Joint effects 2011 - An update of the involvement - 18 Weeks

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Joint effects 2011 Service descriptions NHS Ayrshire and Arran AHP Board Lead on MSK Redesign Judith Reid judith.reid@aapct.scot.nhs.uk AHP Electronic Diary Management Billy McClean billy.mcclean@nhs.net 01563 827197 AHP Low Back Pain Pathway Judith Reid judith.reid@aapct.scot.nhs.uk AHP Orthopaedic Services Carol Kirk carol.kirk@aaaht.scot.nhs.uk 01563 827126 The MSK redesign board was established in October 2010. Phase 1, low back pain pathway was successfully implemented in April 2011, with hand pathway going live in November 2011 and other pathways (hip, knee, shoulder and foot/ankle) through 2012. In line with the quality strategy, several measures will capture effectiveness, safety and patient centredness. EQ5D5L is being used as a continuous measure for all MSK conditions. The STarT tools help inform the management approach, with other measures, e.g. HADS, informing exit routes. Survey and focus group evaluation of both staff and patient perception is in place with snapshot evaluation using CARE measure. Project documents are available. Centralised management of MS Outlook diaries has been introduced across Physiotherapy as a stepping stone to a bespoke electronic patient management system. This has improved efficiency and productivity with a reduction of unfilled slots and reduction in assistant and clinical time used to manage diaries across peripheral sites. Trackcare PMS will be used to manage diaries centrally across AHP MSK services once the redesign is complete and IT solutions have been implemented. The low back pain pathway was implemented in April 2011 as the first pathway within the overarching MSK redesign in line with the Government vision. GPs refer electronically through a single point of contact to access community-based AHP services. A robust process of escalation utilises community-based MSK ESPs (who also work in orthopaedics) to access diagnostic investigations and refer directly to secondary care as required. OT and Physiotherapy provide services to those undergoing elective and trauma orthopaedic surgery. Elective THJR patients have a pre-admission visit by the orthopaedic TI and are reviewed by the TI on the ward post surgery. TKJR patients attend a pre-op joint school (Crosshouse only) as part of the Rapid Recovery Programme. The MDT ensure timely and safe discharge home. Outreach domiciliary visits are carried out where necessary. An OA knee pathway delivers OT and physiotherapy rehabilitation to avoid surgical intervention. These services will be reviewed as part of the MSK redesign. 20 mskscoping2011-rs.indd 20 03/11/2011 11:01
Joint effects 2011 AHP Pain Services Arlene Sloan arlene.Sloan@aapct.scot.nhs.uk Counterweight Programme Carolyn Paton carolyn.paton@aapct.scot.nhs.uk Occupational Therapy Hand Service Gillian Cowan gillian.cowan@aaaht.scot.nhs.uk 01563 827126 Physiotherapy Service Billy McClean billy.mcclean@nhs.net 01563 827197 Chronic Pain services across Ayrshire are managed through anaesthetics. An MCN is being established as part of the MSK redesign. Work has begun on development of a physiotherapyled Level 1 pain management programme. An initial programme of staff education is underway with delivery of service scheduled from April 2012. Collaborative working with Working Health Services, Mental Health and Leisure Services is ongoing and will further enhance management options. Dietetics provide support, education and advice to patients and clinicians through the Ayrshire wide Counterweight programme. The programme provides weight-loss support and nutritional advice to those who are overweight. This approach is embedded within the OA knee and spinal pathways and will be extended as part of the MSK redesign. Hand therapy (Crosshouse only) is provided to in/out-patients following trauma/elective surgery. An Extended Role Hand Clinic is held by the Senior Occupational Therapist to review patients post operatively. Hand therapy is also provided one evening per week. OT also provides a service for Rheumatology patients at Ayr & Crosshouse and attend a ‘one stop’ Multidisciplinary Inflammatory Joint Disease Clinic held at Heathfield Clinic and Ayrshire Central Hospital. Physiotherapy services across primary and secondary care, with specialist services in rheumatology, hands, hydrotherapy and extended scope roles in orthopaedics. Referral systems in place from physiotherapy to orthopaedic services. Injection therapy provided throughout the physiotherapy service and combined clinics (ESP’s and clinical specialists) enabling further investigation as required. Core contributor to low back pain pathway. 21 mskscoping2011-rs.indd 21 03/11/2011 11:01
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