We have started work to transform our musculoskeletal (MSK) services in Shropshire, Telford and Wrekin (STW) to improve the service for our patients and staff. Our ambition is to strengthen our community provision over the next five years to improve the care that people receive.
Our community MSK services include a range of specialisms and departments which are delivered by a number of providers with different referral routes, care pathways and operational practices. This has led to patients and clinicians often feeling frustrated by the time it takes for patient information to be passed from one service to another, resulting in delays to care and treatment.
By enabling our highly skilled teams across these services to work more closely and share patient information easily through a more joined up MSK model, we can remove these barriers and ensure people can access and move through and between our MSK services more smoothly. This will also include closer working with our mental health teams.
The MSK programme of transformation is about making the referral process simpler, ensuring patients are seen by the most appropriate clinician, and reducing waiting times.
We will put in place a Referral Centre which will be the point of access for all referrals and general enquiries across the county, providing people with a choice of different ways to get in touch, including phone and email.
People will then be triaged by a team of specialists, meaning they will assessed, diagnosed and signposted to the most appropriate treatment, within a set time.
Having one single point of referral will enable us to log all referrals in one place so that we have oversight of all our patients to ensure that everyone has equal access to the same high level of clinical care and treatment they need wherever they live in the county.
The care that people will receive will be organised through shared decision making and patient choice. They will receive tailored support to manage their own conditions through self-care with access to advice and therapies and we will reduce or prevent people’s need for surgery with earlier therapy intervention.
As part of this work, we will strengthen our rheumatology service. We are building on the best practice across our service and identifying areas of inequality to improve the way the service runs and making improvements to our Rheumatology Helpline.
The future service will make better use of digital solutions. We will maintain the transformational change and service improvements that have been realised in the response to the pandemic such as remote working and telephone and video-consultations, and continue to provide face to face consultations when needed. The new model will also increase the use of technology in people’s care and improve access to people’s clinical records for staff working within the service.
We are not proposing to reduce services nor limit the treatment options that are currently provided.
The transformation will be delivered in three phases over the coming years in partnership with people who use the services, our staff and stakeholders.
Starting with phase 1, we will be testing a new model of care which places greater emphasis on earlier therapy intervention to reduce or prevent the need for surgery.
Phase 1 (Year 1)
- We are working as a system to develop a more joined up model for our community MSK services in order to improve patient experience, outcomes and service quality. This will include therapies, rheumatology, pain services and involving closer working with our mental health teams.
- We will introduce a Referral Centre which will be the point of access for all referrals and general enquiries across the county, providing people with a choice of different ways to get in touch, including phone and email. This will provide a clear entry route into the service where a team of specialists will assess and diagnose every patient so that they are signposted to the most appropriate treatment, when it’s needed, to reduce waiting times for first appointments.
- Patients will be better supported to manage their own conditions through access to advice and therapies and we will reduce or prevent people’s need for surgery with earlier therapy intervention.
- All our staff will have access to a virtual MSK multi-disciplinary team to provide advice and mentoring so that they can support patients living with MSK conditions with the most appropriate care and information.
- We will strengthen our rheumatology service. We are building on the best practice across our service and identifying areas of inequality to improve the way the service runs and making improvements to our rheumatology helpline.
- The future service will make better use of digital solutions.
Phase 2 (Year 2 to 3)
- Enhance our orthopaedics services
- An outpatients improvement project
- Strengthen the support available for Primary Care
- Potential work to focus on falls, fractures and osteoporosis
Phase 3 (Year 4 to 5)
- A focus on the support for people with long term MSK conditions
- Develop self-management models