NHS Lothian gives patients access to AI physiotherapy in UK-first

By Samantha Smith January 6, 2025

Edinburgh, UK: A new AI-powered physiotherapy clinic, which provides same-day appointments for back pain with zero waitlist via a smartphone app, is now available to nearly 1 million patients across the Lothian region in a UK first.

NHS Lothian in Scotland is the first NHS organisation in the UK to make the new AI clinic, called Flok Health, available to patients across a range of community healthcare settings.

This large-scale pilot follows a series of successful early trials of the technology last year. The clinic has been created by a team of physiotherapy and AI experts in Cambridge, and is the first digital MSK clinic to have been approved by the Care Quality Commission (CQC). The new service has been deployed as a collaboration between NHS Lothian, Flok Health, and the Health Innovation South East Scotland (HISES) Hub.

Created using video footage of a human physiotherapist, Flok Health’s digital clinic is able to offer patients personalised treatment at population scale, in a setting which feels like a structured responsive video call with a physiotherapist.

During recent NHS trials of Flok Health, 100% of patients said their experience with the AI physiotherapist had been “better” or “the same as” what they’d expect from a human physiotherapist. More than four in five patients (86%) reported that their symptoms had improved during treatment with Flok.

The NHS Lothian pilot means anyone registered with one of the 116 GP practices within NHS Lothian can now self-refer directly to Flok’s digital MSK clinic via existing self-referral portals, or can be referred by participating GP practices. Using the technology, they will be able to access a physiotherapy appointment via the Flok app that same day. The service also has significant data integrations and sharing with other NHS services in the region to ensure joined up care for patients and clinicians, and the ability to produce robust multi-faceted analysis of the clinical and cost impacts of deploying the AI service.

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AI-enabled services such as Flok have the potential to improve the patient journey for some people with back pain through providing rapid, flexible access to care. It also offers an alternative management option for those who prefer a digital approach. Working in partnership on this pilot with Flok and Health Innovation Hub, South East Scotland, offers an outstanding and unique opportunity to explore how Flok’s digital back pain service can be integrated within our range of healthcare services.

Phil Ackerman, Consultant MSK Physiotherapist from NHS Lothian

How does the new AI physiotherapy service work?

When patients self-refer or are referred to Flok Health, they receive an invitation to complete an automated video call assessment via their mobile phone immediately.
During the consultation, an AI-powered physiotherapist will evaluate their symptoms and determine whether the AI clinic can safely provide the right treatment for their needs.
If approved for digital treatment, the patient will have access to weekly video appointments with the AI physiotherapist, at a time that suits them, via a smartphone app. There is no waiting list and so patients can start treatment immediately.
Some patients with more complex initial symptoms will receive an additional assessment via a telehealth appointment with a member of Flok’s clinical team, before being approved for treatment or triaged to the most appropriate alternative NHS service.
Patients who are approved to begin treatment with Flok will have round-the-clock access to appointments with an AI physiotherapist who prescribes exercises and pain management techniques, and responds to information patients are providing in real time. The technology means every patient gets a totally individualised experience and care pathway based on their feedback, symptoms, and progress.

The new service manages patients on behalf of the NHS from initial presentation and assessment through to treatment delivery and discharge, and records all interactions and outcomes on an electronic health record.

The clinic is currently available to assess and treat patients across the Lothian region for back pain, with plans to later extend the service to provide care for additional musculoskeletal conditions at population scale.

Jaclyn Ryan, a Nurse from Edinburgh, Scotland, comments:

“I’ve been suffering from excruciating back pain for the last year due to a herniated disc pressing on a sciatic nerve. The pain has been so severe that I’ve had to take time off work and couldn’t sleep at night, despite being on high dose pain medication to cope. The pain and lack of sleep left me completely zombified. I saw an occupational therapist and paid for private physiotherapy, but unfortunately these interventions actually worsened the pain to an unbearable degree.

“On a recent GP visit my GP suggested I try Flok. The results have been unbelievable. The sessions were tailored specifically to the areas where I was finding pain, whereas with traditional physiotherapy I felt that I was being given a one-size-fits-all set of exercises that didn’t work for me at all. After using Flok for just three weeks I could feel my back release and the pain lessen. I’m now back at work and I’m taking fewer pain killers.

“I want other people to know that this service is available to them in Lothian. I’m so grateful to have been able to access the app, and could never have imagined the impact it was going to have on my back pain. The results speak for themselves.”

Finn Stevenson, Co-Founder and CEO of Flok Health, comments:

“We’re delighted to be working with NHS Lothian and HISES to make AI physiotherapy directly available to NHS patients for the very first time. Finding new ways to deliver care at population scale and empower patients with choice has never been more important, with physiotherapy wait lists growing and services facing record patient demand. 1 in 5 of us will visit our GP with a musculoskeletal problem every year. AI enables those who would like to do so to receive faster, digital MSK care, whilst freeing up clinical capacity for patients who want or need to see a clinician in person. It’s about giving patients greater choice, and making sure that they can get the right care at the right time.

“We’ve been thrilled to see the positive impact our AI physiotherapy clinic had during our initial trials with our NHS partners and it’s hugely rewarding to see this service now delivering gold-standard care to patients across Edinburgh and the surrounding region. We’re excited to continue working closely with our NHS partners to deliver innovative, scalable care pathways for physiotherapy, eliminating wait lists and democratising access to world-class care”

NHS trials show promising results

Previous trials of Flok’s AI clinic have shown the majority of patients can be automatically triaged and approved to start digital treatment right away. During a trial carried out by NHS Lothian last year, 92% of patients were immediately approved for AI physio and given access to an appointment on the same day. 5% were automatically referred to another NHS service (for example, NHS 111 or their GP) and the remaining 3% were given an additional assessment with a member of the Flok team.

Data from a trial at Cambridge University Hospitals indicated that the AI clinic had helped reduce wait times for physiotherapy, with wait lists for in-person musculoskeletal appointments increasing by more than 50% once the pilot had ended and the AI clinic was no longer in use.

According to the NHS website, over 30 million working days are lost to MSK conditions like back pain every year in the UK, while NHS Scotland waiting lists are at a record high.

Flok Health’s AI MSK service is due to be rolled out at other NHS sites in the UK later this year.