The Northamptonshire Referral Management 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 Northamptonshire GP should be sent to the Circle Hub for triage (preferably via E-Referrals).

Referrals will be triaged by specialist MSK Extended Scope Physiotherapists to the most appropriate treatment modality 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 detail.

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 of referral are through:


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

What conditions are treated?

Circle triages all patients over 18 years old with an MSK condition. We offer a variety of treatments and many of our patients are referred onto local MSK services.

Areas covered under the MSK service:

  • Orthopaedics
  • Pain management
  • Rheumatology
What treatment will patients receive?

Patients will be triaged to either:

  • Patients will be referred for face-to-face physiotherapy.
  • Community MSK. Patients will be referred to an ESP for a detailed assessment and work-up.
  • Secondary Care. Our Patient Choice team will offer patients a choice of provider
A patient wants to go to a specific hospital for a certain condition, how does the patient exercise choice?

All referrals should now be made to the Circle Northamptonshire MSK service. The patient will still have the same rights to choose a hospital as is currently the case. The Circle Northamptonshire MSK team can advise the patient on their choice.

If a patient has a particular preference for a hospital, the Hub choice team will discuss this with them and arrange onward referral where the clinical intervention warrants a specialist referral to that provider.

Will the service support GPs?

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

    • MSK Practitioners. Experienced physiotherapists will be offered to provide front-line clinics, free of charge, in GP surgeries. The idea is that they will work side-by-side with GPs to support with the numbers of MSK patients, 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.
    • Clinical Steering Group. GPs, Consultants, Physiotherapists and other MSK professionals will have the opportunity to meet and review cases and develop pathways to improve patient care.

If you have any questions, please contact our team on 01604 340 350 or by email at

Useful MSK related links

Document Published Web link Description
Spinal GIRFT January 2019 This document looks at evidence based commissioning for spinal services and forms the basis for our referral pathways for spinal conditions
Evidence Based Interventions Consultation Document July 2018 Provides a guideline to evidence based management of a number of commonly commissioned procedures including knee arthroscopy, injections for back pain, shoulder arthroscopy and a variety of hand clinicians
Musculoskeletal Conditions Update on MKS conditions with a link to Arthritis and MSK Alliance (ARMA)
Everybody active every day October 2014  Update on MSK conditions with a link to Arthritis and MSK Alliance (ARMA)