Next Steps

The Future State

Ongoing Work

• Datasets and outcomes • IT – SCI referrals to physio, pathway stages

monitoring • Ongoing measure of impact• Spinal Pathway completion in light of the Spinal

Services Review Group report• Link with dimensions of Quality Strategy• Collaboration with National MSK Pathways

Project

NHS SCOTLAND MSK ADVICE AND TRIAGE SERVICE

Non- Emergencyself referrers

GP directed

directed from other sources

Protocol Driven

TRIAGE TOOL

Ability to identify:

non-emergency (non 999, A&E) callers with sprains, strains and pains of joints and

muscles

MEDIUM / HIGH RISK

Referred to local MSK hub for access into local services, plus

www.nhsinform.co.uk/msk

0845 604 0001

Ability to redirect to medical services, if safety issues

Ability to redirect to medical services, if safety issues

WHS REFERRAL

for those in paid employment & absent from work for over 4 weeks (Small-medium org)

WHS REFERRAL

for those in paid employment & absent from work for over 4 weeks (Small-medium org)

Triage Tool•Developed by expert panel•Safe: identifies red flags•Employment: identifies WHS•Includes STaRT MSK tool: stratifies into low, medium and high riskHill et al www.thelancet.com 29/09/11

Triage Tool•Developed by expert panel•Safe: identifies red flags•Employment: identifies WHS•Includes STaRT MSK tool: stratifies into low, medium and high riskHill et al www.thelancet.com 29/09/11

LOW RISK

Enhanced self management resources, web, digital TV & APP

www.nhsinform.co.uk/msk

LOW RISK

Enhanced self management resources, web, digital TV & APP

www.nhsinform.co.uk/msk

The E Clinic – future state

Leadership / Mothership

Orthopaedics – The E Clinic

• Electronic vetting by consultant and ESPs• Streamline the vetting process – right person

first time• Managing urgent and named referrals• Anticipated benefits – reduction in internal

referrals (consultant – consultant + consultant to AHP)

• Pilot of 10 /20/30 min slots – clinic profiles • Future – electronic booking from E clinic

G.P.

e-clinic

Shoulder Knee Hip BackGolden JubileeUrgents

GeneralFoot & Ankle

See & Treat

Appliance/Orthotist

Physio

Back to GP

Return Clinic

# ClinicPodiatry:

•ESP•Biomechanical

•Nail Surgery•Chiropody

ESP:•General

•Knee•Shoulder

CarpalTunnel +/- Diagnostic

Teething Issues

Teething Issues

• Timing – large number of referrals pan Lanarkshire

• Time – checking carestream etc• Difficulties of managing allocation to surgeons

(specialism)• Communication

• It’s a learning curve !!

18 weeks RTT Workbench

• Orthopaedic pathways built on trakcare

• Each stage of patients journey identified and times applied

• Plan in place to role out access across NHSL

Prospective monitoring at a patient level !

To boldly go………..