Triage with Tele (TWT): early brief intervention for children’s physiotherapy

Sarah Roberts Team Lead Children’s Physiotherapist

Aneurin Bevan University Health Board


Variations in gait (walking pattern), foot posture and gross motor development (e.g. sitting, standing, walking) are very common in young children. Parents look forward to their children reaching developmental motor milestones such as walking, however if there is any variation from what the parents and family feel is normal this can generate a huge amount of concern and anxiety.

Most of these developmental differences are normal and do not usually require intervention, however parents often seek answers as to why their child is developing in a way they think is abnormal. In seeking answers, parents and Primary Care Practitioners may seek a specialist referral into a Children’s Physiotherapy Service.

Close up of baby's hands and feet

Gait, foot and mild gross motor delay related problems are sometimes difficult to fully describe by both referring health professionals and families.

The current referral system within ABUHB Children’s Physiotherapy is via written referral. A written referral often does not help the triaging physiotherapist to fully understand the presentation of the difficulty and its impact on the child. This results in appointment being offered in most cases.

In 2018-2019, 18% (164) of all patients placed on the ABUHB Children’s Physiotherapy waiting list for an appointment only needed to be seen once and were then discharged. These patients would have sat on a routine waiting list for up to 14 weeks prior to being seen. During this time families can become more anxious and have an expectation that physiotherapy treatment is required for their child’s problem.

Project Aims


Key Outcomes

Over a 3 month period, 46 patients met Triage with Tele (TwT) criteria, 36 attended for an appointment. 18 of these did not require a further physiotherapy assessment.

Of the 36 who attended, 24 undertook a patient satisfaction questionnaire. 100% were satisfied with the appointment.

Feedback from parents is included below:


Next Steps

Our Exemplar Experience

Being a Bevan Exemplar has given me confidence to pursue a project idea and make it happen. I am so grateful for the support and guidance offered to me from being part of the programme.

Bevan With Thanks

Huge thanks to members of the Children’s Physiotherapy team in ABUHB who helped with the delivery and evaluation of this project. These include Armanda Rees Van-Wolferen, Kerri Harris, Zoe Derham-Luckwell, Sam Edwards, Cherie Lamont and Kirsty Lightowler. Also a big thankyou to Cherie Lamont, Charlotte Lamont and Danielle Farrington for their lovely artwork and to Louise Leach and Margaret Manton for their support and guidance.


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