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

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Joint effects 2011 Podiatry Service Helen Jackson helen.jackson@aapct.scot.nhs.uk MSK Podiatry Service accepts self referrals, GP, physio, consultant and other AHP referrals. A team of specialists provide assessment, diagnosis and treatment for children and adults presenting with MSK conditions. Three team members carry out foot and ankle steroid injections and a further three staff input to the multidisciplinary inflammatory joint disease clinics. Special provision is made for diabetic patients who require ‘off-loading’ bespoke devices. Functional orthoses, both bespoke and off the shelf, are provided by clinicians with technical support. A foot and ankle MSK pathway is currently being developed which it is hoped will improve access to imaging, bloods and orthopaedics. Outcome measures: audit, VAS. Plan to start using the Manchester and Oxford foot pain scale. Service Redesign in Orthotics Colin Keith colin.keith@aapct.scot.nhs.uk NHS Borders Musculoskeletal Physiotherapy in 13 locations Maggie Stobie and May Sharp maggie.stobie@borders.scot.nhs.uk may.sharp@borders.scot.nhs.uk 01896 826545 Orthotics provide services across Ayrshire but currently can only be accessed through Orthopaedics. Referral pathways to Orthotics are being reviewed as part of the MSK redesign to allow direct access for GPs and other AHPs and an email triage system set up. Over 60% of the service caseload involves treatment of foot and ankle conditions. Joint working with Podiatry in treatment of diabetic and rheumatoid conditions has been established together with ongoing clinics in Paediatrics and LDS with Physiotherapy. Physiotherapy is delivered at 13 locations and all accept self referral. The orthopaedic ESP includes a multidisciplinary team providing effective assessment of the routine orthopaedic out-patient waiting list at the Borders General Hospital and creates effective management of non-surgical cases. The patient pathway through triage has run since 2008 with future plans to introduce the service into primary care settings. The Physiotherapy Spinal Service has implemented evidence-based guidelines for both primary and secondary care. They treat and manage complex spinal patients and those triaged from the orthopaedic waiting list. The recently launched hip and knee school is part of the enhanced recovery programme, set up to reduce patient length of stay in hospital. Patients are seen before their operation for an hour-long education and exercise class, the classes are run jointly with occupational therapy, enabling home requirements to be assessed and relevant equipment delivered prior to their operation. 22 mskscoping2011-rs.indd 22 03/11/2011 11:01
Joint effects 2011 Musculoskeletal Physiotherapy in 13 locations Continued Podiatry Service Pamela Gordon pamela.gordon@borders.scot.nhs.net NHS Dumfries and Galloway Back Pain Service Ann Grant ann.grant@nhs.net Other services include dedicated physiotherapy time for MSK referrals from the Occupational Health Service and a multidisciplinary Rheumatology team working across primary and secondary care. MSK patients also have access to hydrotherapy. The chronic pain management team includes OT and Physiotherapy working on assessment and management of patients including education and self-management programmes. The Podiatry Service aims to deliver care to patients as near to their home as possible through basing staff in local health centres and all accept self referral. NHS Borders covers a large geographical area and provides a range of primary and secondary care and mental health services to a population of 107,000. The rurality of the area and the dispersed nature of the population are key issues in the delivery of healthcare. There is an MSK podiatry service and orthopaedic triage service based at Borders General Hospital five days per week. This service sees patients on referral from GPs, consultants and other healthcare professionals. The service was implemented to triage all patients referred to Orthopaedics with neck, thoracic and low back pain, directing them for appropriate treatment and investigations and providing GPs with options for future management of symptoms. The team is also working with Pain Association Scotland to establish a service for those with chronic pain. A knee pathway is under development. Improvements: reduction in requests for MRI for back problems and those referred for surgical intervention. Outcome measures: Oswestry Disability Index,VAS HAD scores and self-efficacy questionnaire, DAPOS. Dumfries and Galloway Royal Infirmary Physiotherapy Department Sheryl Reason sherylreason@nhs.net Assessment and treatment of all out-patients with orthopaedic pre- and post-operative conditions. Patients are referred via consultants, GPs or through self referral. Rheumatology conditions are assessed and treated in a one-stop multidisciplinary clinic. A joint podiatry and physiotherapy clinic is held for those with biomechanical problems. MSK rehabilitation is carried out in a gym setting. 23 mskscoping2011-rs.indd 23 03/11/2011 11:01
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