P283 Hydrotherapy and aquatic therapy provision in a post-COVID NHS

Abstract Background/Aims Hydrotherapy remains an important part of treatment for a range of rheumatological, musculoskeletal and other conditions. As there is little robust clinical evidence, hydrotherapy is scarcely included in national guidelines, with the exception of the National Institute for Health and Care Excellence (NICE) Guidance for Spondyloarthritis which recommends hydrotherapy as an adjunct therapy. In recent years, hydrotherapy services have often been targeted in cost-saving exercises by commissioners and providers. There was a concern that this would be further exacerbated by the pandemic with pools closing to become storage space and remaining closed beyond this. Methods Via the All Party Parliamentary Group (APPG) for axial spondyloarthritis (axial SpA), we submitted a Freedom of Information Request (FOI) to establish the status of hydrotherapy pools pre- and post-pandemic. The FOI was sent to all NHS trusts in England asking them about the status of their pool before and after COVID, future plans and reasons for any delay in re-opening. Results 90 trusts (69%) responded. 72% of those had an onsite hydrotherapy pool prior to the pandemic, 90% of which were open. 27% of pools had already re-opened and there were plans to re-open 49%. 2% were due to remain permanently shut with 21% unsure of the future of their pool. The most common reasons for delays in pools re-opening were linked to infection prevention control restrictions, including changing area capacity (23%), social distancing and ventilation (38%). The most common reasons for the uncertainty of when they would re-open were changing area capacity (46%), staff to clean (23%), access to pool i.e., still being used for other purposes (30%), social distancing and ventilation (23%). Of those pools that were already open or due to re-open, 93% had a reduced capacity with an average capacity of 37%. This was largely due to changing area capacity (54%), staff to clean (44%), access to the pool (28%), social distancing and ventilation (55%). Of the pools that were open prior to the pandemic, the condition areas which used them included MSK (92%), neurology (74%), physical disability (77%) and children (77%). 8% of users had axial SpA. Conclusion There is a very real threat to NHS hydrotherapy facilities in England. A lack of robust clinical evidence often leaves therapists and patients in limbo, with anecdotal testimony as to the benefits often not being enough to convince of its value. A co-ordinated cross-condition alliance is needed to ensure: clear local pathways are established into hydrotherapy; pools are considered in new build and refurbishments; robust clinical evidence is produced; hydrotherapy is included in national guidelines; tools are available at local level to audit and promote hydrotherapy; local services can become self-funding via community and patient groups. Disclosure J. Hamilton: None. C. Jeffries: None. S. Whalley: None. D. Webb: None.

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