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

Joint effects 2011
The National Musculoskeletal Redesign Programme
2010 – 2013: Allied Health Professional involvement
The need for redesign was signalled within the Delivery framework for adult
rehabilitation published in 2007. The framework identified that considerable
improvements could be made for patients in both their outcome and experience of
Scotland’s MSK services. In particular by:
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improving access to services
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providing consistent and high quality information about their condition
as early as possible
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providing information and advice to support self-management
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shortening waiting times
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adopting evidence-based treatment plans
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enabling people to stay in or return to work
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ensuring an equal, high quality of care across Scotland
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achieving sustainability and efficiencies to reinvest in better MSK services.
There are three key work areas:
1 Multi-professional MSK care pathways
2 A pilot using NHS 24 telephony to provide a National Advice and Triage Service to
signpost to information and local MSK services.
3 Embedding Working Health Services Scotland in all MSK pathways
Multi-professional MSK care pathways
AHPs within health boards across Scotland are working as part of multidisciplinary
teams, developing and introducing a range of MSK care pathways.
This MSK scoping exercise demonstrates a lot of ‘pathway activity’. More is planned.
Business redesign approaches are being used to modernise services and ensure
patients have access to high quality, consistent information about their condition as
soon as possible.
Pathfinder Boards have focused on pathways that are based around the highest
patient activity, i.e. low back pain, hip and knee problems. They have adopted a
multidisciplinary approach and take a ‘patient-eye view’ of the existing service on
offer, asking the question “why” at each step of the patient journey.
The aim is to reduce duplication and take steps out, so people can access the most
appropriate healthcare option quickly, easily and safely.
There are many more AHPs practicing in new ways, e.g. referring patients for, and
acting on, diagnostic tests, prescribing medication and undertaking injections avoiding
the need for another GP referral. The MSK pathway programme is being supported
by dedicated project management support with training for new roles and advanced
practice provided through NHS Education for Scotland (NES).
The National Advice and Triage Service
NHS 24 is leading on the development of the national point of access to MSK services
using their established telephony platform. The NHS 24 pilot will go live in two early
adopter sites between December and January. The project will be evaluated and is due
to report in early Summer 2012.
The service will operate Monday to Friday, 9.00 am to 8.00 pm. Patients and those
wanting access to advice and information will be encouraged to call a national
number. The first person a caller will talk to will be a call operator. They will be taken
through a series of questions about their MSK problem, covering demographic details,
key safety and problem-specific questions, risk indicators and employment. Call
operators follow protocols developed by MSK experts, have extensive training and
clinical supervision on hand at all times.
The protocol has been developed and endorsed by a national expert panel including
service users and is based on the NHS 24 operating model where patient safety
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