Skip to content

Q logo

Meet the team: #MSKpeersupport


  • Iain Loughran
  • Steve Pett
  • Matt Wynne
  • Michael Butler
  • Lynsey Hetherington
  • Faye Cutler
  • Chris Tarn
  • Fiona Hardie

The problem:

Musculoskeletal conditions affect millions of people in the United Kingdom and are a leading cause of physical pain, psychological suffering, and functional limitations. They create a huge burden for individuals, health services, and economies alike. The majority of treatment is provided in a community setting by physiotherapists and GPs.


The drive to deliver services closer to home has led to a geographical fragmentation of musculoskeletal services and staff. The introduction of specialist musculoskeletal clinics has led to a fragmentation of knowledge and skills, as many experienced staff are no longer based in ‘core’ physiotherapy services.


This has resulted in a dispersion of the knowledge and skill base across each site and service. As an unintended consequence, physiotherapy staff working within these services often feel it is harder to access peer support. This peer support is vital in helping physiotherapists synthesise their learning, critically reflect, and then apply their learning to practice.


Access to a second opinion typically requires a referral to a musculoskeletal service. This adds a delay into the patient journey, increased cost, and reduces continuity of care. Easier access to peer support could reduce the need to refer, increase the quality of required referrals, and improve clinical outcomes.

The Idea:

Physiotherapists treating musculoskeletal conditions face the daily challenge of dealing with patients suffering with up to 200 different conditions. In addition to increased demands on capacity, there has been an increase in the complexity of referrals into ‘core’ physiotherapy and musculoskeletal services


The proposal is to provide a protected space for peer support between physiotherapists in different geographical locations and services that all provide treatment for patients with musculoskeletal conditions. As the staff are currently located across 11 locations and 3 services (physiotherapy, musculoskeletal, and orthopaedics), this peer support would be provided through regular face to face meetings run in the form of an ‘MDT’ or ‘virtual case conference’. They would be ‘chaired’ by a senior clinical member of the services involved and would last 45-60 minutes.


The purpose of the meetings would be to discuss problem (routine) patient cases, to discuss problem patient groups, and to discuss problem professional areas. A range expertise ‘contact’ cards will be also created, to allow the most appropriate signposting outside of the meeting. The discussion and actions will be recorded, along with the overall clinical outcome from cases discussed at the peer support meetings.


These meetings will provide a safe space for case discussion and direct access to peer support. They will help to bridge the gaps that have developed within musculoskeletal services, and will help in supporting staff to improve their clinical reasoning, identify areas for professional development, and improve synthesis of learning and application to practice.

The benefits for Q:

The aim of this project is to improve peer support for staff treating patients with musculoskeletal conditions. The drive to deliver services closer to home spans most traditional community services, and now an increasing number of hospital services. This is likely to lead to similar peer support issues within those services. This project, as a case study and as an emerging model staff peer support, would be beneficial for other Q members facing similar challenges. Materials for the Q website and conferences would help in disseminating the good practice from this project to other Q members and service areas.

How you can contribute

  • Your support for our project (Please add your support via the link)
  • Comments on our proposal
  • Feedback if you have a similar scheme


  1. Guest

    Tracy Hendry 3 years, 2 months ago

    I think any communication and peer support that is protected is vital but across all bands from 4-8 and the ability to pick a choose a range of different clinican's would be beneficial such as a rota system. This would ensure a wide range of discussions regarding different pathways/treatment/conditions from clinicians with different experiences not automatically the closest to your place of work.

  2. Guest

    Amy Coleman 3 years, 2 months ago

    I am a Band 6 Physiotherapist and I would massively appreciate support and supervision from ESPs. As Band 6 Physiotherapists within the core physiotherapy service we provide supervision and support for Band 5s, assistants and student but do not get any formal supervision ourselves. I feel it would be greatly beneficial to all of the Band 6 Physiotherapists to assist our development, clinical reasoning and abilities to support our junior staff more effectively. At present with the ESPs predominantly working in different locations from the core service it is often very difficult to communicate with them and ask for advice without disturbing their clinics, which can then result in potentially unnecessary onward referrals. It is then difficult to get useful feedback after the patient has been referred onwards regarding our clinical decision making for our development. I feel this would have a positive effect in potentially reducing MSK referrals and reducing the number of treatment sessions for patients in core physiotherapy if there is more opportunity to discuss patients with ESPs. It will also assist in improving the development pathway for Band 6 Physiotherapists who wish to progress on the ESP roles. There is a wealth of knowledge within our MSK team which the physiotherapists struggle to access once clinicians move into ESP roles which leaves a lot of pressure on the Band 6 Physiotherapists in core clinics. I feel this peer support project would be greatly beneficial to both services as well as improving patient care in the long term.

  3. Guest

    Gordon Mitchell 3 years, 2 months ago

    This would provide essential bridging of the current skills between physiotherapy and MSK allowing for good communications between departments, development of knowledge and most efficient and effective treatment for patients.

    This would provide essential learning and facilitation for better treatment for our patients.

  4. Guest

    Deborah Ashworth 3 years, 2 months ago

    this will be of valuable as its an area we are currently lacking in. there is a lot of knowledge and experience across the service which can be shared

  5. Guest

    Andrea Meddes 3 years, 2 months ago

    Any peer support is valuable so will be good to be part of a bigger potential structure.

Leave a comment

If you have a Q account please log in before posting your comment.

Read our comments policy before posting your comment.

* required fields

This will not be publicly visible

Please note that you won't be able to edit or delete comments once posted.