New ways to treat those with musculo-skeletal conditions in south Cumbria

A new service for patients referred to the orthopaedic service in south Cumbria – where they see a physiotherapist in newly-designed clinics rather than a consultant surgeon - is being hailed a success.

In the integrated musculo-skeletal (iMSK) service, which is a collaboration of different health providers and commissioners across the area including University Hospitals of Morecambe Bay NHS Foundation Trust (UHMBT) and Cumbria Partnership NHS Foundation Trust (CPFT), clinically triaged patients are reviewed by a community based physiotherapy-led service – and it has resulted in significant reductions in referrals on for review by a surgeon.

Since its launch last December the new service has seen more than 500 new patients in community clinics at Westmorland General Hospital in Kendal and at Dalton, near Barrow-in-Furness, which have resulted in a significant reduction in referrals to an orthopaedic surgeon.

Mr Nigel Courtman, Consultant Orthopaedic surgeon (UHMBT), said: “The iMSK service for patients living in Cumbria has been a long time coming. The concept is not new, and there are many well established services throughout the UK – including a very successful one on our doorstep, based in Heysham.

“Many patients with musculo-skeletal problems do not need to see a hospital doctor (Orthopaedic Surgeon) as their first contact. A large part of their assessment and treatment can be based on physical therapy, and indeed many patients have up until now eventually ended up being treated by a professional allied to medicine rather than requiring an operation. Patients referred into the service are receiving a high quality service delivered by specialist physiotherapists, who are able to diagnose, investigate and treat a multitude of conditions that do not require surgery.

“Patients are being seen in a quicker, timely manner and the feedback we are receiving is excellent. This will also mean that patients who do need to be seen by a hospital specialist will be seen quicker."

“It’s a measure of the success of the service that 41 GP practices across South Cumbria have now referred patients into the iMSK clinics and that the majority of these bookings have been made directly into the clinics using the electronic referral service,” said John Butterworth the manager at UHMBT who has coordinated the arrangements for the new clinics with the partner organisations.

James Geary, Advanced Physiotherapist within the new iMSK service, said: “We have rolled out the service in Dalton and Kendal and that is going to make it possible for patients to be seen a lot closer to home. Because we are a new service the waiting times are a lot shorter.

“Patients are also getting more time with us in the iMSK setting compared to when they see a consultant so potentially we can give them more advice on the complaint they’ve got which goes a long way in helping the patient manage the condition they have got.”

Helen Seward, another Advanced Physiotherapist within the new service, said: “It is a way of offering high quality treatment and assessment services which include further investigations such as MRI and blood tests offered to patients who probably don’t need surgery. Those patients are being managed without having to see an orthopaedic consultant and are still getting the same quality of treatment.”

Iain Quinn, who is also an Advanced Physiotherapist for within the iMSK service, said: “It is a patient-centred service. Patients receive a comprehensive assessment addressing all aspects of their condition and are supported by a range of timely management options including injection therapy.”