Next Steps The Future State

Ongoing Work Datasets and outcomes IT – SCI referrals to physio, pathway stages monitoring Ongoing measure of impact Spinal Pathway completion in light of the Spinal Services Review Group report Link with dimensions of Quality Strategy Collaboration with National MSK Pathways Project

NHS SCOTLAND MSK ADVICE AND TRIAGE SERVICE Non- Emergency self referrers GP directed directed from other sources Protocol Driven TRIAGE TOOL Ability to identify: non-emergency (non 999, A&E) callers with sprains, strains and pains of joints and muscles MEDIUM / HIGH RISK Referred to local MSK hub for access into local services, plus Ability to redirect to medical services, if safety issues WHS REFERRAL for those in paid employment & absent from work for over 4 weeks (Small-medium org) WHS REFERRAL for those in paid employment & absent from work for over 4 weeks (Small-medium org) Triage Tool Developed by expert panel Safe: identifies red flags Employment: identifies WHS Includes STaRT MSK tool: stratifies into low, medium and high risk Hill et al 29/09/11www.thelancet.com Triage Tool Developed by expert panel Safe: identifies red flags Employment: identifies WHS Includes STaRT MSK tool: stratifies into low, medium and high risk Hill et al 29/09/11www.thelancet.com LOW RISK Enhanced self management resources, web, digital TV & APP LOW RISK Enhanced self management resources, web, digital TV & APP

The E Clinic – future state

Leadership / Mothership

Orthopaedics – The E Clinic Electronic vetting by consultant and ESPs Streamline the vetting process – right person first time Managing urgent and named referrals Anticipated benefits – reduction in internal referrals (consultant – consultant + consultant to AHP) Pilot of 10 /20/30 min slots – clinic profiles Future – electronic booking from E clinic

G.P. e-clinic ShoulderKneeHipBack Golden Jubilee Urgents General Foot & Ankle See & Treat Appliance/Orthotist Physio Back to GP Return Clinic # Clinic Podiatry: ESP Biomechanical Nail Surgery Chiropody ESP: General Knee Shoulder Carpal Tunnel +/- Diagnostic

Teething Issues

Timing – large number of referrals pan Lanarkshire Time – checking carestream etc Difficulties of managing allocation to surgeons (specialism) Communication It’s a learning curve !!

18 weeks RTT Workbench Orthopaedic pathways built on trakcare Each stage of patients journey identified and times applied Plan in place to role out access across NHSL Prospective monitoring at a patient level !

To boldly go………..