UK’s first AI physio clinic trialled by NHS to tackle wait times

The UK’s first AI-powered physiotherapy clinic is to be rolled out in the NHS this year to unlock faster, personalised treatment for thousands of patients in pain.

The new platform – called Flok Health – provides same-day access to automated, responsive video appointments with an AI physiotherapist via a smartphone app. Co-founded by medic and former professional rower Finn Stevenson, Flok is the first platform of its kind to have been approved by the CQC as a registered healthcare provider, creating a brand new treatment pathway for physiotherapy patients in the NHS.

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.

The new virtual clinic has been designed to power faster access to care for physiotherapy patients, while reducing wait times and pressure on clinicians. More than 300,000 people in the UK are currently on NHS wait lists for physiotherapy – and one-quarter (26%) of these patients have been waiting more than three months to be seen.

 

Pilot studies with the NHS show 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.

100% of patients said AI physiotherapy was “better” or “the same as” human physiotherapy

In the latest service evaluation, 100% of surveyed pilot patients said their experience with Flok had been at least equivalent to seeing a human physiotherapist, with 57% of patients saying they thought the AI physio experience was better than the traditional alternative.

The digital service was also effective, with more than four in five participants (86%) reporting that their symptoms had improved during treatment with the Flok platform.



Technological developments such as Flok have the potential to substantially improve the care and journey for some people with back pain by complimenting the range of healthcare services available. We're looking forward to continuing working with Flok to further understand and explore the potential for how we could integrate such technology with our current therapy provision.

Alison MacDonald, Executive Nurse Director, NHS Lothian

AI physiotherapy unlocks same-day care and reduces waiting lists

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.

Data from the 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.

Following the successful trial period, Flok’s AI physiotherapy clinic is set to be rolled out by early adopting NHS providers across the UK later this year, supporting thousands of patients with back pain to access vital treatment sooner.

The new technology promises to ease the MSK backlog – guaranteeing same-day access to gold-standard care – and supports more patients to be seen sooner and more frequently, without having to wait for an in-person appointment.

According to the NHS website, over 30 million working days are lost to MSK conditions every year in the UK and they account for up to 30% of GP consultations in England.

 



11 million people suffer from back pain in the UK and 20% of us will visit our GP with a musculoskeletal problem each year. But it’s getting harder and harder for patients to access the physiotherapy they need. With NHS services stretched and wait times growing, thousands are waiting months for an initial appointment, leaving them in pain and often unable to continue their daily routines, such as going to work. Creating faster, more convenient access to physiotherapy services is vital to tackling this crisis. Harnessing new technologies, like AI, can help us unlock individualised treatment for thousands of patients, while reducing pressure on NHS services and freeing up capacity for treating those in need of in-person care.

“We’re proud to be leading the charge on this at Flok. It has been incredible to see the positive impact that AI physiotherapy can have throughout our initial trials with NHS Lothian, NHS Borders, Cambridge University Hospitals and Royal Papworth Hospital NHS Foundation Trust. We’re excited to be working closely with the NHS to develop this new technology and create a new care model for on-demand personalised treatment at population scale.

Finn Stevenson, Co-Founder and CEO at Flok Health

About Flok Health

Flok is the UK’s first autonomous physiotherapy clinic, unlocking same-day access to care for NHS patients. Founded in 2022 by healthcare innovators Finn Stevenson and Ric da Silva, it is the only digital physiotherapy service to be approved under UK regulations (CQC, MHRA) as a registered healthcare provider capable of fully automating treatment pathways. This means that Flok can directly manage all aspects of a patient’s care – from self-referral through to discharge – and meets the same quality and governance standards as in-person NHS services. >98% of Flok’s patients have an entirely automated digital care pathway, interacting directly with the autonomous digital physiotherapist during each appointment.

About the technology

Flok’s AI physiotherapy clinic is built using a new form of clinical decision engine (a registered medical device) written in a proprietary domain-specific programming language, combined with a novel system for real-time responsive video assembly and delivery. This language has been developed by Flok’s technology team to be able to accurately recreate best-practice clinical reasoning for the first time. The proprietary programming language also has safety and explainability at its core, with intrinsic guard rails, and the ability to transcribe its decisions and associated reasoning directly into the patient’s electronic health record, just like a human clinician would.

As a CQC-approved care provider, Flok is committed to ensuring that its clinical services are safe, effective, and secure. The clinic is protected by a large number of safety systems, including an adjacent software service developed by Flok that creates several thousand synthetic patients every night and passes them through the clinic to ensure that the AI physio system responds appropriately, and exhibits the expected clinical behaviour. This process is equivalent to running a large scale clinical audit, every single night of the year.

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.