Information for GPs & AHPs
Healthshare Hull is your MSK Single Point of Access (SPA) service for Hull GP registered patients with muscle and joint pain. Integrated with a Level 2 Advanced MSK Physiotherapist service including efficient one stop shop model working with diagnostic pathways, point of care MSK sonography, landmark and image guided cortisone injections, a digital platform supporting self-care with ability to flex to F2F appointments and exercise interventions in supervised 1-1, group and digital formats.
Established over nine years is our Orthopaedic, Neurosurgical and Rheumatology (medically well managed with clear MSK component) SPA service providing expert Secondary care triage and pathwaying driving down wait times with consistently high surgical conversion rates getting patients to the right place at the right time the first time.
All Orthopaedic referrals (red flags excluded) should be directed through Healthshare Hull to ensure all locally agreed surgical thresholds are fulfilled and conservative care has been exhausted. Can we de-escalate the case and manage conservatively avoiding inherent surgical risks? Does your patient really need surgery? Are they aware of all of their options and the risk/reward profile of each as part of a shared decision plan? Refer via ERS for a rapid opinion ticking the Orthopaedic option.
Inclusion Criteria MSK Service
Patients aged over 18 for telephone and digital self-referrals and over 13 for GP referrals.
All musculoskeletal conditions.
Available investigation does not clearly indicate surgery but advice needed on management.
Orthopaedic referrals for scrutiny of all common Orthopaedic surgeries for surgical de/escalation ensuring patients meet surgical thresholds and have care truly personalised (Healthshare are the ICB commissioned Orthopaedic triage service).
Rheumatology referrals with a clear MSK component with medically well managed Rheumatological pathology. Ambiguous cases where it is unclear if the case has an MSK component. For management of clear Rheumatology cases please refer direct to Rheumatology and not via the MSK service.
Neurosurgery cases where conservative management has not been exhausted eg sciatica, femoralgia, brachialgia, complex spinal.
Patients who require conservative management to reduce the need for Orthopaedic surgery.
Exclusion Criteria MSK Service
Red flag symptoms e.g. suspected cancer, cauda equina, fracture, infection (consider local ED).
Acute traumas (consider MIU/UTC or virtual fracture clinic).
Widespread neurology with or without upper motor neurone signs and those requiring neurological Physiotherapy.
Service users with post-operative or post-traumatic complications (Consider direct referral to Orthopaedics).
Post Orthopaedic/Neurosurgical surgical rehabilitation (consider referral to HUTHT NHS Trust Orthopaedic/Neurosurgical Physiotherapy).
Lumps and bumps without previous investigations (consider imaging via HUTHT radiology).
Injection only patients (consider referral to the GP led injection service).
Housebound patients or domiciliary visits (consider CHCP Community Rehabilitation Service).
Chronic pain management (Consider CHCP Community Pain Service).
Under 13 (Consider HUTHT NHS Trust Paediatric Physiotherapy Team).
Orthopaedic conditions pathwayed on or managed conservatively under the HealthshareHull single point of access service:
Arthroscopy +/- procedure
Bone saving procedures for osteoarthritis/High tibial osteotomy
Medial Unicompartmental Arthroplasty
Patella lateral release
Patella resurfacing
Patellofemoral ligament reconstruction
Total Knee Replacement