Musculoskeletal Disorders

Musculoskeletal (MHS) disorders result in major morbidity in Orkney as in Scotland. Rapid access to AHP MSK services has been a stated priority in 2020 Local delivery plans. Allied Health Professional (AHP) MSK pathway minimum standards (2015) include:

• Agreed standardised musculoskeletal pathways in situ with audit evidence of implementation.
• The primary care improvement plan, with the introduction of physiotherapists in the model and ensuring patients have direct access to MSK First Contact Practitioners will be important.
• Expanding access to support such as the online version of ESCAPE-pain (Enabling Self-management and Coping with Arthritic Pain through Exercise) and utilisation of the NHS Inform MSK advice and triage service when expanded should support appropriate referrals.

The organisation Versus Arthritis has designed a commissioning model for physical activity provision:

• Tier 1: self directed: accessible community facilities
• Tier 2: trained peers and fitness professionals – supervised physical activity e.g., dance clubs, Tai Chi, walking clubs
• Tier 3: structured community rehabilitation programmes- fitness professional, physiotherapist e.g., escape-pain
• Tier 4: individualised support – physiotherapist, sports and exercise medicine.

This model uses physical activity interventions alongside appropriate medical interventions, including medication and surgery where indicated.

The use of MSK-HQ developed by Versus Arthritis – to report symptoms and quality of life would support better tracking of patient improvement.

Overall we need to reduce inequalities and improve outcomes for patients with musculoskeletal conditions. Falls and bone health are related areas of concern - to learn more click here.

Ensuring assessments are carried out as per the Prevention and Management of Falls community framework. 

Innovative ways of working that focus on wider clinical benefit rather than the traditional job roles and historical ways of working. One example of this would be the direct access which has recently been carried out.