The TUPE transfer of clinical staff from the previous MSK provider Healthshare left us with a vacancy rate of 45% compared to the staffing model required to deliver the service (n=24 vacancies). Through intensive early recruitment we have added 23 clinicians with staggered start-dates up until early January 2023 date which will make the service 95% staffed versus model. Locums are currently being used to backfill whilst we await the start dates of some of our new recruits, and further recruitment is ongoing.
VIRTUAL AND IN-PERSON CARE
We are significantly increasing the proportion of appointments that are delivered in-person to align with patient choice and clinical appropriateness. All clinical sites (see below) are operational and seeing a regular throughput of patients following induction week. Virtual appointments will continue to form part of the service offering where applicable (and desired by the patient) which can offer quicker access to initial assessment ensuring patients are accessing the most appropriate service arm.
The service accepts self-referral. This should be via the button on our website here or by calling 01865 634336.
We currently have x10 live clinic venue locations incl. new sites in Banbury and Abingdon. Leisure centres and other community venues are expected to be added early in the new year to offer a greater geographical spread and to support the roll-out of gym-based and group rehab elements of the service model.
TRANSFER OF PATIENT RECORDS
Approx. 20,000 patient records have now been transferred from Healthshare. All of those transferred pre go-live and the majority of those received since then have been successfully registered and are being contacted and seen on a chronological and clinical need basis. Of those still being processed, we have been advised that most are ‘open access’, meaning they are not expected to be actively receiving care. We anticipate all remaining active records will be successfully registered before the end of this month.
LUMPS & BUMPS
Please note that the investigation of undiagnosed lumps and bumps does not sit within the scope of the community MSK service and referrals of this nature are being rejected. Where clinical diagnosis of a ganglion/cyst is made, then please undertake a SDM discussion in primary care and if compliant with prior approval policy and considering removal/aspiration refer to orthopaedics, via community MSK. All other types of non-MSK lumps and bumps should not be directed through the MSK service.
As per the NICE guidance you will have an option of either accessing the 2ww pathway or arranging a local ultrasound through radiology unit, if suspecting or wanting to rule out cancer. If local Radiology does not accept, then you must refer via 2ww pathway if you still have concerns of cancer.
HISTORY OF CANCER
Please be reminded that the ‘Personal history of cancer’ section on the referral form provides information essential for the clinical reasoning of triaging clinicians and should always be completed. Failure to do so is likely to cause a delay in care whilst this information is checked.
Intra-articular injections of the hip are not available via the community MSK service for reasons of patient safety (infection control) and efficacy. If, after community MSK assessment, this were being considered, then the patient will be referred to the orthopaedic department to consider this. In order to have an informed shared decision discussion regarding the alternatives, it can be necessary to consider the orthopaedic implications for this procedure in contrast to considering an arthroplasty.