1. HILLINGDON 2008-9 MUSCULOSKELETAL CLINICS Hillingdon Masterclass

2. MSKClinics • General Saturday Sean Hughes • General Tuesday Rafique Khan • Upper Limb Saturday Srinath Kamineni • Lower Limb Tuesday Ian McDermott Hillingdon Masterclass

3. AIMS • To improve the patient’s care • To give a consultant opinion early on • If possible to plan patient’s management within the community Hillingdon Masterclass

4. Triage of Patients • Since April 2008 • Approximately 30 patients per day • Over 7,500 referrals • Refer to secondary provider • Refer to MSK clinics • Occasionally advice to GP or redirection Hillingdon Masterclass

5. TRIAGEEARLY RESULTS • Month 25th March – 24th April 2009 • 595 patients triaged • 141 to MSK clinic • 60 to Mr Kamineni • 59 Mr McDermott • i.e. 44% of patients sent to clinics Hillingdon Masterclass

6. EARLY RESULTSMSK Clinics • 4 clinics March – April 2009 (S. Hughes) • 78 patients given appointment in clinics • 38 referred to secondary provider • 12 DNA • 2 patients changed appointment • 24 discharged with or without physiotherapy Hillingdon Masterclass

7. EARLY RESULTSMSK CLINICS • 4 clinics March- April 2009 • 64 patients seen • 24 discharged • 38% patients discharged back to GP Hillingdon Masterclass

8. GP ReferralForm • Dependent on the information GP’s provide • Especially Clinical Assessment • Any relevant Investigations need to be enclosed • Any treatment already provided Hillingdon Masterclass

9. TRIAGEComments • Rarely priority needs to be changed to urgent • Redirect to Dermatology; Gynaecology • Outstanding letters • Patient’s Choice - elect not to attend MSK clinic • Specific referral by GP to named consultant Hillingdon Masterclass

10. MSK clinicsComments • Saturday clinics popular • Consultant opinion early on is useful • Expansion to appropriate investigations i.e. MRI • Simple treatment in sterile environment i.e. injections • Use of Specialist Therapists i.e. back therapists • Respond online to the GP Hillingdon Masterclass