Connect partnered with Newcastle West Clinical Commissioning Group (NWCCG) and Newcastle upon Tyne Hospitals NHS Foundation Trust
The need for change
In 2008, Connect operated a community MSK Clinical Assessment and Treatment Service (CATs) commissioned by NWCCG, to move MSK into a community setting.
While some GPs used the service extremely effectively, this was not consistent across the board, with many patients being referred to secondary care unnecessarily.
Patients not being differentiated at secondary care meant low conversion rates for surgery, inefficient use of valuable consultant time and unsurprisingly, poor outcomes for patients. The success of the reforms relied on reducing physiotherapy waits considerably to gain the confidence of GPs.
Reforming the pathway – the solution
Working with nine local GP surgeries and a total patient list of over 77,000, NWCCG commissioned Connect to undertake a MSK pilot study for two years in 2011 and 2012. Other than defined exclusions, GPs referred all patients to the community service, leaving the decision to access secondary care to the MSK CATs service itself.
With new physiotherapy services sited in numerous GP practices to improve access and reduce wait times, every referral was coordinated via a specialised ‘call referral management’ centre. This meant patients were dealt with promptly and efficiently.
Telephone triage was introduced so patients could receive immediate guidance from the comfort of their own home. And sports, exercise and orthopaedic specialists were included as part of the clinical team so patients had specialist care in a convenient and accessible location – in the community.
In just six months, the pilot saved the NHS £42,000. Apply this to a typical CCG population of 200,000 and in 12 months, savings could exceed £220,000.
In this pilot we worked with Newcastle West CCG to meet rising service demands, whilst making modest savings. The below results show that effective partnership working can be cost-efficient and produce outstanding results for the NHS.
more patient care in 2012 than 2010, whilst still reducing overall expenditure and waiting times
increase in community physiotherapy referrals
of GPs rated the reformed MSK service ‘better’ or ‘much better’ than 2010
of patients rated the care they received as ‘excellent’ or ‘very good’
was the amount the pilot saved the NHS in six months
“The UK is challenged with a population that is living longer than ever before, resulting in a growing number of people facing muscular and joint pain as their bodies’ age. We must seek new ways of dealing with their musculoskeletal problems quickly and efficiently, in a location close to their home for convenience and provide quality and early care for them. At Connect, we are keen to support the NHS to implement innovative MSK pathway reform.”
Dr Graeme Wilkes, Clinical Lead for Connect and Consultant in Sport and Exercise Medicine