1. MSK pathway What is the MSK service? This is a multi- professional screening, assessment and treatment service. It has been set up by the RSCH together with the Guildford & Waverley CCG and is made up of members of the Rheumatology, Pain and Orthopaedic teams. These could be an Extended Scope Practitioner Physiotherapist (ESP), Consultant, Clinical Nurse Specialist (CNS), Clinical Specialist Physiotherapist or a GP with a specialist interest (GPwSi). How do I refer? Patients should be referred to the service via the RSS The service aims to provide the most effective and prompt management of a patient’s condition with the most appropriate person and clinical service. This may include x-ray / MRI/ ultrasound/ NCS and treatment/ interventions. Clinics are run at The RSCH or neighbouring community hospital Referrals are screened by a member of the MSK team within 48 working hours (Monday - Friday) of receiving the referral and directed to the most appropriate service. The patient then receives a letter informing them of the next steps; this could be an assessment by an ESP (within 4 weeks of initial screening), a referral for a diagnostic investigations or an onward referral to another service such as Physiotherapy. In some cases a patient will receive an appointment with a Consultant. The service has been set up in a staggered rollout. Lower limb and foot and ankle clinics will be the final clinics set up and will be running from 1 st September. 1 st June 2014 saw the launch of the new Musculoskeletal (MSK) service. Patients with MSK problems who would normally be referred routinely to Pain, Rheumatology or Orthopaedics can now be referred to the MSK service at the Royal Surrey County Hospital via the RSS. What the patients think of the service……. 100% of patients strongly agreed that the clinician they saw treated them with dignity and respect and gave them a clear explanation of their condition and treatment planned. 100% of patients rated the quality of care they had received as excellent/ good 97% of patients would recommend the service to family and friends Excellent interview Exclusion criteria: Paediatrics, TWR, trauma, post –op, patients with red-flags. Audit of the data so far shows the desired outcomes have been met: Overall 73% of referrals are being triaged to ESP clinics and 25% are being triaged to Consultants. Overall 69% of patients are discharged from the pathway after their first appointment “The MSK pathway is an efficient way of appropriately managing patients. The service has been set as a collaboration between the Orthopaedic Consultants and Physiotherapy. The Consultants have established links with the highly experienced ESP’s and are involved in training and the development of triage criteria, all ensuring high levels of governance. Results show very high success in appropriately triaging patients ‘, with negligible numbers referred on from the face to face ESP clinics. In addition there has been a high level of patient satisfaction reported. We anticipate this will have a positive impact on the 18 week pathway” Mr Bradley, Consultant Orthopaedic Surgeon