There are over 200 MSK conditions affecting millions of people, including all forms of arthritis, back pain and osteoporosis. The World Health Organisation, (WHO) and Bone and Joint Health strategies Project (2005 cited by the Department of Health) identified that:
The socio-economic impact is significant and predicted to rise.
The Musculoskeletal Service Specification draws on guidance from Towards the Best Together (East of England SHA 2008) and the Lord Darzi NHS next stage review – High Quality for All (2008) and the Musculoskeletal Framework (DH 2006).
Aims and objectives of service
The aim of the service is to provide a comprehensive, patient-centred, and easy to access community MSK service with high quality, efficient service in line with national guidance and local requirements.
The service objectives are:
Service description / care pathway
The Community MSK service shall offer patients a choice of sites and access to specialist treatment within the local community.
The service shall cover the range of MSK problems common to primary care. These include, for example, but are not limited to:-
Hand & Wrist, Elbow, Shoulder
Foot and Ankle, Knee, Osteoarthritis (OA), Hip, Rheumatology
Back and Neck:
Assessment and treatment of back and neck pain for patients who do not require specialist intervention.
Referrals shall be triaged in a community setting, with patients being seen and managed within the Community Physiotherapy service, or referred on to other appropriate services, as necessary.
The service shall complete a thorough history and undertake physical assessment of patients with suspected MSK disorders. Following assessment, the Provider shall document a Patient Care Plan.
Signposting to various pathways and services
OA Hip and Knee
Patients diagnosed with OA Hip shall be assessed and treated as directed by the OA Hip pathway specified (see the Hip Pathway section of the website).
Patients diagnosed with OA Knee shall be assessed and treated as directed by the OA Knee Pathway (see the Knee Pathway section of the website)
Back and Neck Service
Patients diagnosed with back pain shall be assessed and treated as directed by the Back and Neck Service (BaNS) –see the Spinal Section of the website
Female patients requiring specialist advice and treatment for incontinence shall be assessed and treated as directed by the Female Continence pathway (see the Women’s health Pathway section of the website)
For GP or other Healthcare Professional referrals, if you feel your patient needs to see a Physiotherapist, please hand them a self referral card to complete their details either on line or over the phone, or ask the patient to refer themself via a self-referral system.
GPs shall be provided with a card containing the service contact details. This shall be given to patients that agree to self-refer following a GP practice consultation.
Patients with MSK conditions shall access the self-referring system via a web based portal or by telephone.