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Msk pathways and services


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DRAFT




MSK PATHWAYS AND SERVICES
Last year the Clinical Referral Management Committee commissioned a project focusing on the development of an MSK service that ensured patients received the right treatment at the right time by the right clinician. As a result a new service model has been developed. This includes the implementation of a Musculoskeletal Clinical Assessment and Treatment Service (MSK CATS) provided by a multidisciplinary team.


WHEN TO REFER TO MSK CATS
To support this service model MSK pathways, providing advice regarding referral routes and information to support differential diagnosis, have been developed and agreed in partnership by hospital and community clinicians and GP colleagues. These are available on the NHSR intranet, see link below:
Orthopaedics - MSK Pathways
The pathways are condition specific but for ease of reference have been categorised by body area.
The referral routes detailed within the pathways include:


MSK Referral Options






Orthopaedics

Orthotics

MSK CATS

Physiotherapy

Podiatry

Where appropriate, the recommendation within the pathway will be to refer to the Musculoskeletal Clinical Assessment and Treatment Service (MSK CATS). Typically this will be suggested where:





  • Specialist advice and intervention is required but surgery is not currently indicated

  • There are signs of altered peripheral neurology and neural dynamics

  • The patient has not previously responded to

    • Physiotherapy

    • Podiatry

    • Orthotics

  • Diagnosis is unclear

Patients exhibiting red flag signs or symptoms should be referred directly to secondary care.


The MSK CATS will be provided by a multidisciplinary team and supported by orthopaedic consultants.
To ensure patients are assessed and treated by a clinician with the appropriate clinical skills and expertise the MSK CATS clinic sessions will be linked to specific pathways.
Hence the Choose and Book clinics reflect this arrangement.
The MSK CATS will operate a GP telephone line to provide advice re patient management and referral route/options. Tel: 01709 426635. This will be available between the hours of 8:00 am and 6:00pm Monday to Thursday, 8:00am to 4:30pm Friday.

HOW TO REFER TO MSK CATS

i) Choose and Book

The Rotherham MSK CATS is subdivided as follows:



  • Spinal

  • Shoulder and elbow

  • Hand and wrist

  • Hip and knee

  • Foot and ankle

At present Choose and Book will still show these services as linked to NHSR. This is a coding issue that will be addressed shortly. Some clinics will be provided from both the Rotherham General Hospital site and the Rotherham Community Health Centre. The clinic time chosen will indicate the location. . A small number of generalist clinics will also be provided at Maltby Joint Services Centre.


Please note: If Orthopaedics, Physiotherapy, Podiatry or Orthotics is indicated by the pathway please book this service directly.
ii) Paper Referrals

Please direct all MSK CATS referrals to:



Therapy Service

C Level

The Rotherham NHS Foundation Trust

Moorgate Rd

S60 2UD
iii) Fax

Please direct all MSK CATS referrals to:



Fax: 01709 426600
iv) E mail

Please direct all MSK CATS referrals to:



rgh-tr.mskcats@nhs.net
All referrals received by any of the MSK services (i.e. MSK CATS, Orthopaedics, Physiotherapy, Podiatry, Orthotics) will be screened by a clinician within 2 working days of receipt and either:

  • Referral accepted

  • Transferred within the group of services

  • Returned with advice

The Clinical Referral Management Committee have requested that where referrals are not in line with the pathways, and primary care intervention/management is indicated, referrals are returned. The Rotherham NHS Foundation Trust will work in line with this request and offer advice and support should a referral be returned.

Where a patient, managed by or referred to the MSK CATS, requires secondary care intervention then choice of provider will be offered and the GP advised of this action.


Key contacts

Lorraine Andrews, Outpatient Therapy Manager (email: lorraine.andrews@rothgen.nhs.uk)

Steve Badger, Consultant Orthotist (email: steve.badger@rothgen.nhs.uk)

Mr Ian Carmichael, Clinical Director Orthopaedics (email: ian.carmichael@rothgen.nhs.uk)

Adrian Conn, Podiatry Services Manager (email: adrian.conn@rothgen.nhs.uk)

Barbara Cooper, Professional Lead Physiotherapist (email: barbara.cooper@rothgen.nhs.uk)

Debbie Horne, Group General Manager, Clinical Support (email: debbie.horne@rothgen.nhs.uk)

Rachel Lewis, Clinical Lead Orthopaedic Triaging (email: rachel.lewis@rothgen.nhs.uk)

Diane Simpson, Clinical Director Therapy Services (email: diane.simpson@rothgen.nhs.uk)

Suzanne Stubbs, Business and Service Manager, Orthopaedics (email: suzanne.stubbs@rothgen.nhs.uk)





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