Clinical, Patient Experience and Service Outcomes of a Leisure Centre–Based NHS Musculoskeletal Physiotherapy Service: A Service Evaluation

Background
Musculoskeletal (MSK) conditions place substantial burden on individuals and healthcare systems, increasing the demand for accessible, community-based care. This service evaluation assessed an NHS MSK physiotherapy pilot delivered in a leisure centre in a socioeconomically deprived area.

Methods
A retrospective evaluation of routinely collected data was undertaken for patients attending between August 2025 and January 2026. Adults referred for physiotherapy for MSK conditions received treatment in a community leisure centre. Outcomes at initial and final appointments included MSK health (MSK-HQ), pain intensity (NPRS), physical activity (MSK-HQ physical activity item), and health-related quality of life (EQ-VAS). Linear mixed-effects models evaluated clinical outcomes. Patient experience and service utilisation data were analysed descriptively.

Results
Sixty-four patients (mean age 50.6 ± 14.8 years; 60.9% female) were included, predominantly from socioeconomically deprived areas (mean Index of Multiple Deprivation 2.4 ± 1.5). 53.2% were from ethnic minority backgrounds and 13 languages were represented. Significant improvements were observed across all outcomes: MSK-HQ (+11.2), NPRS (−2.2), EQ-VAS (+19.9), and physical activity (+1.8 days/week) (all p ≤ 0.002). Sensitivity analyses yielded similar results except for physical activity. Minimal clinically important thresholds were exceeded for MSK-HQ, NPRS and EQ-VAS. Patient satisfaction was high, attendance was 72.2%, and 17.2% of patients were referred to community exercise programmes.

Conclusions
A leisure centre–based NHS MSK physiotherapy model was associated with improved clinical outcomes, high patient acceptability and promising service utility. The service engages a heterogeneous population and aligns with NHS priorities for community-based care. Further comparative and economic evaluations are warranted to establish effectiveness and inform future service development.