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What is the challenge your project is going to address and how does it connect to your chosen theme?

Building improvement capability across boundaries

  • Ultimately, the patient will receive the most appropriate care for their musculoskeletal condition and symptoms ensuring their personal well-being and a fit and healthy workforce. There could be in-built decision support in Primary and Community care with good access to published NICE guidance and condition specific infographics, validated outcome measures and patient information.  There would be better governance around shared decision making with the patient, with an improved awareness of when (and when not) to refer for further management or investigations.
  • This should ensure that the patients get faster access to the most appropriate care, with overall  improved efficacy of resources as they move between Clinician’s and Services.

What does your project aim to achieve?

For Patients…

Being referred appropriately. Either to the correct specialty or for the correct test. We’d aim to reduce unnecessary referrals by including decision support for clinicians which includes first line management strategies and links to Third Sector charities, Social Enterprises or Voluntary Organisations.

For clinicians…

Seamless patient care with decision support and documented web based clinical pathways which integrate with EMIS. To start, these can be shared within our Integrated MSK service and sent to GP practices / ( new) Primary Care Networks but the potential could be that these are widely accessible online. We’d hope to improve the quality of referrals / triage outcome. By increasing the number of high quality and detailed referrals into the service, we’d hope to maintain a better balance of capacity and demand whilst keeping waiting times to a minimum. Inappropriate referral numbers should decline.

How will the project be delivered?

Joint enterprise with senior clinical MSK staff, with GP / CCG engagement and IT support.  We’d use a tried and tested software company with proven NHS track record which integrates with EMIS.

The software has the capability for good quality data outcomes in order to monitor efficacy and uptake

What and how is your project going to share learning throughout?

This pilot scheme will be designed to be scale-able. Either across the ELHT Trust division, ELHT Trust, wider Primary Care Networks or larger scale geographical locations.

How you can contribute

  • If successful, I intend to fully scout for support from the Q network

Plan timeline

30 Sep 2019 meet with the software company. Engage stakeholders
31 Oct 2019 obtain updated clinical pathways from Senior MSK clinicians
5 Nov 2019 Start testing, determine auditable outcomes
5 Nov 2019 build the pathways into the software.
2 Dec 2019 tweak / amend and roll out to clinical team to trial
2 Mar 2020 Provisional 90 day data analysis and reflection
6 Apr 2020 Review with key stakeholders. Discuss future strategy


  1. Hi Louise,

    I am really interested to hear more about your pathway ideas. Will they have a 3rd sector element too (thinking here about the role of leisure centres for example which I know some parts of the UK are starting to link in via Escape Pain type services for MSK).

    Best wishes


    1. Hi Anna


      Yes, Without doubt we'd want to incorporate the third sector. We already run an Escape Pain program at ELHT alongside our colleagues in public health. I might like to explore the signposting to Charities too, for example Macmillan.

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