The Bedfordshire MSK Service, part of Circle Integrated Care, is a single point of access for musculoskeletal conditions.

All patients over 18 years old with an MSK condition registered with a Bedfordshire GP should be sent to the Circle Hub for triage (preferably via E-Referral).

Referrals will be triaged by specialist MSK Extended Scope Physiotherapists to the most appropriate treatment pathway and patients will be offered a choice of provider, where available. Patients will be monitored and supported across their pathway.

Clinical triage will be performed within 24 hours. If referrals have insufficient information, Circle staff will contact the practice to request additional information.

How do I refer patients to the service?

The preferred method of referral is to E-refer. This is a more secure referral method and ensures we have quick and easy access to all patient information. However, other methods are referral are through:

Email: msk.bedfordshire@nhs.net

Post:
The Enhanced Services Centre
3 Kimbolton Road
Bedford
Bedfordshire
MK40 2NT

What specialties should be referred to the MSK service?

The following specialties are covered by the MSK service:

  • Orthopaedics
  • Pain management
  • Physiotherapy
  • Rheumatology
  • Podiatry (MSK)
  • Podiatric surgery
What are the potential pathways within the MSK service?

Patients will be triaged to either:

  • Physioline. Patients will have the opportunity to speak with a physiotherapist who can assess their condition over the phone and can suggest exercises and other management techniques with reference to leaflets and online video demonstrations. If, after assessment, the problem is more complex, face-to-face physiotherapy will be arranged.
  • Physiotherapy. Patients will be referred for face-to-face physiotherapy.
  • Community MSK. Patients will be assigned to either an ESP or a GP with a Special Interest in MSK medicine, for a detailed assessment and work-up.
  • Secondary Care. Our Patient Choice team will offer patients a choice of provider, and our Shared Decision Making team will contact patients with certain conditions such as hip and knee osteoarthritis to discuss treatment options.
What happens when patients leave the service?

When a patient has completed their course of treatment, the Bedford MSK Service will discharge the patient back their GP with a clear discharge plan.

Should a patient’s condition require further treatment, and/or onward referral to another allied service, this will be arranged through the Circle MSK hub, and should not require further input from the patient’s GP.

If a patient did not attend (DNA) a hospital MSK appointment for whatever reason, will we have to send through the MSK service again rather than re-referring? Or can they phone the MSK service to reorganise?

If a patient has DNA-ed a hospital attendance, Circle will accept a direct contact at the Integrated Provider Hub from the patient so they can establish if their condition has changed and if the same pathway is still appropriate or if a new or different service is available, and to book them an appointment. The patient will also be able to access the service via the self-referral route.

A patient wants to go to a specific hospital for a certain condition. How does the patient exercise choice?

The Circle Bedford MSK team will advise the patient on their choice of provider.

If a patient has a particular preference for a hospital, the choice team will discuss this with them and arrange onward referral. Once it has been agreed with the patient they will be referred to secondary care a conversation with a choice adviser will be arranged.

Section

Will the service support GPs?

Yes. The service is designed to support GPs and create integrated working. Initiatives include:

    • MSK Practitioners (First Contact Practitioners). Experienced physiotherapists will be offered to provide front-line clinics, free of charge, in GP surgeries. They will work side-by-side with GPs by assessing and treating, or triaging to further MSK services, at the first point of contact.
    • Continuous Professional Learning. Circle will provide education and training opportunities on MSK conditions, based on specific conditions, diagnostic methods and examination techniques. Further information can be seen below.
    • Clinical Steering Group. GPs, Consultants, Physiotherapists and other MSK professionals will have the opportunity to meet and discuss pathways and ways to improve the service.

Educational events

Circle are running education events for GPs and clinicians who would like to learn more about a range of MSK conditions.

Circle’s next event is on Saturday 30th March 2019 at the Rufus Centre in Flitwick and will be a focus on Pain. An email invite will be circulated to all practices in the near future.

If you would like more information, please contact us at bedfordmskevents@circlehealth.co.uk

Clinical Steering Group

This is an evening for clinicians with an interest in MSK to meet and discuss pathways and ways to improve the service.

If you would like to attend, please contact us at bedfordmskevents@circlehealth.co.uk.

You can also send issues or topics you would like to be addressed at these meetings.

Clinical Steering Group meetings are held every other month and are located at Flitwick Manor, Church Road, Flitwick, MK45 1AE – 0330 028 3406.

The dates for 2019 are as follows:

  • Thursday 31/01/2019
  • Thursday 21/03/2019
  • Thursday 30/05/2019
  • Thursday 25/07/2019
  • Thursday 26/09/2019
  • Thursday 28/11/2019

If you have any questions, please contact our team on 01234 3690002 or by email at msk.bedfordshire@nhs.net for general queries or circle.mskgpqueries@nhs.net for clinical queries