue to receive access to their personalised assessment and treatment programme for up to 6 months.

The uptake for this trial has been excellent, and the feedback has been overwhelmingly positive. Thank you to everyone who has signposted patients to the service so far. Analysis of the evaluation data will now commence, and the findings will be circulated to all participating practices once completed

Delivery Partners

Health Innovation Southeast Scotland (HISES)

• Samantha Smith-Garrett
• Ryan Orr

Flok Health

•        Finn Stevenson
•        Chris Ellaway-Barnard

Community MSK Service

•       Clinical Lead: Phillip Ackerman

MORE INFORMATION TO COME ABOUT THIS NEW EXCITING PROJECT