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………..
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