Health services. The Integrated Community MSK Service will treat patients with a range of MSK conditions including their feet serving as an alternative to hospital treatment for the majority of patients. Patients will be referred to secondary care only when there is a need for such services.

Aims of the Service:

— Provide a comprehensive service offering patient choice, improvement in quality of life and individual client centred treatment,

— Flexible and responsive service,

— Maximise integration delivering excellent patient experience, avoid duplication and achieve good clinical outcomes,

— Reduce waiting times,

— Increase access,

— Provide value for money,

— Reduce GP referrals to outpatients in orthopaedics, rheumatology and pain management.

Key Objectives:

— Ensure that patients,

— Can be managed within the capacity and capability of 1 integrated service,

— Are supported to self-manage,

— Receive access to high-quality interventions,

— Stakeholders are satisfied with the service and kept well informed and involved in their care,

— Increase conversion rates from outpatient attendances to surgery,

— Achieve reduction of orthopaedic, rheumatology and pain management referrals to acute hospitals,

— Enable GPs to use the service as alternative to secondary care,

— Work with GPs to increase their knowledge and confidence of diagnosis and management of MSK conditions and improve outcomes for patients.

Key Stages of the MSK Service:

— Seamless care pathways,

— Shared decision making,

— Prevention, support for self-care and advice to patients, carers and professionals,

— Physioline,

— Clinical assessment including screening for serious conditions and pathology indicators,

— Treatment including medicines management,

— Shared management with the patient's GP,

— Management and prevention of MSK complex/chronic pain,

— Onward referral as appropriate for surgical interventions.

The contract has a set of health outcomes and improvements built in as deliverables, including:

— Increase the percentage of patients, completing treatment, reporting high levels of patient satisfaction,

— High number of patients reporting they feel confident to self-manage their condition,

— Provision of patient, carer and referrer education,

— Reduce waiting times for patients with MSK conditions,

— Transfer activity from an acute setting to the community,

— Improve the clinical pathway by developing joint working between primary and secondary care providers,

— Increase the management of patients in primary care without the need for referral,

— Reduce health inequalities by improving access,

— Seek and act on the views of patients in planning change to the service,

— Minimise the number of patients presenting at GP Practices with MSK chronic pain,

— Provide services convenient to the needs of patients,

— Improve patient experience,

— Demonstrate increasing conversion rates for surgery (for referrals from the service to secondary care).