Charting the way forward

Connect Health launches ground-breaking new tool for COVID-19 musculoskeletal risk stratification

1 October 2020

C-CHART (COVID-19 Connect Health Assessment of Risk Tool) introduced to support MSK clinicians make the right decisions in managing patient care whilst services are restricted

A new risk assessment tool which supports MSK clinicians in making difficult decisions in weighing up COVID-19 risk with clinical need, has been rolled out nationwide* and published in the BMJ Open Sport & Exercise Medicine. The journal, which has a strong MSK readership worldwide, published C-CHART, detailing how the ‘tool can serve to improve the consistency of clinical decision-making during restitution of face-to-face MSK services in England’.

As the pandemic caused clinicians to switch from face-to-face musculoskeletal (MSK) care to providing telephone or video consultations almost overnight, Connect Health, the UK’s leading independent community provider of musculoskeletal services (including physiotherapy, orthopaedics, pain, and rheumatology services), initially designed C-CHART to guide their own MSK clinicians to balance the health needs of patients whilst prioritising patient safety during the protracted COVID-19 outbreak.

*The tool is no longer available for download for use in the NHS

To provide feedback and for more info please email

  • The tool does not replace clinical reasoning, assessment and judgement nor does it consider patients presenting with red flags or emergencies or collect any personal identifiable data from individuals.
  • Manuscript bmjsem-2020-000916.R1 – A musculoskeletal risk stratification tool to inform a discussion about face-to-face assessment during the COVID-19 pandemic

Authors of C-CHART:

Andrea Ravindra currently works as an Advanced Physiotherapy Practitioner in Croydon, having previously worked in a leadership role for Connect Health. She completed postgraduate studies in Advanced Neuromusculoskeletal Physiotherapy at King’s College London in 2018.  She is a member of the Musculoskeletal Association of Chartered Physiotherapists and remains involved in research projects external to Connect.


Andrew Cuff BSc (Hons) MSc MCSP, Consultant Physiotherapist & Clinical Lead, Connect Health – Andrew was appointed Consultant Physiotherapist for the North in October 2019. Over the last two years Andrew has held the positions of Developing Consultant Physiotherapist and Clinical Lead for our Wakefield MSK Service and North Kirklees Integrated MSK and Pain Service. Alongside this role he also holds the national position as Upper Limb Subject Matter Expert for the organisation. Prior to joining Connect Health in April 2017, he worked as an Advanced Physiotherapy Practitioner also in the NHS. Whilst a committed clinician, Andrew is also known as an active researcher, having published widely on MSK disorders and is currently studying for a PhD at Keele University with a supervision team involving Dr Chris Littlewood and Professor Nadine Foster. Since 2017, Andrew has sat on the Education Committee for the European Society of Shoulder and Elbow Rehabilitation (EUSSER). Since 2017, Andrew has sat on the Education Committee for the European Society of Shoulder and Elbow Rehabilitation (EUSSER) and has recently been invited to join the board as the Chair for International Links and Communication.


Dr Marwan Al-Dawoud, Director of Clinical Delivery, Connect Health – Marwan joined Connect Health in 2016 as a Sport and Exercise Medicine Physician working as a clinician in the Yorkshire region. He is now the Director of Clinical Delivery and is responsible for the clinical side of the business. He qualified from the University of Manchester Medical School and has subsequently trained in General Practice as well as taking higher-level studies in Sport and Exercise Medicine. He has worked in elite sport since 2007 in the Rugby League Super League, Premiership Rugby Union, Premiership Football, UK Athletics and Ballet. Marwan brings extensive clinical experience from a diverse range of environments coupled with medical leadership and innovation.