NHS NORTH KIRKLEES CLINICAL COMMISSIONING GROUP - MUSCULOSKELETAL SERVICE

North Kirklees CCG is looking for a provider to set up and manage an MSK hub, acting as a single point of access for referral support, guidance and advice and access point for treatment after clinical assessment.

The service will provide MSK orthopaedic triage (examination, assessment, diagnosis and treatment) and MSK physiotherapy services for patients aged 18 years or over who have pain or other symptoms, restricted movement or reduced function from an MSK, Orthopaedic or related symptom, set of symptoms, condition or illness.

In addition, the service will through a hub approach provide advice, guidance and referral for minor hand surgery as well as direct listing with secondary care for primary replacement surgery after satisfactory assessments and diagnostics have been undertaken.

The scope of the service includes; • MSK community physiotherapy – although the assessment functions could be provided in a central location within the CCG, member practices are keen to explore cluster/neighbourhood access to the provision of physiotherapy for treatment. • MSK & Orthopaedic Triage Assessment for primary joint replacement assessment - effectively replacing the need for direct access orthopaedic opinion within secondary care by undertaking the appropriate assessments and diagnostics to support the direct listing of patients with secondary care providers via Choice. • Deliver all services within the agreed clinical thresholds resulting in less utilisation of secondary care or improving the conversion rates for surgery by appropriate assessment and threshold management. • Work in conjunction with the current Tier 2 Pain services provider to ensure holistic pain assessment and treatment service is in place across the care pathway to reduce pain perception and reduce the associated drug/medicines management spend.

Particular emphasis should be made to assessing benefits from earlier intervention for pain services. • To provide minor hand surgery or source alternative arrangements for minor hand surgery and nerve conduction studies. • This list is not exhaustive, it is expected that the provider will manage all MSK related conditions in the remit of the service specification. • The provider will support the local approach to Clinical Threshold Management (CTM) by actively engaging in local pathway development and work within the CTM Working Groups.

The provider will work with secondary care providers to identify conditions and agreed pathways and thresholds that are appropriate for direct primary care to secondary care referral; via the hub (eg hip and knee referrals with a defined Oxford or New Zealand measurement score), working up proposals for minor surgical intervention, secondary care opinion to support self-care or establishing protocols for group based treatment approaches and agreeing the mobilisation of Shared Decision Making tools, such as MAGIC.