August - 2016

Tower Hamlets

MSK Physio and

MCAS

GP Newsletter

Introduction

Dear GPs

In addition to our normal topics, this quarter’s newsletter focuses on

changes to the service that are fast approaching. We also aim to update

you on these changes in person in upcoming GP locality meetings:

• MCAS service move to EMIS (went live 8th Aug)

• MSK Physio move to EMIS (3rd Oct)

• New Single Point Of Access (SPA) e-referral form

Regular items included: • How to contact us – including GP ‘hotline’ e-mail address for urgent queries • Waiting list updates

• Web site info

Single Point of Access Form (SPA)

SPA MUSCULOSKELETAL THERAPIES REFERRAL FORM

Before referring please consider which service may be effective and if the patient would respond to self-

management. Leaflets and information on our service portfolio are available here

If you wish to discuss the appropriateness of a patient’s referral or for require further guidance for clinical

diagnosis please email us. (We aim to respond within 24hrs)

Patient NHS NO Pull through Referring GP Pull through

Patient DOB Pull through Age Pull through

Patient Title Pull through GP Address Pull through

Patient Surname Pull through

Patient Forename Pull through GP Post code Pull through

Patient Address Pull through Practice Tel. Number Pull through

Postcode Pull through Practice email address Pull through

Preferred Telephone No Click here to enter text. Does the patient require an Interpreter?

YES ☐ NO ☐

Specify Language:

Patient consent to receive telephone/text messages

YES ☐ NO ☐ Does the patient require transport?

YES ☐ NO ☐

Have alarm features (such as those suggesting fracture, cancer, inflammatory arthritis) been excluded? If no, please re-assess and consider referring the patient to the relevant acute service as such cases should not be referred to IMAPs.

YES ☐ NO ☐

Main reason for referral (please tick one).

Expert MSK advice ☐ Physiotherapy ☐ Health training and education classes ☐ Persistent Pain Service ☐

Women’s` health physiotherapy ☐ Other (please specify): ☐

If this is a referral for women`s health physiotherapy: Gestation and Expected due date: Click here to enter text.

Any previous pregnancies: YES ☐ NO ☐

Suspected diagnosis, presenting symptoms and examination findings (please cover all three to assist with triage): Click here to enter text.

For how long has the patient had their symptoms? WKS MONTHS YEARS

Is the patient currently off work or on amended duties because of this condition?

YES ☐ NO ☐

If YES please state time period: Click here to enter text.

Is the patient a carer? YES ☐ NO ☐

If YES please state for whom: Click here to enter text.

Management so far

Patient information leaflet given YES ☐ NO ☐ Exercise leaflet given YES ☐ NO ☐

Investigations Requested: N/A

☐

X Ray ☐ MRI ☐ Bloods ☐ US ☐

Please attach relevant report if investigations were not undertaken at Barts Health

Has the patient had physiotherapy for this condition?

YES ☐ IF YES:

NO ☐

DATE OF THERAPY: Click here to enter text.

TYPE OF THERAPY: Click here to enter text.

Has the patient had surgery before for the same condition?

YES IF YES:

NO

DATE OF OPERATION: Click here to enter text.

TYPE OF OPERATION: Click here to enter text.

Please state any other management so far not covered above (e.g. steroid injections, other hospital treatments etc.):

Relevant Past Medical History: (Please attach Medical Hx to e-referral if appropriate) Click here to enter text.

Drug History (in particular analgesics): (Please attach medication Hx to e-referral if appropriate) Click here to enter text.

Please state any reasons why this patient may present a risk to clinical staff: N/A ☐

• Easy to complete with pull

through auto fills

• Access to SPA via EMIS Live

from July 1st

• No more Choose and Book

referrals from July 1st

• No more fax referrals from the

1st July

• Will not be accepted unless fully

completed to allow effective

triage

• E-mail referral to:

BHNT.BartsHealthTherapies@nhs.

net

IMAPS Update • Contract went live on the 1st of July 2016

• EMIS was launched on Monday 8th of August for IMAPS and Persistent Pain

Service (PPS).

• IMAPS and PPS diaries are all now on EMIS and we are paper light

• All triage by Band 8 ESP’s (CAS Clinicians)

• All services are now using partial booking for routine patients only i.e. patients are sent a letter asking them to contact the department within 28 days to book their first appointment.

• The service will provide: • All MSK and Persistent Pain expert triage

• Comprehensive and holistic assessment and investigation of complex MSK and Persistent Pain patients

• Urgent patients are seen within 2 weeks and non-urgent within 6 weeks

• Referral into the patient’s definitive treatment

• GP Education Programme

IMAPs MSK Patient Pathway :

Single Point Access

(SPA)

IMAPS MSK

Secondary Care Referral

e.g. Orthopaedics / Rheumatology

Persistent Pain Service. MDT triage to 1:1 or

psycho-educational

classes

Discharge

Outpatient Physio / Hand

Therapy

MCAS Face to Face

Appointment, Diagnostics &

follow up appointments

Fit for Life Class, OA Hip

and Knee Class and LBP Class

• The MSK Physiotherapy contract goes live on Monday 3rd October.

• All GP referrals are to be seen at MEH on EMIS.

• All secondary care referrals (eg Orthopeadics, Rheumatology) are to be seen at the RLH on CRS (Cerner Millennium).

• We are working on clinical templates which will be used on EMIS when we go paper light.

THIPPS Update

Our Physiotherapy Diary Structures will not change, bar the

removal of 20 minute triage clinic slots. Patients will instead get a

more comprehensive 40 minute initial assessment.

In addition to the above appointment types on offer, we have

developed new classes which will in part be run at various locations

in the community to take care around the borough. These are:

• Fit For Life

• OA Hip and Knee

• LBP Classes

Fit for Life Class The aim of this class is to educate patients on healthy living including pain education, pacing, mindfulness, exercise and healthy eating.

This will be run by the new Band 4 and 3.

The initial session will be 2 hours with an hour long lecture followed by a goal setting session and completing outcome measures

Following this, there will be a maximum of 4 telephone FU appointments over whatever period of time is necessary for the patient to succeed their goals and functional potential.

These will be run at MEH and the Barkantine centre

Both Bengali and English speaking

Lower Back Control and Flexibility

Class

Run by a Band 5 and

Band 3

At MEH (mixed) and

at the Hayaa Gym

(Women Only) which is

part of the East London

Mosque (ELM).

Bengali and English

Speaking classes.

This will be a 12 week

programme of education

and progressive

exercise with promotion

of self-management.

Capacity = 10 patients

per class

OA Hip and Knee Class

Run by a Band 5

and Band 3 at MEH

and at the Hayaa

Gym (Women Only).

It again will be a 12

week rolling

programme including

education, and

progressive exercise

with promotion of

self-management.

Capacity = 10 pts

per class

New Classes Name Duration Aim Location Time & Day

Rehabilitation 60 Individual

exercise

program.

MEH and RLH Various throughout clinicians diaries

Back Control Class 60 LBP Class

focusing on

improving core

strength.

MEH

MEH

ELM

14:15-15:15 Wednesday Men & Women

15:00-16:00 Thursday Men & Women

09:00-10:00 Tuesday WO English &

Bengali speaking

Back Flexibility Class 60 LBP Class

focusing on

improving

movement and

flexibility

MEH

MEH

ELM

15:30-16:30 Wednesday Men & Women

13:45-14:45 Thursday Men & Women

14:00-15:00 Tuesday WO

English & Bengali speaking

Hydrotherapy 30 LBP, Knee and

General

exercise classes

MEH Tuesdays in B6 Diary

OA Hip & Knee 60 Exercise class

focusing on

improving

strength, ROM

& function for

OA hip & knee

ELM

ELM

MEH

MEH

10:30-11:30 Tuesday WO

15:30-16:30 Tuesday WO

English & Bengali speaking

9:15-10:15 Tuesday Men & Women

14:15-15:15 Thursday Men & Women

English & Bengali speaking

All class based options within physiotherapy:

Name Duration Aim Locatio

n

Time & Day

Fit For Life 60 min lecture

60 min goal setting

15 min f/ups

Education on

healthy living.

MEH

MEH

Barkantine

MEH

MEH

MEH

13:30-15:30 Tues English speaking

Long week

13:30-15:30 Fri Bengali speaking

Long week

9:00-11:00 Thursday Bengali

speaking Long week

8:30-9:30 Wednesday Bengali

speaking

Flexi week

10:15-12:15 Monday Bengali

speaking

Flexi week

10:15-12:15 Friday English speaking

Flexi week

Continued…

Future Service Developments

1. Shockwave clinic

2. Private MSK Physio

3. Secondary care referral funding

4. Additional Band 7 at year 2 of IMAPS contract

5. Podiatry Pathway

Ways we are improving GP

Communication

• GP Newsletter

• GP MSK Masterclass

• Locality meetings

• Local GP MSK Teaching

• GP e-mail hotline

• GP waiting area presentation

• PILS

• The above e-mail address is hyperlinked on the SPA

• You can e-mail an ESP (clinical specialist) Physiotherapist with any

questions regarding a referral e.g. appropriate service to refer into,

immediate advice or treatment, appropriate investigations prior to

referral

• You will have a response within 6 hours

GP Hotline BHNT.BartsHealthTherapies@nhs.net

PIL’s are useful in providing patients

immediate advice, education and a

generic home exercise programme.

Can be located at:

1.The hyperlink on the SPA Referral form

Patient Information Leaflets

2. http://bartshealth.nhs.uk/our-

services/patient-information-leaflets-a-z

3.http://www.towerhamletsccg.nhs.uk/gp/int

egrated-msk-and-pain-service.htm

4. patient.co.uk

Contact us For all general, non-urgent enquiries:

• Royal London Therapies:

Tel: 020 7377 7872

Fax: 020 8223 8808

Email: TherapiesRLH@bartshealth.nhs.uk – Please do not send patient idenitifable data to this

address

• Mile End Therapies:

Tel: 020 8223 8274

Fax: 020 3465 6432

Email: TherapiesMEH@bartshealth.nhs.uk – Please do not send patient idenitifable data to this

address

• Docklands Medical Centre:

Tel: 020 3222 4028

Email: TherapiesRLH@bartshealth.nhs.uk – Please do not send patient idenitifable data to this

address

Waiting list updates

• Below is the cross site MSK waiting list for Barts Health as of the end of October

(calculated in-house and subject to weekly changes). We endeavor to reduce this wait

with our forthcoming service developments.

Site/Service Urgent wait in weeks Routine wait in weeks

Mile End Physio 2 9

Royal London Physio 2 7

Persistent Pain service 2

Hand Therapy 4

Womens Health Physio 4

Musculoskeletal CAS 2

Web site additions

• As a reminder our therapies department website can be found here: www.bartshealth.nhs.uk/physiotherapy • Also our patient information leaflets can be found here: http://www.bartshealth.nhs.uk/our-services/patient-information-leaflets-a-z//?letter=P

•In the next coming months we will be adding a FAQ’s and referral guidance section •We also have our first video on understanding pain on the web site, in the patient information section. Please scroll to the bottom of the patient information page to view. See here:

http://www.bartshealth.nhs.uk/our-services/services-a-z/p/physiotherapy/for-patients/