MSK Programme

Judith Reid

February 2018

Active and Independent Living Programme 1

24/10/2017 Active and Independent Living Programme 2

Aim Primary Drivers

Secondary Drivers

Access Performance 4 week target

For people with MSK

problems across

Scotland to have

easy access to a self-

management

resource and early

appropriate advice

and, if necessary,

assessment by an

efficient AHP service

to get them started

on the right pathway

for their treatment

first time

From April 2016, 90%

of patients will be

able to access their

first MSK contact

within 4 weeks

MSK Solutions Tool

Right Person

Web Algorithm

Enabling and

supporting Self

Management

Establish board reporting with trajectories to

understand challenges in

relation to performance

MATS , WEB and Primary Care project plans

attached

Explore TEC solutions to ensure max efficiency and to support patient

care

Engage with other workstreams to

facilitate end to end pathways, best

utilisation of resource, secure

funding opportunities

Explore opportunities to support patients

with persistent pain, alternative

approaches to enable and support self care, ensuring

community resources engaged

and linked in

Productive Patient

Flow

TEC solutions

Best Outcomes

MATS

NHS inform

Web resources

Efficient / Electronic HUB

processes

Primary Care/1st Point of contact

Skilled cohesive AHP teams

SOSDG and Flow Programme

Advanced Practice

Community assets

PROM

ISD data

Minimum Standards Framework

MSK App

Driver Diagram for National MSK Programme

Active and Independent Living Programme 3

Benefits:

To Primary Care Decreased reliance on analgesics Decreased need for GP appointments To Acute services 20% reduction in Orthopaedic demand Reduction in ED attendances To public Timely/immediate access to advice and support Maintain function, work To AHP Workforce Power of the data, articulate the message Inform developments, education and workforce requirements Meaningful impact on QoL Impact on Life Curve

Key Performance Indicators

Active and Independent Living Programme 4

Code Definition

Data completeness Reporting via ISD for MSK Physiotherapy, Occupational Therapy, Orthotics, Podiatry Inclusion of MATS data Align with review of SMR00

4 week performance Compliance with 90% target, Body Part, mode of contact, referrals per head of population, DNAs

Self management rates

Referral avoidance

Diagnostics Reduction in demand for imaging modalities

Impact on secondary care referrals

Reduction on demand on Orthopaedic services

PROM – EQ 5D 5L, MSK HQ

Outcome data to inform future treatment approaches, snap shot

Qualitative feedback, CARE, stories, focus groups

Service users, stakeholders

Evaluation framework for primary care model

Improvement in primary care capacity, impact on demand to MSK and secondary care services Cost benefit, reduced prescription costs

Project Plan – Milestones

5

. Active and Independent Living Programme

Aug-17 Sept-

2017

Oct

2017

Cross Party Meeting Scottish Parliament

2xtesting days web algorithm

MATS call back functionality

reporting from primary care survey monkey

Unavailability Code live

Project Proposal Physio test of change MATS

report MSK HQ MATS data, inform future plan

Project Plan – Milestones

6

. Active and Independent Living Programme

Nov-17 Dec-17 Jan-18

Analysis of repeat callers MATS

SCI link for web tool

MSK Services Fit for the Future Event

Develop SLWG to inform CHI match, Connectivity and information governance for MSK Adviser

MATS data reporting ISD

Analysis of repeat callers MATS

update information NHS inform

Update information leaflets for Solutions tool

Draft MSK Position statement

Webex session to progress outputs from Fit for the Future Event

Project Plan – Milestones

Active and Independent Living Programme 7

Feb-18 Mar-18 Apr-18

Fife go live MATS

Agree Clinical testing plan MSK Adviser with GGC

Scope Clinical testing Plan for MSK Adviser with Orthopaedics

MSK Position Paper consultation with MSK Leads

Plan Implementation Islands go live MATS

Project Plan – Milestones

Active and Independent Living Programme 8

July-18 Oct-18 Jan-19

Service User Engagement to inform MSK Improvement

In collaboration with primary care agree consistent message for public

MATS Implementation plan for 100% Scotland

TEC plan for MSK

MSK Adviser Implementation plan

Update MSK Minimum Standards Framework

Realistic Medicine Clinical Strategy

Modern Out Patient Primary Care Transformation

GP Contract / MoU SOSDG

Build on success and Evidence Clinical Pathways

Waiting Times Target, Definitions, Reporting AHP MSK Minimum Standards Framework

Advanced Practice Roles Competencies

MSK Services Fit for the Future Position Statement

Prevention and Early Intervention Access

Health Message Partnership

Research and Innovation Workforce

Prevention and Early Intervention

• Review of the Minimum Standards Framework

• Role of Waiting Lists

• Technology Enabled Care

• Range of resources, formats and platforms

• Co creative approach with service users

• Community assets

• DE medicalisation

Public Health Message

• Consistency

• Primary Care Campaign

• Marketing

• Position Statement

• 5 year plan

Access

• MATS

• 100% of Scotland

• Enhance model

• Improve efficiencies

• AHP leadership in NHS24

• Tiered Model

• Other agencies

• Community assets

• Physical Activity

Access MSK Advisor

• Complete builds and testing

• Technology solution CHI match and SCI interface

• Implementation Plan

• Financial Evaluation

– Server maintenance, ongoing improvement, savings to HC system, income generation

Partnership

• Primary Care

• Radiology

• Orthopaedics

• ED/Out of Hours

• Pain

• Mental Health

• Vocational Rehab

Research and Innovation

• Data, definitions

• Operational Measures

• Capture personal outcomes, PROM

• Inform developments

• Advanced Practice and Leadership Roles

Workforce

• HEIs

• NES

• Skill Set

• Roles and Competencies

• Capacity

• Component of overall AHP workforce plan

• Matrix to evaluate impact across the whole system

Requirements for Now!

Priorities

• MATS 100% for Scotland

• MSK Advisor

• Testing 1st point of Contact roles in Primary Care

• Prevention and Early Intervention

Requirements

• Engagement, resource to enhance MATS model

• Investment to implement functionality for NHS Scotland

• Robust reporting of learning and impact to inform sustainable model

• Workforce planning tool

• Marketing/Media Campaign/Public Engagement

Risks

• Primary Care: GP Contract

• MSK Advisor: Investment to date, eHealth opportunity

• MATS: AHP Leadership

• Modern Out Patient: Escalating Demand